Bacterial STIs are caused by bacteria passed from person-to-person during sexual activity. There are three infections in this category: Chlamydia, Gonorrhea, and Syphilis.
What is chlamydia?
Chlamydia is a sexually transmitted bacterial infection caused by Chlamydia trachomatis bacteria. It is among the most common STIs in the world.
In Canada, the majority of cases are aged 15-24, and more than twice as many reported cases are from women than from men.1 Early data for 2004 shows that the rate of chlamydia infection rose by 74.2 percent from 1997-2004. In 2003, that rate of chlamydia infection was about 180 infected people for every 100,000 people.2
How do you get chlamydia?
Chlamydia can be passed along by having unprotected oral, anal or vaginal sex.
Using condoms can help prevent the spread of chlamydia. Condoms and dental dams can also be used for protection during oral sex.
Chlamydia bacteria can infect the cervix, rectum or the urethra. Sometimes, it can also infect the throat after performing oral sex. Infection can also spread to the eyes by touching an infected area and then touching the eye. In places where treatment is not available, these eye infections can be very serious and can cause blindness.
Most people infected with chlamydia will not have symptoms. For those who do have them, they usually appear between 2 days to 2 weeks after contracting the infection, but it can take longer. Chlamydia is typically more serious for women than for men, but women are also less likely than men to have symptoms.
For women, symptoms may include:
- burning while urinating
- vaginal discharge or a change in normal discharge
- bleeding between menstrual cycles, or during/after intercourse
- increase in pain during menstruation or during intercourse
- abdominal or lower back pain
- occasionally causes fever and chills
For men, symptoms may include:
- itching of the penis
- pain while urinating
- discharge from the penis
- in some cases, there may also be pain or swelling of the testicles
- about half of men will have no symptoms and many will have only mild symptoms
For women and men, symptoms of rectal infection may include:
- Painful bowel movements
Testing for chlamydia can be performed with a swabbing of the infected area (cervix, urethra, rectum) or with a urine sample. Remember, chlamydia testing is not included in a woman’s regular Pap smear test.
A health care professional may ask for the contact information of recent sexual partners or ask that you inform them that they need testing.
Chlamydia infection can be cured with antibiotics, usually with a single dose.
Follow your health professionals’ instructions, and, as with any medication, take as directed and complete the entire duration of the prescription, even if your symptoms disappear.
Impact if not treated
In women, chlamydia can cause Pelvic Inflammatory Disease (PID), which means that the infection has spread to the reproductive organs. This can cause infertility, chronic pelvic pain and ectopic pregnancy. Symptoms of PID can include foul-smelling discharge from the vagina, high-fever or muscle aches.
Chlamydia can also cause problems getting pregnant or during pregnancy, including miscarriage, preterm birth and low birth weight. Sometimes, the infection can be passed from mother to child during birth, causing a lung or eye infection or even pneumonia.
For men, chlamydia can sometimes cause prostate swelling and inflammation of the urethra and Epididymis. In very rare cases, it can cause infertility in men.
In rare cases it can also cause Reiter’s Syndrome, which causes symptoms such as rashes, sores and arthritis-like joint pain. Chlamydia infection can also increase the chance of transmitting HIV.
What to tell your partner
Like many sexually transmitted infections, many people who are infected with chlamydia will have no symptoms and will be unaware they are infected.
For this reason it is very important to be honest with your partner(s), and also to be honest with your health care provider about your sexual history. Chlamydia is curable with antibiotics, but it can cause long-term damage such as infertility if it is not treated.
Explain to your partner what testing and treatment involves, and you may want to offer to accompany them for support.
When can I have sex again?
Ask your health care provider. Generally, it will be safe to have sex one week after both you and your partner have completed the entire duration of antibiotic treatments, provided all symptoms have disappeared. You can reacquire chlamydia immediately after your infection has been cured.
Remember, your recent sexual partner(s) have to be tested, and if they are also infected, you will need to wait until they have finished treatment and been completely cured before having sex.
