I have a few follow up questions.

1) how common is bleeding between periods for chlamydia infections in women? Is this an advanced symptom?

2) I know they say wait 7 days from completion of treatment before engaging in sex.  However would you be noninfectious after 4 or 5 days?

3) Would testing two weeks from treatment to “test for cure” be too early?  I would like to avoid a false positive if at all possible.  

Thanks for your help!

1. Spotting between periods is a fairly common chlamydia symptom, but I am unaware of any details on the proportion of infected women who experience this. Probably a fairly small minority. More important, because there are several causes of bleeding between periods, chlamydia probably accounts for under one percent of such cases. And you said you have experienced this previously. I have no way of knowing whether you chlamydia was involved this time, but most likely it was not. So if spotting continues after treatment, it probably doesn't indicate treatment failure.

2. You're right to (apparently) believe 7 days is longer than necessary. It's common advice because human nature dictates that many people will probably resume sex sooner than advised; because symptoms take longer than infection itself to resolve, and it's a good idea to avoid sex when having discharge, pain, etc; and finally to provide greater opportunity to assure the infected person's partner(s) have been treated. But probably most people are non-communicable within 2-3 days of single dose treatment with azithromycin. It is very unlikely you would still be infectious after 4-5 days.

3. Generally it is recommended that test of cure not be done before 3 weeks.The reason is that the test may remain positive that long, even with cure -- the test detects chlamydial RNA, which can persist long after all organisms have died. However, if you test negative at 2 weeks, the result is reliable; there is uncertainty only if positive. But since your priority is to not risk a false positive result, you definitely should wait until 3 weeks or more.

Also, related to test of cure but slightly different:  All persons with chlamydia should be retested once again after 3-4 months. That detects both the occasional delayed treatment failure (which sometimes happens with azithromycin, but not doxycycline); and because statistically, a high proportion of infected persons re-acquire chlamydia within the several weeks after an initial infection. So be sure and have another test after 3-4 months.

HHH, MD