For women whose partners used condoms, chlamydia was reduced by three percent and gonorrhea by 34 percent. In all likelihood, condom use was inconsistent, and the spermicides used with caps or diaphragms may have provided added protection.

Surgical procedures such as IUD fitting, abortion, D-and-C, fetal monitoring, salpingography (a procedure where the tubes are outlined with a dye to check for blockage) can cause chlamydia to spread higher and affect the lining of the uterus and the tubes. Therefore it is preferable to have a negative chlamydia culture confirmed before these procedures and at the first prenatal visit.

When Your Doctor Should Suspect Chlamydia

The doctor herself should be on the look-out for chlamydia if she notes a heavy yellowish greenish discharge from the cervix, and a stain of cervical cells shows more than ten pus cells per high power field. She may also be suspicious if the cervix bleeds easily while taking the PAP smear. Sometimes there is also a characteristic yellow or yellow-greenish colour on the white swab used for taking the culture.

There are certain signs of infection in the PAP smear itself that could provide clues to chlamydia, but these are not present enough of the time to make this a reliable screening test.

Your doctor should also suspect chlamydia if you complain of urethral and or bladder irritation and pus cells are found in the urinalysis but nothing is grown on the culture.

Dr. H. Hunter Handsfield of the Seattle King Department of Public Health and his colleagues did a study of just over 1,000 women and found that if women had two or more of the following factors, this would predict 90 percent of chlamydial infections. These factors were: age 24 or less, sex with a new partner in the preceding six months, internal exam showing yellow-green discharge from the cervix; bleeding from the cervix caused by taking the culture, and finally no birth control or non-barrier birth control method.

How Often Should You Get Checked ?

Most of the time there are no symptoms, so a sexually active woman has to insist to be checked routinely at least once a year and once for every new sexual partner. When you go to your doctor for a check-up, a sample will be taken from the cervix during an internal exam.

It is especially important that women under 24 be checked every year and frequently throughout the year if they have made love with a new person. The highest incidence of chlamydia is highest in women 15 to 19 years.

Symptoms And Complications Of Chlamydial Infections

The main symptoms of the women who are fortunate enough to have warning symptoms are increased or abnormal vaginal discharge, lower abdominal pain, and pain on urination. There can also be irregular vaginal bleeding and upper abdominal pain.

The most serious complication of chlamydia is acute or chronic pelvic infection, which if left untreated or if treated incorrectly, can lead to permanent infertility, painful disabling periods and possible hysterectomy.

After one episode of PID, says the Canadian PID Society, a woman's chance of becoming infertile is 15 percent, after three episodes of PID, the risk of infertility is over 50 percent. Furthermore, after only one episode of PID, a woman has a tenfold increased risk of ectopic pregnancy (a tubal pregnancy that has to be ended surgically). Tubal pregnancies can rupture and bleed thereby causing a life threatening emergency.

Women with IUDs have a much higher risk of PID than women not using IUDs. For this reason, I do not advise IUDs as a form of birth control, especially in women who have never had any children.

The Canadian PID Society lists the following symptoms of PID: lower abdominal pain, lower back pain, fatigue, fever, vaginal discharge, vaginal bleeding, abdominal swelling and increased sedimentation rate (a general blood test which suggests inflammation). Some women also experience painful sex and painful periods. However, few women experience all these symptoms. Most experience only one or two.

The first symptom that women usually experience is low mild dull bilateral pelvic pain.