Chlamydia
Chlamydia is a bacterial STI that can infect the urethra, cervix, anus, throat or eyes. Most people don’t experience symptoms and don’t know they have it until they get tested. This is why regular testing is important.
Chlamydia is easily treated with antibiotics, and will not go away unless you treat it. If left untreated, chlamydia can cause pelvic inflammatory disease (PID), leading to chronic pain and infertility. Untreated chlamydia can also cause pain and swelling in one or both testicles. Chlamydia is also known to cause other complications such as arthritis.
Understanding chlamydia
Chlamydia is a nationally notifiable infection, meaning that all cases are reported anonymously to state or territory health departments. This is primarily to identify outbreaks and improve healthcare responses.
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Chlamydia is caused by bacteria and can be transmitted during unprotected vaginal, anal or oral sex. It settles wherever it enters the body, so depending on the sex you’re having, that might be the urethra, cervix, anus, throat or, less commonly, the eyes.
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Many people have chlamydia without getting symptoms. Regular STI testing is the best way to detect infections that don’t show symptoms.
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Chlamydia is the most commonly reported bacterial STI in Australia, and serious health complications can emerge from it being unnoticed for a long time – another reason why regular testing is important.
Signs and symptoms
Chlamydia is usually asymptomatic. When symptoms do appear, it’s typically within 1 to 3 weeks of exposure, and what you notice depends on where the infection is.
Vagina/vulva
Chlamydia can present no symptoms at all. If signs or symptoms are present, there may be:
- yellowish-white or increased vaginal discharge,
- pain or a burning feeling when you pee,
- pelvic pain, especially during sex,
- irregular bleeding, particularly between periods or after sex; and
- an unusual vaginal odour.
Penis
Chlamydia can present no symptoms at all. If signs or symptoms are present, there may be:
- watery, sticky or milky discharge,
- redness at the opening of the urethra,
- stinging or burning when passing urine; and
- pain and swelling in one or both testicles.
Anus/Rectum
Chlamydia can present no symptoms at all. If signs or symptoms are present, there may be:
- anal itching,
- a feeling of needing to poo, even when your bowels are empty,
- anal discharge or bleeding; and
- pain when passing a bowel motion.
Throat
Chlamydia can present no symptoms at all. If signs or symptoms are present, there may be:
- a sore throat that doesn’t go away,
- fever,
- swollen lymph nodes; and
- ulcers or white spots at the back of the throat.
Eyes
Chlamydia can present no symptoms at all. If signs or symptoms are present, there may be:
- redness and irritation,
- swollen eyelids,
- mucous discharge or watering,
- sensitivity to light; and
- swollen lymph nodes around the eyes.
What does chlamydia look like?
How is chlamydia transmitted?
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Chlamydia is mainly passed on through unprotected vaginal, anal or oral sex, as well as sharing sex toys without condoms. It can also be transmitted by infected fluid entering the eye.
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Swapping fluids during mutual masturbation, docking or ‘nudging’ genitals without a condom, and fingering or fisting without gloves or another barrier can also transmit chlamydia.
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Chlamydia can also be passed from parent to baby during birth.
Getting tested for chlamydia
Chlamydia often does not cause any symptoms, so regular sexual health testing is an important part of looking after your sexual health. You do not need to have symptoms to get tested. Your doctor or sexual health nurse can help you work out which tests you need based on the types of sex you have and where you may have been exposed. You can view a list of sex worker-friendly sexual health clinics on our Where to Test resource.
What happens during the test?
Testing usually involves a urine sample or a swab from the parts of your body where you have had sexual contact, such as the cervix, urethra, anus or throat. The tests you need will depend on the types of sex you have and where you may have been exposed.
If you have a vagina and do not have symptoms, you can ask to self-collect a vaginal swab rather than having a doctor or nurse collect it during an examination. If you have symptoms such as pain, discharge or abnormal bleeding, or are having a cervical screening test at the same time, your doctor or nurse may collect the swab for you.
For information about online sexual health testing, see our Online Sexual Health Testing resource.
When should I get tested for chlamydia?
Chlamydia can be detected around 1 to 2 weeks after exposure. Regular testing is recommended even if you feel well, as chlamydia often does not cause symptoms.
- Talk to your doctor or sexual health nurse to determine how often to test based on the services you offer at work, and your personal sexual activity.
