|
ANN ARBOR,
MI - Every year, millions of American women get a sexually transmitted disease that they may never know about - until they
try to get pregnant and find they can't, or develop chronic pelvic
pain that haunts them for life.
That's why
it's crucial for women of all ages to get tested for chlamydia even
if they don't have symptoms, to get treated right away with antibiotics
if they have it, and to take precautions such as using condoms whenever
they have sex, says a University of Michigan Health System expert.
These steps are especially important for sexually active women under
25, who have the highest risk of infection - and the most to lose.
The same advice
of testing, treatment and protection goes for men, who bear the
blame for passing chlamydia to their partners, says Mark Pearlman,
M.D., an associate professor in the Departments of Obstetrics &
Gynecology and Surgery who studies gynecological infections.
"Chlamydia
is the most common sexually transmitted infection in the United
States, with about four million cases a year. Everyone who has sex
can have chlamydia," says Pearlman. "Compare that with a million
cases of gonorrhea ,
and 500,000 cases of genital herpes, a year."
Besides the
title of most common STD, chlamydia bears another, even more serious
crown, says Pearlman. "It can be extraordinarily dangerous in terms
of a woman's future reproductive health - it's the most common cause
of infertility
in the United States," he says.
In those who
do become pregnant despite the infection, their pregnancy is very
likely to be ectopic, or outside the uterus, putting the mother's
life in danger, says Pearlman. Even if the pregnancy is normal,
the baby's eyes and lungs can become infected at birth.
Luckily, UMHS
and other health care providers are making it easier for women and
men to find out if they have chlamydia, using a recently introduced
urine test that is easier to take and more precise than other tests
because it detects chlamydia bacteria through DNA analysis. If the
test is positive, a 10-day course of antibiotics can clear up the
infection and prevent complications.
But it's those
women who don't get tested who worry Pearlman and other health experts
the most. Chlamydia infections often lurk undetected because they
don't cause symptoms, even while they're permanently harming a woman's
reproductive system.
"We think that
about two-thirds of the time there are no symptoms with this infection,"
Pearlman explains.
Even if symptoms
do appear, women may ignore them. That's a mistake, because vaginal
discharge, pain or bleeding during and after sex, abdominal pain
and fever can all signal an infection of the cervix that could later
go "underground" and cause more damage further up in the woman's
reproductive system. The infection could also progress immediately
to sepsis and even form a painful abscess that only surgery can
fix. Any woman experiencing such signs should consult her doctor
or other health care advisor and seek testing.
A long-term
infection by Chlamydia trachomatis bacteria is what can lead to
lasting harm, Pearlman continues. The infection is a leading cause
of pelvic inflammatory disease, or PID, a chronic condition that often
causes lower abdominal pain but can also lurk in a woman's system
without symptoms, blocking the Fallopian tubes. About 40 percent
of untreated chlamydia infections lead to PID, according to the
Centers for Disease Control and Prevention.
"When PID is
symptomatic, it can be diagnosed and treated," Pearlman says. "But
nearly two-thirds of the time the symptoms aren't present, and women
only find out they've had it years later when they have blocked
tubes and have difficulty getting pregnant, or do get pregnant and
have a tubal, or ectopic, pregnancy."
The CDC estimates
that one in five women with PID will become infertile, and almost
as many will experience debilitating pelvic pain. One in 10 will
have a life-threatening tubal pregnancy.
As for men,
the physical result of a chlamydia infection may be pain during
urination or discharge, and perhaps some sensitivity in the testicles.
But even more, men bear the psychological burden of knowing they
can harm their partner by passing along an undetected infection.
"Men who are sexually active, particularly young men who are, should
consider getting a chlamydia test and have a discussion with their
health care provider," says Pearlman.
Men who don't
know if they or their partners are infected should wear a condom
during sex, though condoms are not 100 percent effective in preventing
any infection. "Regular and proper use of condoms can significantly
reduce the likelihood of a chlamydia infection, and that's true
for gonorrhea and HIV too," says Pearlman. "So, routine condom use
at the time of sexual intercourse is a good preventive measure."
Even with precautions,
regular discussion with a doctor or health care professional, and
regular testing, are vital for any sexually active person. Anyone
under 25 years of age who has had sex with one or more people should
be extra careful, as chlamydia infection is most common in the teen
and young adult years. In fact, of the 23,107 cases reported in
Michigan in 1999, 7,486 cases - almost 40 percent - were in young
women aged 15 to 19.
Women don't
have to submit to a swab test of the cervix anymore if they want
to find out if they're infected, Pearlman adds.
"In the last
few years simple urine testing has become available, and it's just
as reliable as the cervical testing, in some cases more reliable,"
he says. "It's sensitive, meaning it picks up most cases, and it's
specific, which means that if the test comes back positive you can
rely on the result." But just as with the older test, women need
to talk with their health care providers to ask for the test, or
discuss whether it might be needed because of their sexual history
or pregnancy plans.
Facts about
chlamydia infection:
- Chlamydia
is a sexually transmitted disease caused by a bacteria. It can
infect and be spread by men and women alike.
- An estimated
3 million to 4 million chlamydia infections occur each year, with
about 2 million people carrying the disease at any given time.
- Because
many people become infected without knowing it, and never get
tested, only about 660,000 cases were found in 1999, the most
recent year for which numbers are available.
- Michigan
has required reporting of chlamydia since 1992. Compared with
the rest of the U.S., Michigan's chlamydia rates are about average,
with 23,107 cases reported in 1999.
- Forty percent
of Michigan's cases in 1999 were in teen girls aged 15 to 19.
In Washtenaw County alone, 79 percent of cases detected in 1999
were in people aged 24 or younger.
- Two-thirds
of women and half of men infected with chlamydia will not experience
symptoms.
- Forty percent
of untreated chlamydia cases in women will lead to pelvic inflammatory
disease, or PID. Two-thirds of PID cases don't cause symptoms,
but the remaining 20 percent will suffer chronic pelvic pain.
Twenty percent of women with PID will lose fertility.
- Chlamydia
costs the United States economy $2 billion each year in direct
and indirect costs.
- The U-M
Health System offers a new test for chlamydia that doesn't involve
a cervical swab. Instead, women and men can have their urine tested
with a more accurate DNA analysis. UMHS also tests pregnant women
for chlamydia before they give birth, to protect the baby.
Find out
more on the World Wide Web and via phone:
American
Social Health Association - Chlamydia
Centers
for Disease Control: Chlamydia
or call
the
CDC Sexually
Transmitted Disease hotline, (800) 227-8922.
Trained health professionals are available to answer your questions
and provide referrals 24 hours a day, 7 days a week. All calls are
private, personal and confidential.
Written by
Kara Gavin
###
(Return
to press releases)
|
