Chlamydia Transmission Question

[GotPlayed]

Here is my situation:

I have been dating my girlfriend since April 2008.  We did not sleep together until August 2008.  Before her, the most recent I had sex was in March of 2008.  The sex was protected except I received unprotected oral sex.  From April 2008- till the present, my girlfriend and I have had unprotected vaginal sex anywhere from 5-10 times.  Other than that we have always used condoms.  The most recent unprotected event was roughly 3 weeks ago.  After the most recent unprotected event I started to have burning while I urinate and discharge for which I got tested for Gonnorreah and Chlamydia.  The test just returned positive for Chlamydia.  Neg for Gonn.  I suspected that my girlfriend had cheated on me and I confronted her about it.  She is now accusing ME of giving it to HER!  She claims that she has not had sex for over a year before me.  I have been told that Chlamydia can hide itself well and a lot of people don't have symptoms.  Other than unprotected oral sex I cannot even remember the last unprotected vaginal/anal sex I have had before this because it has been soooo long.  I have already been treated with one dose of Zithromax as of today.  There is the background, here are my questions.....

1.  Is it possible that I was carrying Chlamydia all along and am just now (9 months later) displaying the symptoms and have passed it on to her?

2.  Is Chlamydia commonly transmitted to the penis from receiving oral sex?

3.  If I am unable to get to my "follow-up" appointment (work in another country, and returning there soon.  I am not certain of the availability of clinics there) is there another antibiotic I can be taking in the meantime to MAKE SURE my infection is cleared up?

4.  Is there any way to find out how recently a person was infected with this?

I know that is a lot of information and questions.  Your feedback is appreciated more than you know.  Thanks a lot!

[H. Hunter Handsfield, M.D.]

There is a slight chance you were infected first, i.e. that you were the one who brought the chlamydial infection into your relationship.  But more likely it was her.  Women can carry chlamydia for many months and easily for a year, but men usually do not carry the infection that long.  In addition, your symptoms suggest a newly acquired infection, not one you were carrying for a long time.  Finally, it sounds like you weren't recently at risk, since your previous vaginal sex was condom-protected and chlamydia is rarely acquired by oral sex (maybe never).

However, I don't see that the issue is very important.  Regardless of who first was infected, it doesn't necessarily mean that either of you was unfaithful.  Most likely the infection was carried into the relationship from some distant past partner and nobody is at fault.  This is not something for either you or your partner to get worked up about.

1) It is unlikely you were carrying chlamydia for 9 months, as I described above.

2) No.  Chlamydia rarely infects the mouth or throat and therefore is not commonly transmitted by oral sex.  This is a confusing area, because some STD education websites (and even some STD experts) don't understand this and say that chlamydia can be transmitted by oral sex.  They are wrong; the research on this is quite clear.

3) You don't need another antibiotic to "make sure" you were cured.  Azithromycin (Zithromax) is highly reliable against chlamydia.

4) There is no test to learn how long someone has been infected.  But as I said above, it really doesn't matter.  I suggest you have a heart to heart discussion with your partner and that both of you approach this situation with maturity, understanding, and mutual respect.

Thanks for the thanks about the forum.  I hope this information helps you and your partner get through this rough patch in your relationship.  Don't let an impersonal infection get in the way of a potentially rewarding relationship.  At the same time, perhaps your partner's reaction to the situation, and maybe yours as well, are saying something important about the nature and future of your relationship.

Best wishes--   HHH, MD

[GotPlayed]

Doc,

Again, I thank you for your information.  I have never posted before but have read for a while and you all do great work here on Medhelp.org.  A few follow-up questions if you have time.

1.  I took my dose of antibiotic roughly 24 hours ago and my symptoms are about the same, not clearing up.  Can I expect this to take a matter of hours, days, or weeks?

2.  I am very concerned for the well-being of my ex-girlfriend no matter how the relationship ended.  She informed me she will be seeking treatment soon.  How likely is it that this infection will cause her serious problems ie, infertility or similar.

3.  Lastly, I have always been very safe in my sexual endeavors.  Like I said, before this, I cannot even remember the last time I had intercourse without a condom other than oral sex.  Are condoms just as effective against Chlamydia as they are against other STD's?

Thanks again and Happy New Year!

[H. Hunter Handsfield, M.D.]

1) It takes a few days for the drug to work.  You can expect improvement in your symptoms to start in the next day or two, but it will take several days, maybe up to 2 weeks, for them to clear up entirely.  

2) Your concern for your partner is commendable.  There is a small chance of infertility from every chlamydial infection in a woman, perhaps more so in those with prolonged infection, as your partner might have had.  But in the absence of abdominal pain or fever (indicating fallopian tube infection), it isn't very likely.  This is something she should discuss with her health care provider, though.  She should not delay getting examined, tested, and treated.  The sooner the better.

3)  Condoms are virtually 100% protective against chlamydia.

Thanks for the thanks.  HNY to you as well.

[GotPlayed]

Doc,

Sorry to beat an old question to death but there have been more developments.

My ex-girlfriend supposedly has been tested and her results supposedly have come back negative.  Is this even possible?  As I said before, I have not had sex with anyone but her recently.

Is it possible my symptoms were a UTI or something similar and I received a false positive test?  From the research I have done, this seems unlikely, but would like your opinion.

Is there any other way Chlamydia can be transmitted (I know it is a bacteria) other than sex?  Thanks....

[H. Hunter Handsfield, M.D.]

Like most infections (pneumonia, colds, influenza, gonorrhea), chlamydia goes away without treatment.  It can take anywhere from a few weeks to several months, but it goes away.  If your sexual history is correct, your ex-girlfriend almost had to be infected, for the reasons described in my original reply.  Either her infection cleared up on its own; or maybe she had an antibiotic for something else which happened to clear her chlamydia; or her test was falsely negative.  Although false posiive tests are very rare (and therefore your own positive test is reliable), false negative tests are fairly common.  This is why it is important your partner be treated for chlamydia, regardless of her test result.

Genital chlamydial infections are transmitted only by sex.

With this, you're going to have to move on.  You are never going to know for sure who was infected first and when.  The important thing is that your infection has been treated and cured, and you no longer have any responsibility for your ex-gf's health.  It is time to put all this behind you.