- Testing for chlamydia should form part of your regular sexual health testing.
- Get tested if you develop symptoms such as unusual discharge, pain or abnormal bleeding.
- If a client or partner lets you know they have tested positive for chlamydia, you should get tested yourself. However, if you have been exposed to chlamydia, keep in mind that testing too soon after exposure may not detect an infection.
What happens if I test positive for chlamydia?
Chlamydia won’t clear up on its own and can lead to complications if it’s left untreated. However, chlamydia is one of the most straightforward STIs to treat.
What treatment options are available for chlamydia?
If it’s caught early, chlamydia is treated with a single dose or short course of antibiotics. Take the full course as prescribed, even if you feel fine, and be aware it may cause side effects. If complications have developed, you might need a longer course of antibiotics. Be mindful that treatment cures the infection, but it doesn’t make you immune. This means it is possible to get chlamydia more than once.
How much does treatment cost?
- Government-funded sexual health clinics are usually 100% free and confidential for everyone, including tourists and international students, regardless of Medicare status.
- If you see a general practitioner (GP), you may pay a fee or be bulk billed.
- Medicare card holders can access some newer online testing services for free such as SISTR, Stigma Health, Clinic365 and STI Doctor.
- If you are not covered under Medicare, you can access online testing services for a fee, which could be useful if you live in a rural area.
Will testing positive for chlamydia impact my ability to work?<br />
If you test positive for chlamydia, it is recommended that you avoid sex until 7 days after starting treatment. If taking time off work or avoiding sex is not possible, using condoms can reduce the chance of passing chlamydia on, although they do not completely prevent transmission. You could also consider offering alternative services, using additional barriers such as gloves and dams, or doing phone or online work while you complete your treatment.
Other information
- Some antibiotics can affect how well some types of hormonal contraception work. Check with your doctor, nurse or pharmacist about whether you need to use a backup method while taking your antibiotics.
- If you are prone to getting thrush after taking antibiotics, speak to your doctor, nurse or pharmacist about ways to prevent or manage it. Probiotics may help some people, but the evidence is mixed.
- If you test positive for chlamydia, you might choose to disclose this to other sex workers you have recently done a booking with, or your regular doubles partner. This means they can get tested and treated if needed. Your local sex worker peer organisation can help you work out how to do this.
Legal considerations
Chlamydia is a nationally notifiable infection, which means confirmed cases are reported confidentially to state or territory health departments. This does not mean that your employer or clients will be notified. Some states and territories have laws relating to sex work and sexual contact while you have an STI or blood-borne virus (BBV). These laws vary between jurisdictions and can change, so check our BBV, STI and the Law resource or speak with your local sex worker peer organisation for advice about your situation.
If contact tracing (also called partner notification) comes up, your local sex worker peer organisation can help you work out a process that protects your privacy and takes into account the different types of sexual contact involved in sex work.
How can I prevent transmission?
Because chlamydia often has no symptoms, regular sexual health testing is one of the best ways to stay on top of your sexual health. Using barrier protection (like condoms, dams and gloves) during bookings can also reduce the chance of passing or acquiring chlamydia.
Safer sex strategies
Using protective barriers such as condoms, gloves and dams can reduce the risk of chlamydia transmission. Avoid touching your eyes or genitals if your hands have come into contact with semen or other body fluids, and wash your hands before touching them. Other safer sex strategies include:
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Change condoms when you change activities, body parts or partners. For example, use a fresh condom when switching between anal, vaginal or oral sex, and when moving from one body part to another, such as from the vagina to the mouth. Use condoms on shared sex toys and change the condom between partners or when using the toy on different body parts.
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Use enough lubricant. Lube reduces friction during sex, which can help prevent irritation and small tears in the skin or mucous membranes. This can be particularly important during longer bookings or activities involving a lot of friction. Water-based or silicone-based lubricants can be used with condoms, but oil-based lube degrades condoms made with latex, polyurethane/polyisoprene.
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Watch out for semen! During hand relief, point the penis away from your face and hold the base of the condom when withdrawing to help prevent semen from spilling onto your face or into your eyes.
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Check your client’s body for visible signs of STI before the service. One way to check if a client with a penis might have chlamydia is to gently squeeze or ‘milk’ the penis along the shaft before they shower or use the toilet. A thick or milky discharge can be a sign of infection.