Untreated chlamydia can lead to complications, including infertility and chronic pain. Most people do not show symptoms of the infection, so it can easily go undetected and, thus, untreated.

According to the American College of Obstetrics and Gynecology (ACOG), chlamydia is the most commonly diagnosed sexually transmitted infection (STI) in the United States.

A chlamydia infection may cause no symptoms. However, left untreated, it can cause pelvic inflammatory disease (PID) in females. In males and females, it can cause inflammation of the liver capsule and reactive arthritis.

Damage to the reproductive system can also lead to infertility or issues with getting pregnant. Chlamydia is treatable with antibiotics.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Most people with chlamydia have no symptoms. For this reason, it often goes undiagnosed and untreated.

Infection with the bacteria Chlamydia trachomatis causes chlamydia. It spreads through oral, vaginal, or anal sexual contact. Semen does not have to be present for chlamydia to pass between two people.

Chlamydia can also pass to an infant during childbirth.

According to the Centers for Disease Control and Prevention (CDC), about 10% of males and 5–30% of females diagnosed with chlamydia develop symptoms.

Symptoms can be different in males and females. General symptoms include:

In males, symptoms also include:

In females:

In females, the bacteria can also cause cervicitis, an infection of the cervix. Symptoms of cervicitis may include discharge and bleeding, usually after sexual intercourse or any irritation of the cervix.

Further infection can spread into the reproductive system and cause PID.

Symptoms of PID include abdominal and pelvic pain. PID can lead to tubo-ovarian abscess and infertility through scarring of the fallopian tubes.

Untreated chlamydia can lead to further infection, infertility, pregnancy complications, chronic pain, and more.

Complications may be different for males and females, but both can develop reactive arthritis, which affects the joints, urinary tract, and eyes. The infection can also spread to the rectum, eyes, throat, or other organs.

Further, chlamydia can cause inflammation of the urethra, known as urethritis. This condition produces symptoms that resemble those of a urinary tract infection.

Having a chlamydia infection can also increase a person’s chances of contracting HIV.

Some of the complications of chlamydia in females include:

Pelvic inflammatory disease (PID)

PID involves chronic inflammation of the reproductive organs. It can occur in women who do not receive treatment for chlamydia.

Some PID cases can lead to perihepatitis, also called Fitz-Hugh-Curtis syndrome. This causes inflammation of the liver capsule and peritoneum, producing pain in the upper-right portion of the abdomen.

PID can cause scar tissue to form in and around the fallopian tubes and lead to tubal blockages. It can also cause ectopic pregnancy, infertility, and long-term pelvic pain.

Symptoms of PID include:

As chlamydia rarely causes symptoms on its own, a doctor should evaluate any of these symptoms.

Pregnancy complications

Untreated chlamydia can pass from a parent to an infant during childbirth.

If chlamydia does pass on to the baby, they could also develop conjunctivitis or pneumonia. Additionally, the baby may deliver early (pre-term delivery).

According to the CDC, doctors should test pregnant people for chlamydia at the first prenatal visit. If chlamydia is present, they can treat it with safe antibiotics. If they treat it early, it is less likely to cause pregnancy complications. Doctors recommend a test of cure 4 weeks after completing treatment.

Additionally, untreated chlamydia could develop into PID during pregnancy, causing symptoms and pain.

According to the CDC, chlamydia rarely causes health problems in males. However, some complications can occur, including:

Testicle inflammation

Untreated chlamydia can lead to infection and inflammation of one or both testicles, called epididymitis.

Epididymitis is an infection of the epididymis, a tubular structure on the back of the testicles where sperm cells mature. Symptoms include testicular pain, painful urination, and painful ejaculation.

If not treated promptly, epididymitis can lead to an abscess and sepsis. Rarely, it can cause infertility.

Untreated chlamydia carries further risks. A person can spread the infection to others and also develop more serious infections, such as HIV.

HIV

Untreated STIs such as chlamydia may put an individual at higher risk of getting or spreading HIV.

One reason is that the behaviors that carry a risk of chlamydia transmission — such as not using condoms, having multiple partners, and having anonymous partners — may also increase the risk of HIV transmission.

Also, a sore or inflammation from an STI, such as chlamydia, may make the body more vulnerable to an HIV infection. Sores and broken skin may allow infection with HIV that intact skin may have stopped.

