Chlamydia: The Hidden S.T.D.

• PRINT

What if a disease could secretly invade your organs and prevent you from ever having children — without so much as a telltale sign? That disease is here. It's called chlamydia, and today in the U.S. it's become the most common sexually transmitted disease or STD (an infection that passes from person to person via sexual contact). You may never have heard of chlamydia. Nonetheless, it will infect people at a rate more than 3 times as great as the infection rate of gonorrhea, the nation's 2nd most widespread STD.

Health officials had only a murky sense of chlamydia's infection rate until systematic national testing began in 1996. The results are so alarming that doctors now urge sexually active girls to be tested for the disease every six months. (Doctors specify girls because they're more likely than boys to suffer devastating effects without knowing it.) "It's an epidemic of massive proportions," says Dr. Susan DeLisle, an STD expert with the CDC in Atlanta.

INVISIBLE INFECTION
Chlamydia is a bacteria, a microorganism that invades human cells. Like other STDs, it enters the male or female body through sexual contact and the exchange of body fluids, like semen or blood. In most cases chlamydia spreads without symptoms — which is why medical researchers named it from the Greek word for "cloak." "Everything about this disease is like its name: cloaked and secretive," says DeLisle.

Three-quarters of all infected females (and half of infected males) have no idea they're infected, and therefore don't seek treatment, say health officials. Those who do feel the effects typically experience one or more of the following symptoms within weeks of infection:

FEMALES

• any unusual vaginal discharge or bleeding
• burning when urinating
• lower abdominal pain

MALES

• any discharge from penis
• obstructed or painful urine flow
• burning and itching around the penis
• pain and swelling in the testicles

TOLL ON GIRLS
Chlamydia exacts a particularly harsh toll on high-school girls. About half of all cases occur in girls between the ages of 15 and 19. CDC studies show that as many as 1 in 10 sexually active teenage girls may be infected. Girls who have sex with more than one person face even greater risk.

Why are teenage girls so susceptible? The answer is their reproductive organs, the body parts devoted to producing babies. The uterus, or womb, is shaped like an upside-down pear. Its lower end narrows into a protective opening called the cervix. The immature cervix found in teenage girls is lined with fresh tissue easily subject to infection by chlamydia. "It's possible to get chlamydia when you're older," says DeLisle. "But the teenage cervix is far more vulnerable."

But chlamydia's invasion may not stop at the cervix. It can creep upward to the uterus and fallopian tubes, two spaghetti-size branches that extend like arms to the ovaries, which produce eggs. The damage may go unnoticed for months, or even years. Although a girl will continue to ovulate (produce eggs), she can still be left infertile (unable to have children).

Normally, eggs migrate down the fallopian tubes to the uterus. The eggs may be fertilized (set into reproductive motion) if they encounter sperm, tadpole-shape male sex cells that swim upward. But chlamydia can thwart the process by causing inflammation in the fallopian tubes. The resulting swelling and scarring pinches off the fallopian tubes, just as stepping on a hose blocks the flow of water. Result: Eggs don't reach the sperm or the uterus, and never develop into embryos (the first stage of human development). This condition, known as pelvic inflammatory disease, affects up to 1 million women in the U.S. Half of all PID cases may be due to chlamydia.

STOP THE SPREAD
How can you avoid chlamydia? "Abstinence is the only sure way to avoid an STD," says Marshall Glover, director of the CDC's STD hotline. "Unless they've been tested, you can't know if your partners are infected."

If you think you might be at risk for chlamydia, ask a doctor to administer a urine test. If you're infected, a doctor will prescribe antibiotics, drugs that kill bacteria. But antibiotics won't safeguard you from being reinfected by the same partner, or another. And remember: Birth-control pills may help prevent pregnancies, but they don't protect females from chlamydia and other STDs.

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