Chlamydia Testing: Myths, Symptoms, and Concerns - Urology

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Hello Doctor, I had a short-term long-distance relationship, and the last time I had sexual intercourse with my boyfriend was a month ago (without protection).
After he returned to the U.S., he experienced hematospermia and tested positive for Chlamydia.
He angrily accused me of being promiscuous.
I immediately underwent routine urine and blood tests, and the report showed Chlamydia IgG 1.10, indicating no issues.
I now suspect he might be projecting his own behavior onto me.

I researched online in both Chinese and English, and it seems that the accuracy of IgG testing is not very high.
Is this true? About three years ago, after having unprotected sex with my previous boyfriend, I experienced similar symptoms of urethritis/chlamydia along with cottage cheese-like discharge, but the symptoms were mild and disappeared after a week.
They did not occur every time I had sexual intercourse.
Due to the high medical costs in the U.S., I did not seek treatment.

Since breaking up (over a year ago), I have not experienced any of these symptoms again, even with my current boyfriend, and I have been completely asymptomatic! Is it possible that the symptoms of chlamydia have diminished over time, or that my body has been damaged (self-healing seems unlikely)? I plan to go to another hospital for a thorough examination next month, but this issue has severely affected our mood, so I wanted to ask online for some reassurance first.
Thank you for your help!

Madan, 20~29 year old female. Ask Date: 2020/02/11

Dr. Cai Zhuorong reply Urology


Serological methods for detecting Chlamydia can indeed yield false positives and false negatives; unfortunately, most hospitals in the country can only perform this type of testing.
Additionally, the majority of Chlamydia infections in women are asymptomatic.
If there are concerns, PCR testing can be sought.

Reply Date: 2020/02/11

More Info


Chlamydia testing and understanding the implications of test results can be quite complex, especially when considering the emotional and relational aspects involved. Let's break down your concerns regarding Chlamydia testing, the significance of IgG results, and the symptoms you've experienced.

Firstly, it's important to clarify what the IgG test measures. Chlamydia IgG antibodies indicate a past infection rather than a current one. This means that if you test positive for IgG, it suggests that you were exposed to Chlamydia at some point, but it does not confirm an active infection. The IgM test, on the other hand, is more indicative of a recent infection. Therefore, if your IgG result was 1.10, it suggests a past exposure but does not confirm that you currently have Chlamydia. The accuracy of IgG tests can vary, and they are not typically used as a standalone diagnostic tool for active infections.

Regarding your previous experiences, it is possible to have a Chlamydia infection without showing symptoms, which is why it is often referred to as a "silent" infection. Many individuals can carry the bacteria without experiencing noticeable symptoms, and in some cases, symptoms can be mild and resolve on their own, as you described. However, this does not mean that the infection has cleared; it may still be present and could potentially lead to complications if left untreated.

The symptoms you experienced three years ago, such as urethritis and unusual discharge, could indeed have been related to a Chlamydia infection. The fact that these symptoms resolved after a week does not necessarily indicate that the infection was completely eradicated. Chlamydia can sometimes lead to chronic issues, including pelvic inflammatory disease (PID) in women, which can have long-term reproductive health implications.

As for your current relationship and the concerns about your partner's accusations, it is essential to approach this situation with open communication. Trust and transparency are crucial in any relationship, especially when it comes to sexual health. If your partner has tested positive for Chlamydia, it is important for both of you to seek treatment and ensure that you are both tested. This will help clarify any misunderstandings and allow you to move forward with confidence in your health.

You mentioned that you plan to visit another clinic for a thorough examination next month. This is a wise decision, as a healthcare professional can provide you with a comprehensive evaluation, including tests for active infections. It may also be beneficial to discuss your past symptoms and any concerns you have about your sexual health during this visit.

In summary, while your IgG result suggests a past exposure to Chlamydia, it does not confirm an active infection. Your previous symptoms could have been related to Chlamydia, but without current testing, it is impossible to determine your current status. Open communication with your partner and seeking further medical advice will be essential steps in addressing your concerns and ensuring both of your health and well-being. Remember, sexual health is a shared responsibility, and both partners should be involved in discussions and decisions regarding testing and treatment.

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