[Question #7201] Chlamydia Transmission & Symptoms Timeline

8 months ago

Mid-Feb 2020: got tested for STIs, came back all negative 

Mid-March: started a consistent relationship with a guy; sex always was protected with a condom 

June 26: had protected sex for the last time with that guy

July 24: had sex with a new partner (male), this time unprotected

Had sex again with the new partner on Aug. 1 and Aug. 5. I started getting symptoms (bleeding in between periods, odd discharge, painful urinating) immediately during/after the Aug. 5 encounter and scheduled an appointment with my OBGYN.

Met with my doctor on Aug. 18 and tested positive for chlamydia. 

I had never had any sort of symptoms prior to the first week of August, and will reiterate that I got negative tests in the spring and my only other partner before my most recent partner used a condom. 
My most recent partner has the same story though: says he got tested in the spring, had protected sex with one other person shortly after getting his negative test results, then had sex with me. He says he has had no symptoms.

I am trying to find out who gave me Chlamydia so I can notify whoever necessary. Is it possible for it to be dormant for months (or even years) and THEN have very obvious symptoms after being dormant? Or is it more likely that I got infected and within 2-3 weeks started to have symptoms?

If so, is it possible in any way that it could’ve been transferred from one of our prior partners even though condoms were used?

I’ve read that symptoms are extremely rare. But I had very obvious symptoms, and it’s been unclear when those symptoms normally appear and if they can show up for the first time months or years after exposure with no symptoms.

My doctor was not very helpful in her response to this question so any guidance is greatly appreciated.
Edward W. Hook M.D.
Edward W. Hook M.D.
8 months ago

Welcome to the Forum and thanks for your confidence in our service.  I'll be glad to comment on what I feel are several questions.

Symptoms.  you are correct that chlamydial infections are most often asymptomatic for both men and women.  They do occasionally cause symptoms however.  When they do, the symptoms you describe, intermenstrual bleeding, spotting, vaginal discharge and discomfort on urination all may be caused by chlamydial infections.  They may also be due to other problems which often co-exist with chlamydial infection including other STIs such as trichomoniasis or disruptions in your normal vaginal bacteria of the sort that occur with bacterial vaginosis.  I would ask your doctor if you were checked for these problems just to be sure. 

Where did your infection come from.  From my reading of your timeline, the only partner with whom you've had unprotected sex is the new partner you were with on July 24, August 1 and August 5.  He may have had an infection that he was unaware of.  When your infection was transmitted is not clear.  Chlamydia is not always transmitted from person to person on the first exposure and when it is, symptoms may not occur immediately.  As I understand it, your prior partners used condoms.  Condoms are highly effective for prevention of chlamydial infection as long as they do not break (this occurs about 1% of the time condoms are used) and as long as they are worn throughout the entire sexual encounter.

I hope that these replies are helpful.  If anything is unclear, please don't hesitate to seek clarification with your up to two follow-ups.  EWH

8 months ago
Is it common for symptoms to appear about 2 weeks after potential exposure? Or, If hypothetically the condom broke with my previous partner back in March, would  it be possible for me to be infected but not have any symptoms appear until August? 
Edward W. Hook M.D.
Edward W. Hook M.D.
8 months ago
There are no good estimates of how long it takes for symptoms to occur following acquisition of infection.  Symptoms never start within a day or two of infection and, if symptoms are going to occur, they would most often do so within a few weeks of acquisition.  Beyond that, it’s hard to say although I would think that it would be most unusual for symptoms to take five months to appear. Sorry I cannot be more precise.EWH---