Chlamydia: From Whom, How Long Ago, and What About My Fertility?
Given that Chlamydia is the most common of the reportable sexually transmitted infection/sexually transmitted disease (STI or STD) we get many questions here at WebMD from very worried women. The most concerned questions tend to be focused on how/when the infection was acquired, and what impact will it have on future fertility. The following is a summary of the answers to those questions, and some related issues as well.
Who Gave Me Chlamydia?
If you are a sexually active woman aged twenty five years or less--and especially if you are aged less than twenty--you are a part of the largest Chlamydia infection demographic. If you are a female performing receptive oral, anal, or vaginal sex you can get Chlamydia, if secretion contact is present. Thus you need to be honest with your GYN about your sexual practices so you can be screened for possible Chlamydia infections of the pharynx, rectum, or vagina/cervix. Chlamydia can be passed between both heterosexual, and same sex couples-although its incidence is less than 1% in women who are exclusively lesbian.
How Long Ago Did I Get Chlamydia?
The incubation of a Chlamydia infection is reported to be one to three weeks. It can take up to six weeks in some cases. From one perspective it would be great if one could count back a few weeks to find the culprit-partner. But that would require that tell-tale symptoms be present. Alas, up to 75% of women and perhaps 50% of men have no symptoms. This can make it difficult to establish blame for the infection. It also means that infected persons can unknowingly continue to spread Chlamydia for a long time.
Many family planning programs do universal screening for Chlamydia among women aged twenty five or less--or if there is a new sexual partner. Certainly if a woman comes in with symptoms of vaginal discharge, the GYN or clinic would be likely to test for STDs, as well as for other vaginal infections. There is often screening during the initial prenatal visits in an attempt to prevent the infant from becoming infected during delivery with Chlamydial infections of the eyes or lungs.
Other instances when a woman might be tested for Chlamydia would be if she presents for an infertility work up, or with pain from a pelvic infection. These two conditions are linked. If Chlamydia ascends up through the cervix to infect the uterus/tubes/ovaries a woman can develop "Pelvic Inflammatory Disease" ("PID"). Some symptoms of PID include: lower abdominal pain, pain with sex, breakthrough bleeding, fever, or even nausea.
Studies have shown that between 20-40% of women with untreated Chlamydia will go on to develop scarring inside the Fallopian tubes, or bands of scar tissue ("adhesions") inside the pelvis. Inflammation from the untreated infection creates this scarring. This impacts fertility by blocking the tubes so fertilization cannot occur, and by "webbing" the open end of the Fallopian tubes to impair egg "capture" at ovulation. One author (Mardah, 2004 ) posits that the "The tubal infection may become chronic in spite of antibiotic therapy." This would infer that even after treatment a percentage of women may have tubal damage.
How Will Chlamydia Affect MY Fertility?
It has been calculated that perhaps 1,000,000 women per year will get PID of some type. Of those, an estimated 10% will develop infertility. One landmark study (Westrom, 1996) followed almost 1,500 women, of whom about 2/3 had confirmed PID as documented by a laproscope. Among the women with a PID history 7.8% had tubal occlusion where the tube was scarred closed. By contrast, a comparison group without PID had less than 1% tubal occlusions.
In this same study it was determined that the risk of PID caused infertility was tied to:
The severity of the infection influenced the relative risk (RR) of tubal infertility:
PID can be caused by other organisms (eg gonorrhea, anaerobic bacteria), thus this study attempted to identify the risk of tubal damage from having only Chlamydia :
From this data it can be inferred that the greatest impact of Chlamydia on fertility would arise if a woman had a severe PID and/or repeated infections.
Could I have had a false positive Chlamydia test?
There are a variety of tests for Chlamydia; each has its own specificity and sensitivity which means that each has a different risk of false results. There are three basic types: culture, immunoassay, and nucleic acid amplification (NAAT). For a clear explanation of each, click here.
To summarize the scientific studies comparing the reliability of the various tests, the culture and immunoassay types are between 10-30% less sensitive than the nucleic acid amplification tests (Gaydos, 2004). A few of the immunoassay tests will cross react with the subtypes of Chlamydia which are not implicated in GYN infections. Some labs will do a confirmatory test if the screening test is positive--especially if a non-NAAT variety. It is important to note that false negative tests can occur as well.
Thus if Chlamydia is suspected a clinician will often "treat first; ask questions later." Given the lack of symptoms in many Chlamydia infections this may be the best way to prevent its GYN outcomes.
Related Topics:
Technorati Tags: chlamydia, womens health, STD, sexual health
Who Gave Me Chlamydia?