It is always a good idea to use condoms to prevent STIs, but they are particularly important after you or a partner has been treated for an STI.
What is gonorrhea?
Gonorrhea is a bacterial Sexually Transmitted Infection. It is caused by the bacteria Neisseria gonorrhoeae. Gonorrhea is also known as “The Clap”.
Though gonorrhea infection was on the decline, the number of people with gonorrhea infection is on the rise in Canada. The bacteria are also becoming resistant to certain types of antibiotics. From 1997 to 2004 the number of reported cases of gonorrhea nearly doubled in Canada, rising from 14.9 to 28.9 per 100,000.1
How is gonorrhea spread?
Gonorrhea is spread through unprotected oral, anal and vaginal sex with an infected person. It can also be spread from an infected mother to her baby during birth.
Condoms can help prevent the spread of gonorrhea during anal or vaginal sex, and condoms or dental dams can be used for protection during oral sex.
Gonorrhea infection may occur in the rectum, penis, cervix or throat.
Both men and women may have no symptoms, and sometimes a woman’s symptoms may be mistaken for a bladder or urinary tract infection.
Remember, infected people who have no visible symptoms can still transmit the infection to others.
For those who do have symptoms, they usually appear within two to seven days of infection, but this can take up to 30 days. Throat infections may cause a sore throat, though symptoms are rare.
Many women do not have symptoms. Those that do have symptoms may experience:
- Burning during urination
- Rectal pain, itching, bleeding discharge
- Vaginal bleeding or pain
- Yellowish-white vaginal discharge
Some men may have very mild symptoms or no symptoms at all. Those who do may experience:
- Discharge from the penis
- Burning when urinating
- Painful/swollen testicles
Symptoms of rectal infection may include:
- rectal discharge, itching or bleeding
- painful bowel movements
For men and women, testing for gonorrhea requires a swabbing of the infected area or a urine sample. It is important to remember that this test is not part of a regular pap test screening for cervical cancer.
Oral antibiotics can usually cure a gonorrhea infection in just one dose, but it can be reacquired immediately after treatment. Some may be resistant to certain antibiotics. Your recent sexual partners should also be informed as they may require testing and/or treatment.
Impact if not treated
Untreated gonorrhea can cause Pelvic Inflammatory Disease (PID) in women, which can cause chronic pelvic pain, infertility and ectopic pregnancy.
What is syphilis?
Syphilis is a bacterial STI that is caused by the bacteria Treponema pallidum. It is generally a very rare STI, but it can cause serious and permanent damage to the body if it is not cured. In some rare cases, particularly where treatment is not available, syphilis infection can cause death. Syphilis infection is very uncommon in Canada, but the number of cases is rising very quickly. From 1997 to 2004 the rate rose 908%, from 0.4 cases per 100,000 people to 3.9 cases per 100,000 people.(1) These cases were mostly among men who have sex with men.
How do you get syphilis?
Syphilis is a sexually transmitted infection that is passed along through anal, vaginal or oral sex. An infected pregnant woman can also pass along the infection to her unborn child.
The best way to help prevent syphilis is to practice safer sex practices by using condoms each and every time you have sex. Condoms or dental dams can be used for protection during oral sex.
Untreated Syphilis infection can progress through four stages: primary, secondary, latent and tertiary. It is most infectious in the first two stages, and does the most harm during the latent and tertiary stage. Syphilis produces a wide range of symptoms that mimic other illnesses. For this reason it has become known as “the great imitator”, and is often very difficult to diagnose.
Syphilis produces different symptoms at each stage of infection. However, some people may not experience symptoms at all during some stages, and others may have some symptoms and not others. These people with few or no symptoms are still infectious, and can still progress to later stages of Syphilis infection.
As a person progresses from stage to stage, the symptoms of syphilis may go away without treatment. This does not mean that the infection is gone. A person may think that the infection has cleared on its own after symptoms disappear, but the infection will persist and long-term infection can cause serious and permanent damage to the heart, brain, bones or blood vessels.
