[Question #5776] Chlamydia

19 months ago
  I was recently did an at home test for STDs and  I was positive for Chlamydia. My doctor called in a prescription for azithromycin the same day and I took the antibiotic. I am concerned because I have read about Chlamydia and pelvic inflammatory disease. I didn't experience any symptoms, which I've read is common, so I'm not sure how long I've had Chlamydia. If there were symptoms they must have been very mild. Do I need to worry about PID now that I have been treated? Can a doctor tell me if I had/have PID after taking an antibiotic?  When I read about PID, the articles make it sound like you can have it for a long time and not know or have symptoms. I know this service is not a replacement for seeing a doctor so I do plan to follow up with one. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
Welcome to the forum. Thanks for your question.

Congratulations for seeking testing. Too many people at risk, especially young women, don't take advantage of opportunities to pick up STDs like chlamydia. 

Although fallopian tube inflammation -- salpingitis, the hallmark of PID -- can occur in women with chlanydia without symptoms, most PID is obvious because of low abdominal pain, sometimes severe enough to be quite alarming. The risk of PID probably rises with duration of infection, but still the chance is low you have had any important tubal damage in absence of pain or other symptoms like vaginal discharge.

It's a good idea to see a doctor to check for other STDs, like gonorrhea; and anyone with any newly diagnosed STD should be tested for syphils and HIV. A physician's advice often is wise to guide such testing. In addition, an in-person visit will check for vaginal infections like bacterial vaginosis, trichomonas, and yeast. And as you suggest, However, it probably won't help much in determiining whether you have had PID despite absence of pelvic symptoms. It could give a clue, for example if you have unepxected tenderness internally during the exam. But with or without professional exam, you needn't be serious worried. The large majority of asymptomatic chlamydial infections in women leave no discernible damage (e.g no effect on fertility).

Don't forget to inform your sex partner(s) -- any within the past 2 months, or even more distant past partners if he or they are likley sources. Also, you should know that recent research indicates that azithromycin fails to cure up to 5% of chlamydial infections in women, so you should be retested after treatment. Retesting usually is recommended about 3 months after treatment, to detect both azithromycin failure and new infections in women who have resumed sexual activity. If that's not likely, a test of cure can be done 3-4 weeks after treatment.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
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18 months ago
One more question. How long does it take for the antibiotic to have full effect? or how long until the infection is gone? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
18 months ago
Chlamydia is eradicated within 7 days of starting tretment. Sometimes sooner, but 7 days is always safe for resuming sex.---