If you are a sexually active woman aged twenty five years or less--and especially if you are aged less than twenty--you are a part of the largest Chlamydia infection demographic. If you are a female performing receptive oral, anal, or vaginal sex you can get Chlamydia, if secretion contact is present. Thus you need to be honest with your GYN about your sexual practices so you can be screened for possible Chlamydia infections of the pharynx, rectum, or vagina/cervix. Chlamydia can be passed between both heterosexual, and same sex couples-although its incidence is less than 1% in women who are exclusively lesbian.
How Long Ago Did I Get Chlamydia?
The incubation of a Chlamydia infection is reported to be one to three weeks. It can take up to six weeks in some cases. From one perspective it would be great if one could count back a few weeks to find the culprit-partner. But that would require that tell-tale symptoms be present. Alas, up to 75% of women and perhaps 50% of men have no symptoms. This can make it difficult to establish blame for the infection. It also means that infected persons can unknowingly continue to spread Chlamydia for a long time.
Many family planning programs do universal screening for Chlamydia among women aged twenty five or less--or if there is a new sexual partner. Certainly if a woman comes in with symptoms of vaginal discharge, the GYN or clinic would be likely to test for STDs, as well as for other vaginal infections. There is often screening during the initial prenatal visits in an attempt to prevent the infant from becoming infected during delivery with Chlamydial infections of the eyes or lungs.
Other instances when a woman might be tested for Chlamydia would be if she presents for an infertility work up, or with pain from a pelvic infection. These two conditions are linked. If Chlamydia ascends up through the cervix to infect the uterus/tubes/ovaries a woman can develop "Pelvic Inflammatory Disease" ("PID"). Some symptoms of PID include: lower abdominal pain, pain with sex, breakthrough bleeding, fever, or even nausea.
Studies have shown that between 20-40% of women with untreated Chlamydia will go on to develop scarring inside the Fallopian tubes, or bands of scar tissue ("adhesions") inside the pelvis. Inflammation from the untreated infection creates this scarring. This impacts fertility by blocking the tubes so fertilization cannot occur, and by "webbing" the open end of the Fallopian tubes to impair egg "capture" at ovulation. One author (Mardah, 2004 ) posits that the "The tubal infection may become chronic in spite of antibiotic therapy." This would infer that even after treatment a percentage of women may have tubal damage.
How Will Chlamydia Affect MY Fertility?
It has been calculated that perhaps 1,000,000 women per year will get PID of some type. Of those, an estimated 10% will develop infertility. One landmark study (Westrom, 1996) followed almost 1,500 women, of whom about 2/3 had confirmed PID as documented by a laproscope. Among the women with a PID history 7.8% had tubal occlusion where the tube was scarred closed. By contrast, a comparison group without PID had less than 1% tubal occlusions.
In this same study it was determined that the risk of PID caused infertility was tied to:
The number of times a woman had PID:
Zero episodes---1%
Two episodes---11.3%
Three episodes--19.8%
Zero episodes---1%
Two episodes---11.3%
Three episodes--19.8%
The severity of the infection influenced the relative risk (RR) of tubal infertility:
Mild infection-------- RR 1.0
Moderate infection---RR 1.8
Severe infection------RR 5.6
Moderate infection---RR 1.8
Severe infection------RR 5.6
PID can be caused by other organisms (eg gonorrhea, anaerobic bacteria), thus this study attempted to identify the risk of tubal damage from having only Chlamydia :
Nonchlamydial--------RR 1.0
Chlamydia-------------RR 1.7
Chlamydia-------------RR 1.7
From this data it can be inferred that the greatest impact of Chlamydia on fertility would arise if a woman had a severe PID and/or repeated infections.
Could I have had a false positive Chlamydia test?
There are a variety of tests for Chlamydia; each has its own specificity and sensitivity which means that each has a different risk of false results. There are three basic types: culture, immunoassay, and nucleic acid amplification (NAAT). For a clear explanation of each, click here.
To summarize the scientific studies comparing the reliability of the various tests, the culture and immunoassay types are between 10-30% less sensitive than the nucleic acid amplification tests (Gaydos, 2004). A few of the immunoassay tests will cross react with the subtypes of Chlamydia which are not implicated in GYN infections. Some labs will do a confirmatory test if the screening test is positive--especially if a non-NAAT variety. It is important to note that false negative tests can occur as well.
Thus if Chlamydia is suspected a clinician will often "treat first; ask questions later." Given the lack of symptoms in many Chlamydia infections this may be the best way to prevent its GYN outcomes.
