What to Know About Chlamydia in the Throat

Chlamydia is the most common sexually transmitted disease (STD) among people 15 to 29 years of age. It is caused by a bacteria known as Chlamydia trachomatis, which can be passed from one person to the next through vaginal, anal, and oral sex. When it occurs in the mouth or throat, it is referred to as oral chlamydia.

People often suspect they have chlamydia when they get genital and urinary tract symptoms like painful urination or vaginal discharge. But those who get it through oral sex don't always connect the symptoms to the disease because they can be easily attributed to other conditions.

This article takes a closer look at the symptoms and causes of oral chlamydia. It also explains how this common STD is diagnosed, treated, and prevented.

Symptoms of Oral Chlamydia

Most of the time, people with oral chlamydia do not have any symptoms. The only major one they may have is a sore throat, which can be confused with any number of other conditions from allergies and colds to strep throat and acid reflux.

When symptoms of oral chlamydia do develop, they often include:

• Sore throat
• Redness in the mouth or oral
• Swollen tonsils
• Swollen lymph nodes in the neck
• Bumps on the tongue
• Mouth pain
• Mouth sores
• White spots in the back of the throat or tonsils
• Sores around the lips
• Mild fever
• Fatigue

Chlamydia can take anywhere from one to three weeks after sexual contact to develop, which is another reason why many don't make the connection between their symptoms and this infection.

Complications

Oral chlamydia can sometimes lead to secondary oral infections. Because the body is so busy fighting chlamydia, it is less able to fight other infections that contribute to gum diseases like gingivitis and periodontal disease. Dental pain, bleeding gums, and tooth loss are among the complications of these diseases.

Arguably, the bigger concern is that people with oral chlamydia are able to pass the infection to others. Depending on which part of the body is affected, chlamydia can lead to complications such as:

• Conjunctivitis (pink eye)
• Epididymitis (inflammation of the spermatic cord)
• Pelvic inflammatory disease (PID) (infection of the female reproductive organs)
  
• Ectopic pregnancy (implantation of a fertilized egg outside of the womb)
• Reactive arthritis (joint pain and swelling triggered by an infection)
• Male or female infertility

In addition, having chlamydia increases the risk of HIV. This is because chlamydia triggers an inflammatory response that draws white blood cells, called CD4 T-cells, to the site of the infection.

These are the very cells that HIV targets for infection. Because of this, chlamydia ends up "helping" HIV establish an infection.

Causes

A person can get oral chlamydia by performing oral sex on someone who is infected. This includes oral-penile sex, oral-vaginal sex, and oral-anal sex.

Chlamydia trachomatis can also be transmitted from the throat of someone with chlamydia to the penis of someone without the infection. Interestingly, research suggests that chlamydia is unlikely to be passed from the throat to the vagina or rectum.

All current evidence indicates that chlamydia cannot be passed through kissing.

Certain risk factors can increase a person's risk of getting chlamydia, most notably:

• Having multiple sex partners
• Not using condoms consistently
• Being sexually active before age 25
• History of STDs
  

Oral chlamydia is far less common than genital chlamydia. Research shows that around 10% of people who visit an STD clinic have genital chlamydia, but only around 1.5% have oral chlamydia.

Diagnosing Oral Chlamydia

Getting a swab test done is the most accurate way to know whether you have oral chlamydia. After swabbing the mouth and throat, the healthcare provider sends the sample to a lab for evaluation using a technology known as a nucleic acid amplification test (NAAT).

NAAT tests multiple the genetic material of bacteria (or in other cases, viruses) to positively identify the cause of an infection. The test is sensitive to even a small number of bacteria and can usually return results within one to two days.

NAAT swabs can also be used on the vagina, cervix, or rectum. In addition, NAAT technology is used to detect Chlamydia trachomatis in a urine sample.

Testing for chlamydia outside of the genitals or rectum is not a routine part of STD screening. This accounts for why oral STDs often go undiagnosed and untreated.

Treatment

Oral chlamydia is treated with antibiotics, just like genital or anal chlamydia. There are several treatments recommended by the Centers for Disease Control and Prevention (CDC):

• Preferred treatment: 100 milligrams (mg) of doxycycline taken by mouth two times daily for seven days
• Alternative treatments: 1 gram (g) of Zithromax (azithromycin) taken by mouth in a single dose, or 500 mg of Levaquin (levofloxacin) taken by mouth once daily for seven days

After treatment is completed, sex should be avoided for no less than seven days.

If you have been diagnosed with chlamydia, all sexual partners need to be informed and treated. Repeated infections are common when this does not occur. Chlamydia reinfection increases the risk of complications such as PID and ectopic pregnancy.

How to Prevent Oral Chlamydia

Abstinence is the only way to completely avoid oral chlamydia. Barring that, you can lower your risk by reducing your number of sex partners.

Using condoms or dental dams consistently can also reduce the risk of either passing or getting an STD like chlamydia. This not only include external (male) condoms but also internal (female) condoms.

If you don't have a dental dam, you can simply cut a condom lengthwise and open it flat.

Summary

Oral chlamydia is caused by Chlamydia trachomatis bacteria and passed through oral sex. This is the same infection behind genital or anal chlamydia, which are more common.

Symptoms include sore throat, fever, fatigue, mouth sores, and swollen tonsil or lymph nodes, but many cases show no symptoms at all. The bacteria can be detected by testing a sample of fluid collected during an oral swab.

Antibiotics are needed to treat the infection. Without them, oral chlamydia can lead to secondary mouth infections, dental pain, and gum disease. More importantly, people with undiagnosed oral chlamydia can pass the infection to others.

A Word From Verywell

Even though oral chlamydia is not very common, it could be an indication that you have chlamydia of the vagina, penis, or anus as well. If you suspect you have been exposed to chlamydia or any other STD, get tested—even if the symptoms are mild or absent.

Because chlamydia poses significant health risks to people with vaginas, the U.S. Preventive Services Task Force recommends screening for all sexually active females 24 years or younger, as well as females 25 years or older who are at an increased risk of infection.