Women Age 25 and Younger Should be Aware of Risk of STD: Chlamydia
Treponema pallidum (syphilis), Neisseria gonorrhoea (gonorrhoea), Chlamydia trachomatis (chlamydia), Trichomonas vaginalis (trichomonas) and HIV have all been classified as high priority for inclusion in the STI prevalence survey. The first four STI are curable, cause considerable adult and infant morbidity and mortality, are spread primarily by sexual transmission and are often asymptomatic in women.
In the United States, about 1 million cases of gonococcal infection are reported every year, but experts believe that there may be at least 2 million more cases that are never treated by a doctor. Highest rates for gonococcal infections are in young men 20 to 24 years old, followed by older teen males ages 15 to 19. Highest rates for females are in teens ages 15 to 19.
When one STD is present, others may be also. For example, many people who have gonorrhea also have another common STD called chlamydia. It's wise, therefore, for medical professionals to look for and treat other STDs when a GC infection is diagnosed or suspected.
Chlamydia is a bacterial infection of your genital tract that spreads easily through sexual contact. You may not know you have chlamydia because the signs and symptoms of pain and fluid discharge don't show up right away, if they show up at all. Many people experience no signs and symptoms.Chlamydia isn't difficult to treat once you know you have it. If not treated, chlamydia can spread through the uterus to the fallopian tubes, causing pelvic inflammatory disease (PID). PID is an infection of the entire female reproductive system. It can cause serious damage, such as infertility. PID also increases the risk of tubal pregnancy (a pregnancy outside the uterus).
Chlamydia can be transmitted from the mother to her baby during birth. It can cause eye infections and lung infections in the newborn baby. Contamination of the hands with genital discharge may lead to a conjunctival infection following contact with the eyes. Babies born to mothers with infection of their genital tract frequently present with chlamydial eye infection within a week of birth (chlamydial “ophthalmia neonatorum”), and may subsequently develop pneumonia.
More than 4 million urogenital Chlamydia trachomatis infections occur in the United States annually. They occur in young, sexually active persons from all socioeconomic groups, with prevalence ranging from 5 percent to 20 percent. Women, especially, bear the burden of disease, with consequences of genital infections ranging from pelvic inflammatory disease to ectopic pregnancy and infertility. These sequelae are associated with a large economic burden.Because up to 80 percent of infected women are asymptomatic and therefore do not seek medical care, screening of young, sexually active women has been recommended.
Chlamydia may be acquired jointly with gonorrhea and/or syphilis, so individuals with one sexually transmitted disease must be screened for other sexually transmitted diseases as well. Untreated chlamydia can lead to pelvic infection and infertility.Only approximately 30% of women will have symptoms due to chlamydia -- hence screening sexually active women for chlamydia is necessary to diagnose and treat asymptomatic women in order to decrease the risk of developing complications. Women who do have symptoms may note vaginal discharge, burning on urination, or abdominal pain.
Few studies of the prevalence of chlamydial infection in U.S. military populations have been published, and there have been no studies using DNA-amplification techniques among women not seeking health care. Because adolescents have the highest prevalence of disease and most military recruits are young, we conducted a large prevalence study and risk-factor analysis of female recruits from throughout the United States who began basic training at Fort Jackson, South Carolina. We performed this study to determine the extent of infection, assess the feasibility of screening urine specimens for C. trachomatis by the ligase chain reaction, and assess which epidemiologic correlates would be useful for implementing an effective chlamydia-control program for female recruits.
In the United States, adolescent girls and young women are not being routinely screened for chlamydia, the most commonly reported sexually transmitted disease in the United States, experts warned today at the annual meeting of the American College of Obstetricians and Gynecologists (ACOG) underway in San Diego.
"Although ACOG, the Centers for Disease Control and Prevention (CDC), and the US Preventive Services Task Force recommend annual screening for chlamydia in all sexually active women age 25 and younger, as well as other asymptomatic women at high risk for infection, studies show it isn't happening," Dr. Stanley Zinberg, ACOG's deputy executive vice president, said in a written statement.
It's estimated that 2 million cases of chlamydia go undiagnosed and untreated each year in the US, often leading to pelvic inflammatory disease, which can cause infertility and ectopic pregnancy. An ectopic pregnancy occurs when the fertilized egg doesn't implant on the wall of the uterus, but in another location, such as the fallopian tubes. If undiagnosed, an ectopic pregnancy can result in serious illness or death.
ccording to ACOG, a recent study by the CDC and the Agency for Healthcare Research and Quality found that routine chlamydia screening is highly cost-effective, with the potential to prevent an estimated 60,000 cases of pelvic inflammatory disease, 8,000 cases of chronic pelvic pain, and 7,500 cases of infertility annually if screening guidelines are followed.
Some healthcare providers wrongly believe that STD prevalence is low in their practice, and this may explain why they're not screening for chlamydia, ACOG points out in a statement.
"As physicians, we need to dispel the stigma and bias that so often surround STDs," Dr. David E. Soper, professor of ob-gyn at the Medical University of South Carolina in Charleston said in a statement. "The reality is that STDs are diseases of humanity. Humans become infected doing what humans do."