Chlamydia is one of the most common sexually transmitted infections (STIs) globally, caused by the bacterium Chlamydia trachomatis. It can be transmitted through vaginal, anal, and oral sex. Despite its prevalence, chlamydia often goes unnoticed, as most individuals do not experience noticeable symptoms. However, untreated chlamydia can lead to serious complications, particularly affecting reproductive health.

The good news is that chlamydia is both preventable and highly treatable. Early diagnosis and appropriate antibiotic treatment can effectively cure the infection and prevent long-term damage. This article explores how chlamydia is treated, the most commonly used medications, potential side effects, preventive strategies, and ways to manage the condition long-term.

Why Chlamydia Treatment Is Important

Chlamydia often presents no symptoms, especially in its early stages. Because of this, many people may be infected without knowing it. If left untreated, chlamydia can lead to severe complications such as pelvic inflammatory disease (PID), infertility, and an increased risk of ectopic pregnancy.

Timely treatment achieves three key goals:

  • Eliminate the bacterial infection

  • Prevent transmission to sexual partners

  • Avoid long-term reproductive health complications

Chlamydia can be cured entirely with antibiotics, and treatment is most effective when started early. However, reinfection is common—often because sexual partners have not been treated simultaneously. For this reason, healthcare providers typically recommend that both partners receive treatment.

Antibiotics for Chlamydia: Main Options

The most effective and widely used treatments for chlamydia are antibiotics. Two medications are primarily prescribed:

  • Doxycycline

  • Azithromycin

Your provider will recommend a regimen based on your medical history, lifestyle, symptoms, and whether you're pregnant.

Doxycycline: The First-Line Treatment

Doxycycline is a tetracycline-class antibiotic and is typically the first-line treatment for non-pregnant adolescents and adults with chlamydia. It works by inhibiting bacterial growth, effectively halting the infection.

Recommended dosage:
100 mg twice daily for seven days.

Why it's preferred:

  • Highly effective, including for rectal and oropharyngeal chlamydia infections.

  • Shown to be more successful in eliminating Chlamydia trachomatis from the rectum than azithromycin.

Common side effects:

  • Nausea or vomiting

  • Diarrhea

  • Appetite loss

  • Dry mouth

Serious side effects (seek medical help):

  • Severe headache

  • Blurred or double vision

  • Allergic reactions (e.g., hives, rash, difficulty breathing)

  • Sensitivity to sunlight or skin blistering

Pregnancy considerations:
Doxycycline is not recommended during pregnancy due to potential effects on fetal bone and tooth development. Pregnant individuals should discuss alternative treatments with their doctor.

Azithromycin: A One-Time Dose Option

Azithromycin is a macrolide antibiotic used as an alternative to doxycycline, especially for those who are pregnant or cannot commit to a seven-day regimen.

Recommended dosage:
A single 1-gram dose taken orally.

Advantages:

  • Convenient one-time treatment

  • Suitable for pregnant people

  • Easier for individuals who struggle with multiple-day prescriptions

Common side effects:

  • Stomach cramps

  • Diarrhea

  • Nausea and vomiting

  • Headaches

Serious reactions to monitor:

  • Irregular heartbeat

  • Swelling of the face, lips, or throat

  • Difficulty breathing or severe dizziness

Despite its convenience, azithromycin may be less effective than doxycycline for rectal infections. Your provider may perform follow-up testing to ensure the infection is resolved.

What To Expect During and After Treatment

Once treatment begins, symptoms (if present) usually improve within a few days. However, it’s crucial to complete the full course of antibiotics—even if you start to feel better.

After treatment:

  • Avoid sex for 7 days after completing antibiotics to ensure the infection is cleared.

  • Inform all recent sexual partners so they can also be tested and treated if necessary.

  • Consider retesting after three months, especially if there’s a risk of reinfection.

Remember, antibiotics can treat chlamydia but cannot reverse any long-term damage from delayed treatment. The earlier you address the infection, the better.

Chlamydia in Pregnancy

Chlamydia during pregnancy can lead to complications like preterm birth or transmission of the infection to the baby during delivery, potentially causing eye infections or pneumonia.

Azithromycin is typically used during pregnancy because of its safety profile. Pregnant individuals are usually retested three to four weeks after treatment and again in the third trimester to ensure the infection has not returned.

Preventing Reinfection and Transmission

Reinfection is a major concern with chlamydia. Up to 25% of individuals are reinfected within months, often due to untreated partners.

Here are key steps to avoid reinfection:

  • Ensure your partner(s) are tested and treated before resuming sexual activity.

  • Use condoms consistently, even during oral and anal sex.

  • Abstain from sex for 7 days after completing treatment.

  • Get retested in 3 months, especially if you have a new partner.

  • Avoid douching, which can disrupt the vaginal flora and increase STI risk.

Managing Chlamydia Long-Term

Chlamydia is curable, but its long-term effects can be serious if not treated promptly. If the infection spreads to the uterus and fallopian tubes, it can cause PID, which may result in:

  • Chronic pelvic pain

  • Infertility due to fallopian tube scarring

  • Risk of ectopic pregnancy

In people with male reproductive systems, untreated chlamydia can cause epididymitis, leading to pain and potential infertility.

Adhering to treatment, completing all prescribed doses, and following up with your provider are crucial steps to prevent these outcomes.

Chlamydia and STI Testing

Because chlamydia often causes no symptoms, routine screening is essential, especially if you're:

  • Under 25 and sexually active

  • Over 25 with new or multiple partners

  • Pregnant

  • At higher risk (e.g., previous STI, men who have sex with men)

Testing typically involves a urine sample or a swab of the affected area (vagina, cervix, rectum, or throat). Many clinics offer confidential, low-cost testing options.

Supporting Your Health Through Lifestyle Choices

While antibiotics are the cornerstone of treatment, lifestyle choices play a key role in managing and preventing chlamydia:

  • Get tested regularly as part of your routine health checkups.

  • Avoid risky sexual behaviors, such as having multiple partners without protection.

  • Communicate openly with partners about STI testing and protection.

  • Seek care promptly if you notice any symptoms like unusual discharge, pain during sex, or burning during urination.

Final Thoughts

Chlamydia is common and often silent, but it doesn’t have to lead to long-term health issues. Through regular screening, prompt treatment with antibiotics like doxycycline or azithromycin, and protective sexual behaviors, you can manage and eliminate the infection.

Open communication with your healthcare provider and sexual partners is key to ensuring full recovery and preventing reinfection. By staying informed and proactive, you can take control of your sexual health with confidence.