Dear Dr. G,

I know you usually answer questions for men.

However, I hope you can help resolve my sexual health issue related to a Sexually Transmitted Infection (STI) I contracted. Don’t get me wrong, I am not promiscuous, but I admit I had a previous sexual relationship that ended at least six months ago.

I have started a new relationship, and everything was fine until we began having sex. After we started having intercourse, my boyfriend began experiencing painful urination and continuous penile discharge.

We initially thought he might have contracted a UTI due to dehydration, but the symptoms persisted, and he went to the doctor. The doctor suspected chlamydia, and my boyfriend was tested for other STIs, including gonorrhoea and HIV. Thankfully, the other tests were normal.

My boyfriend was treated with antibiotics, and most of his symptoms resolved. He accused me of passing the infection to him and asked me to get tested. At first, I was furious because he suspected I was unfaithful.

As I am now getting tested, I started feeling guilty and doubting myself.

I want to ask Dr. G for clarification about STIs.

What exactly is chlamydia? Is it the same as gonorrhoea? Is it possible I was infected with chlamydia from my previous relationship and was completely unaware of the infection? What are the consequences of not getting treatment? As I get tested for STIs, I worry I might be a dormant carrier.

Regards,

Dormant Deborah

Chlamydia is a word derived from Greek, meaning “cloak”. As the name suggests, the infection often remains hidden. It is a sexually transmitted infection with an incubation period between exposure and the ability to infect others of two to six weeks.

Chlamydia is one of the most common STIs, affecting about 4.2% of women and 2.7% of men worldwide. The United States reported 1.4mil new cases in 2014, mostly among newly sexually active individuals aged 15 to 25. Globally, 61mil new cases of chlamydia are reported annually.

It is more common in women than men, as many women may harbour the infection without symptoms. Although most women are unaware of the infection, symptoms may include vaginal discharge and a burning sensation during urination. In severe cases, chlamydia may lead to pelvic inflammatory disease and future infertility.

Men are more likely to experience symptoms, including penile discharge, painful urination and testicular swelling. Men are more likely to seek treatment to eradicate the disease without dormant bacteria causing repeated transmissions. Similarly, gonorrhoea is another common STI transmitted with chlamydia.

Gonorrhoea is colloquially known as the clap and is caused by the bacteria Neisseria gonorrhoeae. The disease dates back to the Old Testament, and the term “gonorrhoea” was first coined by Greek physician Galen before 200CE, referring to it as “an unwanted discharge of semen”. Gonorrhoea affects about 0.8% of women and 0.6% of men.

An estimated 100mil new cases are reported yearly, mostly among newly sexually active young adults. Untreated gonorrhoea can spread to joints and heart valves, accounting for at least 700 related deaths annually.

Although some cases are asymptomatic, infected men often experience severe symptoms, including copious pus discharge from the penis and a burning sensation during urination. Women may also be asymptomatic with dormant infections in the genitalia. In severe cases, women can experience vaginal discharge, bleeding between periods and pelvic pain.

Sexually Transmitted Infections (STIs), also known as venereal diseases, spread through sexual contact, including vaginal intercourse, anal and oral sex. Common bacterial infections include gonorrhoea and chlamydia, and parasitic infections such as trichomoniasis. STIs do not always show symptoms, increasing the risk of transmission.

Fulminant symptoms may include vaginal or penile discharge, genital ulceration and pain during urination. Traditionally, gonorrhoea and chlamydia are diagnosed through gram staining, but modern PCR testing methods are increasingly common. Testing for screening and active infection is crucial to reduce the spread.

Individuals are often tested for other STIs, as co-infection with chlamydia, syphilis and HIV can be as high as 54%. Chlamydia and gonorrhoea can be prevented with abstinence, condom use and having sex with one uninfected partner.