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Chlamydia - effects on the penis and vagina
This sexually transmitted infection merits a page all to its own because it is now the most common sexual disease. But one of its biggest problems is that very often it does not produce any symptoms until it's well-established, by which time things can be very serious - at least for women. The odd thing is that for men, chlamydia is often nothing more than a minor irritation around the penis. If you transmit it to a woman, however, it can result in her suffering infertility or ectopic pregnancy.
Symptoms in men include a mild pain when urinating and/or a small amount of white or clear thin discharge or thick pus-like discharge from the penis. You may also experience pain or swelling of your scrotum, because the chlamydia bacteria can travel up the urethra to the epididymis and into the tubes which carry sperm out of the testicles. This may result in infertility which is sometimes only discovered when a couple are trying to conceive and cannot do so. And the link with chlamydia may never be made, either by the couple or their doctor.
Symptoms in women include vaginal discharge, pain during urination, stomach pain and vaginal bleeding after intercourse. Sad to say, these may only develop when the infection is advanced, by which time the chances of infertility or pelvic inflammatory disease are also quite high.
Chlamydia takes one to three weeks to show up after exposure, although between 10% and 20% of men who are infected don't develop any symptoms at all. And in two studies conducted by the US military, 10% of men tested were infected but didn't know it! Barrier contraception (a condom) obviously provides protection against infection since the bacteria cannot enter the urethra in your penis when you have intercourse.
Unfortunately, up to an amazing 80% of women will show no symptoms until they have a serious reproductive problem: and when you consider this fact alongside the large number of men who show no symptoms even when they are infected, you can see why chlamydia is spreading so rapidly. Chlamydia is especially common among people under 25 years of age.
In the past, the test for chlamydia involved putting a probe up your urethra (the tube which emerges at the end of your penis) and sampling the resultant smear for bacteria. This was rather unpleasant, not to say painful, so it's pleasing to know that a new test has become available, one which uses only a urine sample.
The only good news about this insidious infection is that it's easily curable with antibiotics. It is crucial that your sexual partners are treated as well, since when you have this infection, you will pass it on to about 50 or 60% of the people you have sex with. So getting treated and then returning to unprotected sex with your partner can be a swift route to reinfection.
This is an infection of the epididymis, which is the tubing on the back of the testicles through which sperm travel as they mature on their journey from testicle to vagina (or wherever else your semen ends up). Your testicles may feel painful or there may be localized swelling and hotness on the epididymis itself.
Such an infection develops when bacteria get into your epididymis via your penis and urethra. Gonorrhea and chlamydia are often associated with epididymitis, although sometimes the tests for those diseases prove negative and there is no obvious explanation of where the infection came from. And although epididymitis is not especially common, it can sometimes be problematic, recurring time and again despite the administration of antibiotics. If it doesn't clear up with a course of antibiotics, doctors tend to investigate the whole of your urinary tract, including your kidneys and urethra to make sure, for example, that there are no infections or structural anomalies where bacteria may be hiding.
As you know, the urethra is the tube which runs along the length of the penis and allows semen and urine to flow out of the body. It's one of those places which can easily harbor bacteria - as, unfortunately, can the vagina. Any infection or inflammation of the urethra is called urethritis, and when the bacteria causing the infection cannot be identified, the diagnosis is likely to be "non-specific urethritis" or NSU.
The typical symptoms of urethritis include a discharge of pus from your penis (even if it's only a drop or two in the morning when you wake up), a burning sensation during urination, itching in your urethra at other times, or, bizarrely, no symptoms at all. (In which case, you might reasonably ask, how do you know you have it? The answer, sadly, is that you can infect your partner and she may develop some nasty symptoms.)
So, if you have any of those symptoms, you should see a doctor, who will check with a swab to see if lab tests can identify any bacteria. As I mentioned before, gonorrhea and chlamydia bacteria are the most likely candidates - and they are often found together. Once again, though, your sexual partners all need to be tested and checked and until the results come through, you should abstain from sex in case they reinfect you.
The problem is that up to 40% of men who are treated for urethritis will experience a recurrence within six weeks. This may indicate that the infection has reached the epididymis or the prostate. This usually means a longer course of stronger antibiotics, but for most men the condition will gradually clear up in time. About 25% of men will experience persistent difficulties which don't respond to antibiotics; the good news, however, is that even hard-core cases usually clear up by themselves over time.
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