Most men don’t get a clear sign they have chlamydia.

Experts estimate that as few as one in 10 experience symptoms, which increases the risk of long-term health issues, as well as the chances of passing it on to a partner.

When symptoms do occur, they can include a burning sensation when urinating, burning or itching at the opening of the penis, swelling or pain in the testicles, or discharge from the penis.

In some cases, chlamydia can infect the rectum and lead to pain, bleeding, and discharge.

What is chlamydia?

Chlamydia is an infection caused by the chlamydia trachomatis bacteria. It spreads primarily through vaginal, anal or oral sex with someone who is infected. It is the most commonly reported sexually transmitted infection in Canada, but it is sometimes called the “silent” infection because the majority of people who are infected do not have any symptoms and are unaware of their condition. 

Rates in Canada have been steadily rising since 1997[i], with the number of reported cases jumping from 87,283 in 2009 to 117,008 in 2018[ii] -- an average increase of about 5 per cent per year.

More than three-quarters of chlamydia cases reported in Canada in 2018 were in patients aged under 30. It disproportionately affects sexually active youth and young adults.

If left untreated, chlamydia can cause serious health problems and lead to infertility. The only way to find out if you have it is to be tested. It can be diagnosed via swabbing or a urine sample and is treated with antibiotics.

How does it spread in men?

Chlamydia is a bacterial infection that is usually transmitted through vaginal, anal and oral sex, or through contact with infected genital fluids. 

Chlamydia cannot be spread by sitting on toilet seats, swimming in a pool or sharing baths, towels or cutlery. It also can’t be spread through kissing, although a throat infection can spread to a partner who is receiving oral sex.

In addition to being transmitted through sex, chlamydia can also be spread via genital-to-genital contact, sharing sex toys that are not washed and through infected vaginal fluid or semen getting into your eye.

Those who have been treated for chlamydia and recover can get the infection again if they have sex with a person who has chlamydia.

Symptoms

Although many men don’t get symptoms, in those who do they usually surface between two and six weeks after having unprotected sex with an infected person. In other cases, they may not develop for several months.

Symptoms can come and go quickly, disappearing after only a few days. Even if symptoms disappear you may still be carrying the infection and could pass it on to others.

Common symptoms include:

• Pain when urinating

• White, cloudy or watery discharge from the tip of the penis

• Burning or itching in the urethra (the tub that carries the urine out of the body)

• Pain in the testicles

• In some cases, chlamydia infects the rectum and men can experience rectal pain, bleeding or discharge

• Eye infections can also occur due to contact with infected genitals

What happens if chlamydia is left untreated in men?

In men, chlamydia left untreated can lead to pain and swelling in the testicles, known as epididymitis. Men who do not receive treatment for chlamydia can develop scarring of the urethra, which makes urinating difficult. It can also lead to infertility. However, men generally face less severe long-term health impacts from chlamydia than women.

There have been some reports of men developing Reiter’s Syndrome, which causes inflammation and swelling of the joints, but it is rare.

Chlamydia has also been found to increase the infectiousness of and susceptibility to human immunodeficiency virus (HIV) in both men and women.

How do you test for chlamydia in men?

A urine sample is normally required to test for chlamydia. In men, a sample of discharge from the urethra may be taken for testing. The throat or rectum may also be tested for infection.

Testing is available free of charge in Canada via your family doctor or other clinics. Low-cost mobile testing options are also becoming increasingly popular for the privacy and convenience they offer.

If you’re a sexually active man under the age of 25 who has unprotected sex, you are at greater risk of infection. Regular testing is recommended.

Treatment

Chlamydia can be easily treated with antibiotics. However, it’s very important to complete your course of medication, even if your symptoms subside. Those infected with chlamydia can resume sexual activities only when directed to do so by their healthcare provider.

How can you prevent chlamydia?

Chlamydia is extremely common but practicing safe sex can help reduce the risk of getting chlamydia and other sexually transmitted infections. That includes consistently and correctly using a condom and other safe barriers. The only way to completely avoid it is to abstain from vaginal, anal, or oral sex, or to be in a monogamous relationship in which both partners have tested negative.

If you suspect you have chlamydia or are diagnosed, it’s important to tell your partners that they could have an infection. 

Those at greatest risk of contracting chlamydia in Canada include sexually active youth and young people. The risk increases for those engaging in unprotected sex with different partners. Regular testing is recommended.

[i] Choudhri Y, Miller J, Sandhu J, Leon A, Aho J, "Chlamydia in Canada, 2010-2015," Can Commun Dis Rep, vol. 44, no. 2, pp. 49-54, 2018.

[ii] Overall and sex-specific rates of reported chlamydia cases in Canada, 2009-2018: Report on sexually transmitted infections in Canada, 2018 - Canada.ca