The clinical signs that would (or should) make a women's health care provider suspicious about chlamydia primarily are those of cervicitis: abnormal appearing mucus or discharge from the cervic, edematous (swollen) cervical ectopy (a reddened, beefy appearance to the cervicx), and induced bleeding (a swab in the cervix, or collecting a pap specieman, causes bleeding). Also, clinical evidence of pelvic inflammatory disease, with pelvic tenderness on examinatio; or evidence suggesting a urinary tract infection, but with negative culture tests for common UTI bacteria. However, all these are poorly predictive except in younger women. Any of these signs (or all of them together) do not suggest particularly high risk for chlamydia in a 40 year old women, but would be highly suggestive in a 20-year-old.
To answer your second question, it probably is extremely rare for chlamydia to persist 10 years. The best research follwed women for 4-5 years, and only a very few who didn't receive treatment still were infected 4 years after the initial diagnosis. Also, longstanding chlamydia is an unlikely explantion for recurrent cystitis. Among other things, it is likely your health care providers treated most of your cystitis episodes with antibiotics. Most such antibiotics also would have cured chlamydia, if it were present.
Thanks for your thanks about the STD Forum. I hope this information is helpful.
HHH, MD
YES, this was very helpful. This is very reassuring to have a precise and competent reply. Thank you very much Doctor Hunter Handsfield.