Related Topics:
Technorati Tags: chlamydia, womens health, STD, sexual health
2 Comments:
New York Philharmonic Orchestra –How some members sexually abuse young college girls
The most traumatic experience in my life turned out to how some of the musicians of the NY Philharmonic Orchestra manipulated my wife.
They Are:
1.Before we married, the flute player, Musician #1,used
emotional/sexual abuse, fear and rape on my wife. I remember sitting
in the audience during a masterclass and suddenly, I was just
watching, the police came and escorted me out of the building. He
saw me and was looking for sexual conquest, another notch on his
belt for my wife. During private lessons, he would teach breathing
lessons and sexual touch my wife to arouse her. He made her drive 2 hours to New Jersey to his house one night. I was playing a musical show and did not know. I found out many of these events way after they happened. He arrived late and yelled at her for waiting in the car in the street. Inside, he got what he wanted. Another time, he made her drive to Hartford, CT since he was a teacher at Yale University. He was always yelling and angry with her. He used the techniques of emotional abuse, sexual abuse, fear, anger and rape for a promise with a job with the orchestra. What did I get-gonorrhea. He did not recognize. He always told my wife that she was using him to make me jealous, a common technique using blame to abuse. He went in and came out of mental institutions his entire career. When he had sex with my wife-2x, he would get mad and make her leave the house late at night. He was evil. The last time he came out of a mental institution, on the same day, he hung himself on the shower rod. For some reason, I felt a sense of closure and in a weird way was happy. I know many girls from the 70's while I was a music student. They se a psychologist, suffer from PTSD, are depressed and afraid to tell their husbands who do not know since they have children and a marriage. But since that time, he destroyed many girl's lives and made them go into denial of being raped. It is natural for women to go into this state and try to forget since some are submissive and taught this since they were young.
2. Musician #2- During lessons he would try to undress my wife by
unbuttoning her shirt to cop a feel and get oral sex. He never
succeeded but his wife was in the house. In addition, he came over
our house and acted as a friend of mind while behind my back he was trying. My wife was in a state of fear and afraid to tell me. Well,
he was an alcoholic and drank himself to death. He was into
collecting guns and rifles and I wonder if this had an affect on
creating fear to my wife.
3. Musician #3- He would invite my wife to NY Philharmonic
rehearsals and give her the impression of a job. Then ask my wife to
lunch and have a lesson in his Manhattan studio. In his home in
Brewster, NY, he would try in his studio the common abuse methods by impressing his students with his playing but he was not a good teacher since he did not know how to teach the methods to achieve these goals in playing. Meanwhile, while he tried, I was waiting in the car outside and his wife was in the house a real low life bas.......d.
Today there is one person left.(3 out of 4 have died). What a relief. Anger has left and I wait for God's justice. I contacted many
offices and executives of the NY Philharmonic and no one replied. I consider myself an advocate for this form of rape. Recently, a clarinetist was revealed for doing these pervert actions. The Philharmonic spoke to him; imagine. He should have been taken out with handcuffs during a concert for all to see and for him; be revealed for his actions for the last 30 years.
Never take a lesson in his private studio or take an invitation to lunch or meet the orchestra at a rehearsal as a false idea that you will get a job. If he grabs you from behind, give him dead weight and fall to the ground. On the way down, strike with your elbow real hard in his family jewels. Brain to Pain. Then, with a fist, hit him in the temple and mouth, right and left hand combo, then 2 stikes to his chest and abdomen. When he is down, give him a light karate chop on his throat. Say this to yourself everyday. It is a karate technique to act quickly. Don,t panic or be fearful. He will never expect it. Then SCREAM. If sex should happen, call the police to take you to the hospital for STD and DNA testing. Keep a log of hours of date, time and place if he should make any sexual advances or comments during your lesson. Watch Texas Walker Ranger and Jackie Chan movies on TV to develop courage and simple techniques. Subscribe online to the mayo clinic. They will describe things that will develop later on in life to you like PTSD, anger, depression, bad marriages and etc. There are many different types of rape. SPEAK OUT. MEDITATE ON SELF DEFENSE AND ACT QUICKLY. I know, I was tough and faced a similar situation. I told him to stop and reported him to the authorities. Don't worry about your instrument because it can be replaced by insurance or by suing him. Speak with your parents. They pay tuition and have a say in the school. He deserves to be hurt. Mostly older men that have this fantasy for younger girls and how there fantasies that they are tight. They will not stop and when they get it and you may have fallen in love, then you will get dumped for his next conquest. Don’t be afraid to hurt him because he will hurt or kill you. Let’s face it. Who comes first. Never go to house even though hid wife is there. They tried that on me in his studio. They are evil. Meditate on defending yourself. It works!
Dawn
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