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Sex and STIs: Chlamydia can lead to infertility

Gudrun Heise
December 21, 2022

Chlamydia? An STI? Me? No, that's impossible! But, according to official estimates, 250,000 to 300,000 people per year are infected with this disease in Germany alone.

Chlamydia bacteria
Chlamydiae are bacteria. They reproduce in a host cell.Image: Imago/Science Photo Library

Do we know our bodies as well as we think we do? When it comes to STIs — also known as sexually transmitted infections — maybe not. 

Chlamydia is no exception — it is the most common sexually transmitted disease in the world, caused by bacteria that primarily attack the mucous membranes of the sexual organs: the vagina, penis, anus and urethra.

Chlamydia may be an uncomfortable topic to discuss on a romantic evening, but it is important to use good protection to safeguard yourself and others.

The best method of prevention is using condoms. If you have sexual contact with someone infected with chlamydia and don't use protection, you may be at risk of infection. An infection can develop within one to three weeks.

If chlamydia is treated in time, you can prevent adverse health effects. But it is not very easy to recognize a chlamydia infection.

Here are the most important symptoms: discharge from the penis, vagina or anus, a burning or pain when you urinate, or pain during vaginal or anal sex. In women, intermittent bleeding can also be a sign of infection.

Chlamydia can lead to infertility

Spotting the disease is the hardest part.

"Eighty percent of women have no symptoms," explains Norbert Brockmeyer of the Center for Sexual Medicine and Health in Bochum, Germany.

Often, doctors diagnose a chlamydia infection by chance, during a fertility test. In the worst case, the infection has spread unnoticed, leading to infertility for both partners.

"Fifty to 60% of all couples who go to clinics [because they're finding it difficult getting pregnant] once had chlamydia. The disease is likely a significant cause of infertility," Brockmeyer said.

In Germany, it is estimated that there are currently 100,000 women for whom chlamydia is the reason they cannot conceive.

In women, chlamydia is localized in the vaginal area. From there, the bacteria can spread to the abdomen.

"In the vagina or cervix, the bacteria are no longer detectable, but the fallopian tubes can become clogged, and the ovaries become inflamed. An infection can even lead to tumors," Brockmeyer said.

Prostate graphic showing testicle, epididymis, urinary bladder and other anatomical parts
Chlamydia can enter the body through the urethra

In men, chlamydia can enter the scrotum via the urethra and infect the testes. The sperm duct can also become obstructed and a serious inflammation can lead to infertility.

"There is even evidence that the chlamydial pathogens can accelerate the progression of prostate cancer," Brockmeyer said. However, he added that there is still very much in this area that has not been fully researched.

An untreated chlamydia infection also increases the risk of contracting HIV because the mucous membranes are more sensitive and permeable because of the inflammation.

All sexual partners should be tested

If there are symptoms that point to a chlamydia infection, it is important to talk to a doctor and to sexual partners. Women should contact their gynecologist while men should see a urologist or dermatologist.

"The partner should always be involved in treatment; otherwise, there can always be a recurrence of infection," Brockmeyer said. 

Graphic of female anatomy showing the cervix, fallopian tubes, hands and other parts
A smear test of the cervix shows whether an infection is presentImage: Colourbox

Treatment involves seven consecutive days of antibiotics. In the vast majority of cases, this is successful. After that, there is no longer any risk of infection.

the patient should consult a doctor again after four to six weeks to ensure that the infection has cleared up, or find out whether additional treatment is necessary.

"Such an examination is quite important for a full recovery," Brockmeyer said. "Unfortunately, this is still carried out far too rarely in Germany. In England, it's different. There, doctors perform a so-called 'test of cure' on about 90 percent of their patients and achieve a high cure rate."

This is not embarrassing at all!

The number of unreported cases for many STIs — including chlamydia — is very high. Many people are reluctant to go to the doctor. After all, they have answer personal questions about their sexual activity.

"You can get an infection in the mouth, in the throat. You can get infected genitally, you can get infected anally. You can also infect yourself from genital to anal, from anal to mouth or vice versa," Brockmeyer says.

Love scene in art shows two people nude and embracing in black and white
Chlamydia is primarily transmitted during sex and can also infect the respiratory tract and even the eyesImage: picture-alliance/akg-images

Chlamydia can become chronic. "It smolders like a fire in the underbrush, and at some point it can develop into a big fire," Brockmeyer said.

This article was translated from German.

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