Primary Infection Symptoms
The main symptom of primary syphilis is a single open sore at the point of infection, typically on the genitals, anus or throat. This sore will typically appear Between 10 to 90 days after infection (21 days on average).
This sore will heal spontaneously in 3-8 weeks, but this does not mean that the syphilis infection is gone or that the person is no longer infectious. Because the sore is painless and heals on its own, some people may not seek treatment, and may even forget about the sore entirely after a while. If you develop this sore, it is very important to seek treatment.
Secondary Infection Symptoms
Symptoms of secondary Syphilis generally occur three months after contracting the infection. They mimic flue symptoms and may include hair loss (including eyebrows and eyelashes), muscle and joint pain, rashes (particularly on the palms and soles of the feet), and fever and swollen glands. People with secondary syphilis may also generally feel unwell and you may lose weight.
Again, these symptoms will typically disappear on their own, but this does not mean that the person is no longer infected or that they are can no longer transmit the infection to others. Secondary symptoms usually lasts 3 to 12 weeks, but may persist for years until the infection moves into the latent stage. Once in the latent stage, a person may still have “relapses” in which secondary symptoms will reappear.
Latent Infection Symptoms
After primary and secondary symptoms disappear, an infected person will enter a latent stage of syphilis, in which they will have no symptoms. However, this does not mean they are no longer infected, and in the early latent infection the person may still transmit the infection to others. During this time, the syphilis bacteria may continue to multiply and infect the body. A person in the latent stage may occasionally return to the symptoms of secondary infection. This latent stage may last for one year to 30 years.
Tertiary Infection Symptoms
Tertiary syphilis occurs in 40% of untreated infected persons. This stage is very destructive. It is the stage at which the long-term damage caused by syphilis bacteria results in various major health complications. These complications can include major internal or external sores, serious cardiovascular and mental health problems, and damage to other organs such as the eyes and ears. In some cases, these complications can lead to death.
Syphilis testing is performed through a blood test, or by a swabbing from an infected sore.
Syphilis can be cured with antibiotics. Remember, a person can reacquire syphilis infection, so their partner(s) should also be tested.
Impact if not treated
Untreated Syphilis can cause potentially life-threatening complications, and permanent damage to the brain, heart, bones, and blood vessels. Sometimes, syphilis can cause mental disorders or neurological problems. In very rare cases, untreated syphilis infection can be fatal. Syphilis is curable with antibiotics but over time it can cause permanent damage to your health, so it’s important to get tested for STIs if you are at high risk or if you are experiencing symptoms.
Pregnant women can pass syphilis on to their unborn children, and children infected with syphilis at birth or before have what is called congenital syphilis. Congenital syphilis is very serious, and can cause serious medical complications or death.
Because Syphilis can cause lesions and sores on the genitals or anus, it increases the risk of HIV transmission.
Is it contagious?
Syphilis is most infectious during the primary and secondary stages, and can also be infectious during the early latent stage, particularly during relapses to secondary stage symptoms.
What to tell your partner
Syphilis is easily treatable, but the longer it goes untreated, the more harm it can cause. Your partner will need to be tested and/or treated immediately. It is very important to be honest with your sexual partners. The earlier your partner(s) know they may be infected the more likely they will be to avoid long-term health complications.
When can I have sex again?
You should not have sex again until you have been treated, your symptoms have disappeared, your tests for syphilis are negative and your health care provider informs you that you are no longer infectious. Your partner(s) should also be tested.
Did You Know?
In 2006, a study followed 2419 people who had attended an STI clinic. Every three months following their visit to the clinic, the study’s participants were retested for chlamydia, gonorrhea and trichomonas. The study found that about one in four of the women and about one in seven of the men tested positive for at least one new STI within the next year.
Peterman TA et al; RESPECT-2 Study Group (U.S.). High incidence of new sexually transmitted infections in the year following a sexually transmitted infection: a case for rescreening. Ann Intern Med. 2006 Oct 17;145(8):564-72.