Chlamydial Infection in Men

What is chlamydial infection?

Chlamydia is a common sexually transmitted infection of the male sexual organs. Men often do not know they have a chlamydial infection because they may not have any symptoms. However, chlamydia can be passed to female sexual partners and cause severe infections and complications for them, their pregnancies, and their newborn babies.

How does it occur?

The organism that causes the infection is called Chlamydia trachomatis. It is similar to bacteria. The infection is usually passed from person to person during sexual intercourse. It can also be passed by other intimate contact with the genital or rectal area.

In men chlamydia usually infects the urethra. The urethra is the tube that passes through the middle of the penis. Urine and sexual fluid (semen) flow through the urethra. Infection of the urethra is called urethritis.

Chlamydia may also infect the epididymis or prostate gland. The epididymis is a coiled tube attached to the testicle. It stores and carries sperm. The prostate is a gland at the base of the penis. It produces nutrients for sperm. Infection of the epididymis is called epididymitis. Prostate infection is called prostatitis.

The anus and rectum may also be infected if you have anal intercourse. An infection in this area is called proctitis.

What are the symptoms?

Often there are no symptoms, especially early in the infection. If your urethra is infected, you may have:

• discharge from the penis
• burning when you urinate.

Infection of the epididymis causes pain in the testicle.

Possible symptoms of prostate infection are:

• discharge from the penis
• discomfort when or after you urinate
• pain during or after intercourse
• lower back pain.

Sometimes infections of the prostate or epididymis are sudden and severe. These infections may cause fever or other symptoms of illness. They require prompt medical attention.

Possible symptoms of anal infections are:

• irritation around the anus
• pain when you have a bowel movement.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. To diagnose infection of the urethra, you will probably have a lab test of a sample of fluid from the opening of the urethra. For this test, a slim swab is inserted into the opening of the urethra at the tip of the penis. Sometimes a urine test may be done to check for chlamydia.

Your healthcare provider may swab the anus for tests if you have had anal sex or are having symptoms in that area.

Lab tests help your provider know what is causing the infection and which antibiotic will work best. However, it is often not possible to identify the organism that is causing infections of the epididymis and prostate gland.

How is it treated?

Taking antibiotics usually cures the infection. Most infections of the urethra require 7 days of antibiotics. Sometimes the infection can be treated with a single dose of antibiotic. Prostate infections may need 2 to 4 weeks of treatment.

Many healthcare providers begin antibiotic treatment before lab results are available. In the case of epididymitis or prostatitis, an antibiotic is chosen that is effective against chlamydia and other possible causes of the infection. You may need to take more than one antibiotic, especially if there is a chance you have other infections, such as gonorrhea.

Your sexual partner or partners should also have treatment even if they have no symptoms. Discuss this with your healthcare provider.

How long will the effects last?

The symptoms of urethritis usually are gone within a few days after you start taking the antibiotic. However, it is very important to kill all of the chlamydia. Take your medicine for as long as it is prescribed, even if your symptoms are gone before you have finished taking it.

The symptoms of epididymitis and particularly prostatitis may take several more days to go away completely.

If you keep having symptoms despite the antibiotics, be sure to tell your healthcare provider. It is especially important to tell your provider if any symptoms come back after you finish taking the antibiotic.

Chlamydia can cause infertility. The risk of infertility is greatest if you have an infection for weeks or months without treatment.

How can I take care of myself?

• Follow the full treatment prescribed by your healthcare provider. This includes taking your medicine for as long as it is prescribed, even if your symptoms are gone before you have finished taking it.
• Take aspirin, acetaminophen, ibuprofen, or naproxen to reduce pain.
• If you are taking the antibiotic tetracycline or doxycycline, avoid milk products 1 to 2 hours before and after you take the medicine. Also, avoid sun exposure. The medicine may cause you to be very sensitive to the sun and get a severe sunburn.
• Follow your healthcare provider's instructions for follow-up visits and tests. Your provider will check that the infection is gone.
• Tell everyone with whom you have had sex in the last 3 months about your infection. They must also be treated, even if they have no symptoms. Do not have sex before both you and your partner have finished all of the medicine and your provider says it is OK.
• Call your healthcare provider right away if:
  • You develop severe abdominal or back pain.
  • You are having difficulty or increased pain when urinating.
  • You vomit and cannot keep the medicine down.
  • You develop a fever over 101.5°F (37.8°C).
  • You feel you are getting sicker rather than better.
  • Your symptoms come back after you have finished taking the antibiotic.

How can I help prevent chlamydial infection?

• Make sure you tell your sexual partner(s) that they have been exposed to chlamydia.
• Reduce the risk of infection by always using latex or polyurethane condoms during foreplay and vaginal, oral, or anal intercourse.
• Have just 1 sexual partner who is not sexually active with anyone else. Make sure your partner has been tested for chlamydia and other sexually transmitted diseases.
• If you have had unprotected sex (without a condom), see your healthcare provider to be checked for sexually transmitted diseases even if you do not have symptoms.
• When boys and men are victims of sexual assault and are at risk for having been infected with chlamydia or other infections, they should be treated.