[Question #7074] Chlamydia long term damage

61 months ago

I recently tested positive to chlamydia, in my regular monthly check-up. I advised my regular partner immediately, and we both sort treatment straight away. I estimate that at most, she would have had the infection for 2 weeks (16 days), given our sexual history testing and partners. My partner was experiencing unusual discharge after her period (which she had put down to her period, until I informed her), and bleeding in between period, for the first time (the same day we saw the doctor and obtained the antibiotic). She has a family history of ovarian cancer, and difficulty in getting pregnant.

My question is, does it seem likely that the chlamydia infection has progressed to PID in this 2 week time period? And is there a way for her to assess any damage caused?

H. Hunter Handsfield, MD

61 months ago

Welcome and thanks for your question. I happened to log on soon after you posted it: most users shouldn't expect nearly real-time replies!

Your concern for your partner's health is commendable. Happily, you have little to worry about. Little or no serious reproductive tract damage is likely within 2 weeks. That your partner has not had symptoms to suggest PID (like pelvic pain or fever) also is good evidence against PID. "Silent" PID certainly can occur, but would not cause fallopian tube damage or other serious consequences this soon. There is no easy way to assess such damage except laparoscopy, i.e. a surgical procedure to examin the fallopian tubes. But there is truly no need. (And you probably couldn't find a physician willing to do it in this situation. Nobody ever laparasopes women after a single episode of chlamydia without overt evicence of PID.)

The only slight concern might arise if your partner has had chlamydia previously. Second episodes progress to PID more frequently and perhaps more rapidly than first infections. However, even in this situation, the risk after only two weeks, and with no symptoms of PID, is very low.

The important thing here is that you both be treated with doxycycline or azithromycin. (Doxy is preferable, especially in women.) And of course your previous partner(s) in the past couple of months also need to be informed and treated. Once these have been accomplished, the episode is done and you (and your partner) need not worry about long term consequences. There won't be any.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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