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| |    Gonorrhea and Chlamydia by Marjorie Greenfield, M.D. reviewed by Elisa Ross, MD Gonorrhea and chlamydia are sexually transmitted bacteria that affect both men and women. In women, untreated gonorrhea or chlamydia can lead to pelvic inflammatory disease (PID), a serious infection of the uterus, fallopian tubes, and ovaries. This, in turn, can cause infertility, tubal pregnancy, and chronic pain. In the U.S., chlamydia is about three times as common as gonorrhea. It is estimated to affect between 3 and 5 percent of the population. Symptoms of gonorrhea and chlamydia It's very important to note that many men and women with gonorrhea and chlamydia present no symptoms at all. When this is the case, diagnosis is made only if the person routinely gets screened for STDs or if a partner with the infection tells them to get checked.
For women, testing can be done during a pelvic examination by sending cervical secretions to the lab. In men, a tiny cotton-tipped swab can be inserted into the penis. Newer tests are being developed that allow the testing of both men and women to be done with a urine specimen, which many people find less intimidating than the typical physical exam. The standard tests for gonorrhea and chlamydia are quite good, but they are not 100 percent accurate. There can be false positives, where the test shows infection when there really isn't any; or false negatives, where the test comes back negative, despite the presence of infection. This means that your practitioner must use some judgment in interpreting test results and considering treatment. For instance, if your sexual partner's test came up positive for gonorrhea and your test was negative, your practitioner may still opt to treat you, as the risk of a possible infection is so much worse than taking what might be unnecessary antibiotics. Other tests Chances are, if you've caught one STD, you may have been exposed to others. If you are diagnosed with either gonorrhea or chlamydia, you might want to consider also getting tested for syphilis and HIV. Any unusual bumps or sores in the vaginal area should be shown to your practitioner in case they turn out to be herpes or human papilloma virus (HPV). Since cervical cancer is also considered a sexually transmitted disease, routine Pap tests are particularly important for women who have had sexually transmitted infections. Treatment Antibiotics are effective in treating these two infections, but a different antibiotic is usually needed for each. Doxycycline (Vibramycin) and azithromycin (Zithromax) both work against chlamydia. While more expensive, the azithromycin is a great choice because treatment can be taken in just one dose, and it is approved for use in pregnancy. Gonorrhea can be treated with an injection of a cephalosporin antibiotic like ceftriaxone (Rocephin) or drugs of the quinolone family like ciprofloxin (Cipro). Because chlamydia is so much more common than gonorrhea, doctors usually add in treatment for chlamydia if the test shows gonorrhea--just in case the other infection missed detection. Many people, in fact, have both infections at the time of diagnosis. If you are diagnosed with either or both of these infections, your sexual partner(s) should be notified. Sexual partners should be treated even if their test doesn't show infection, as the results might be a false negative. Prevention Abstinence, of course, is the best prevention. Limiting the number of lifetime sexual partners and using condoms for all acts of intercourse can be quite effective. Many people equate being HIV negative as being free of all STDs, but there are many sexually transmitted infections that don't have symptoms or routine tests for diagnosis. It is best to rely not on trust, but on barriers like condoms in order to prevent sexually transmitted infection.
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