Chlamydia Symptoms: When Do They Appear & How Long Do They Last?

Chlamydia trachomatis infection is often asymptomatic (70% women, 50% men). When symptoms occur:

Timeline

• Incubation: 1–3 weeks post-exposure (range 5–30 days).
• Duration without treatment: Weeks to months; can persist intermittently for years.
• With treatment: Symptoms resolve in 1–2 weeks (azithromycin 1g single dose or doxycycline 100 mg BID × 7 days).

Common Symptoms

Women	Men
Abnormal vaginal discharge	Urethral discharge (watery/mucoid)
Dysuria	Dysuria
Intermenstrual/postcoital bleeding	Testicular pain/swelling (epididymitis)
Lower abdominal pain	Rectal pain/discharge (if receptive anal)
Rectal symptoms

Complications of Untreated Infection

• PID (women) → tubal factor infertility, ectopic pregnancy, chronic pelvic pain.
• Epididymoorchitis (men) → infertility.
• Reactive arthritis (triad: urethritis, conjunctivitis, arthritis).
• Perinatal transmission → neonatal conjunctivitis, pneumonia.
• Increased HIV acquisition/transmission.

Testing & Partner Management

• NAAT (urine, swab) – gold standard.
• Test for gonorrhea, HIV, syphilis concurrently.
• Expedited partner therapy (EPT) where legal.
• Abstain until 7 days after treatment completion (both partners).

Annual screening recommended for sexually active women <25 and at-risk older women.