[Question #3467] Chlamydia
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89 months ago
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I've been to the same OBGYN since 2015, and was recently diagnosed with Chlamydia. My Dr.'s office claims that they've never tested me for it before, since I didn't specifically ask for an extra culture to do so. This has been very stressful, since I'm in a committed relationship. My boyfriend also tested positive for Chlamydia after we had sex unprotected for the first time last month, but he has been tested in previous years that we've been together (a condom broke once, and he's performed oral sex on me many times) and tested negative for Chlamydia in the past. My question i...is it possible for Chlamydia to lay dormant in a woman for 2 1/2 years? and is it typical that an OBGYN would not automatically test for STD's with the culture swab? and why would we receive different medications with different follow up windows (I was told to come back in three weeks. He was told to come back in three months). Thank you.
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H. Hunter Handsfield, MD
89 months ago
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Welcome fo the forum. Thanks for your confidence in our services. Your questions cover a wide range of policies and routine practices regarding chlamydia diagnosis and treatment.
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Most public health agencies (e.g CDC, local and state health departments) and professional societies (like ACOG, the American College of Obstetricians and Gynecologists), recommend routine chlamydia testing of sexually acive women. However, there are limitations, related to age and other factors. You might discuss your doctor's routine testing practices with the doctor or his staff. I agree with the implication of your question: sexually active women should not have to remind their doctors of the recommendations. At the same time, if women assume they are tested routinely, it still is wise to ask about it.
For an often chronic, low grade infection like chlamydia, it often is difficult or impossible to know when or from whom any particular infection was acquired. However, chlamydia is not frequently transmitted by oral sex, and I would assume that your boyfriend's infection probably wasn't from an oral sex exposure. It is more likely he had vaginal or anal sex with an infected person.
The maximum duration of chlamydia isn't really known. The longest documented carriage in a woman is 4 years. However, most infections are cleared by the immune system within a few weeks or months.
Two treatment regimens are recommended routinely for chlamydia: azithromycin in a single dose of 1 gram; and 7 days of doxycycine. You can't fault any physician for preferring either one.
Repeat testing after treatment is controversial. in general, testing is recommended for everyone after 3-6 months. The purpose is to detect both reinfection and the rare occurrence of treamtment failure. Three week testing is mostly to detect treatment failure; longer intervals emphasize reinfection. Neither is always right or always wrong. But the usual recommended practice is retesting at 3-6 months.
At this point, I really wouldn't worry much about the origin of your shared infection. The imporant thing is that you both have been treated. Follow your doctors' advice about follow-up testing.
I hope this information is helpful. Let me know if anything isn't clear.
HHH, MD