Chlamydia transmission

Chlamydia is a contagious disease that spreads through contact with genital secretions. This means that if a person has chlamydia, it can spread to others through sexual contact or childbirth.

Transmission can occur through oral, vaginal, or anal sex or childbirth. Semen does not need to be present, and ejaculation does not need to happen for infection to occur.

A person can avoid this by taking any treatments for chlamydia recommended by a doctor as soon as possible. A person should also avoid having sex while undergoing treatment and wear condoms every time they have sex after treatment.

Chlamydia spreads through vaginal, anal, or oral sex without a condom and with a partner who has chlamydia.

To limit the risk of chlamydia infection, a person should consider talking with sexual partners openly and asking for proof of negative testing.

According to the CDC, people in the following groups should have a chlamydia test every year:

  • people under the age of 25 years
  • people 25 years and older with risk factors including multiple sexual partners or a sexual partner with an STI

Additionally, the following behaviors increase the risk of contracting chlamydia:

  • having more than one sexual partner
  • having a sexual partner who has more than one sexual partner
  • having an STI now or in the past
  • not using condoms consistently when not in a mutually monogamous relationship
  • exchanging sex for money or drugs

Testing for chlamydia can be done with a urine sample or swabs taken from the genitals, mouth, throat, rectum, or cervix.

A person can order an STI testing kit online or from a sexual health clinic. They can perform the test themselves at home and send it to the clinic through the mail.

Alternatively, they can visit a doctor’s office or sexual health clinic in person. A medical professional may take the samples, or the person may do it themselves.

Learn more

Learn more about chlamydia and STI testing.

A doctor will diagnose chlamydia after conducting a thorough medical history and physical examination.

Based on this, they may order laboratory tests, including a urine sample or swab, to test for the presence of Chlamydia trachomatis.

A doctor will diagnose chlamydia based on a positive chlamydia test.

The doctor will also rule out other STIs and, in females, may look for signs of PID.

Chlamydia is easily treatable with antibiotics.

A person undergoing treatment should avoid sexual activity for at least 7 days or until their symptoms are gone.

A person should take all antibiotics as prescribed, even if they start to feel better. If symptoms persist beyond the recommended treatment, they should contact a doctor.

Infants with chlamydia usually develop conjunctivitis or pneumonia. These infections are treatable with antibiotics.

Chlamydia reinfections are common. Having more than one chlamydia infection increases a person’s risk of reproductive health issues.

To avoid reinfection, an individual should avoid all sexual activity until they finish treatment. After treatment has ended, they should make sure to wear condoms correctly every time they have sex. This can help prevent chlamydia and other STIs.

To reduce the chance of reinfection, a person should ask all sexual partners to get tested for chlamydia before they resume any sexual activity.

The only way to completely avoid chlamydia is not to have oral, vaginal, or anal sex.

People at the lowest risk of chlamydia are those in monogamous relationships with a partner who tested negative for chlamydia.

This section answers some frequently asked questions about untreated chlamydia.

What happens if you leave chlamydia untreated for 3 years?

Chlamydia is an infection and, in many people, may continue to spread throughout the body.

Leaving a chlamydia infection untreated for years increases the risk of developing serious complications such as pelvic inflammatory disease (PID) and further infections.

For women, PID can cause:

  • scar tissue that blocks fallopian tubes
  • ectopic pregnancy
  • infertility
  • long-term pelvic pain

What is late-stage chlamydia?

Late-stage chlamydia refers to an infection that has spread to other parts of the body.

For example, it may have spread to the cervix (cervicitis), testicular tubes (epididymitis), eyes (conjunctivitis), or throat (pharyngitis), causing inflammation and pain.

Chlamydia is an STI that can easily spread because it is mostly asymptomatic.

A person can contract it through sexual activity. In pregnancy, it can also spread to an infant through childbirth.

Untreated chlamydia leads to health problems, including PID for women and perihepatitis, or swelling of the lining of the liver. In men, it can cause an infection of the testicular tubes.

Chlamydia can also cause rectal and eye infections, reactive arthritis, and infertility.

Chlamydia is treatable with antibiotics. The individual should abstain from intercourse during treatment, and partners should receive chlamydia tests and treatment if necessary.