Chlamydia (Chlamydia trachomatis) is the most diagnosed bacterial STI in the Netherlands, with tens of thousands of diagnoses a year at the GGD and GP combined. The infection is most common among young people, with the highest rates in women aged 15 to 24.
Often without symptoms
Up to 90% of women and about half of men with chlamydia notice nothing. When symptoms do occur they can include: changed discharge, a burning feeling when urinating, spotting between periods or lower abdominal pain in women, and discharge or a painful scrotum in men. An anal infection can cause itching, pain or discharge.
When and how to test?
The test is a NAAT (PCR) on first-catch urine (men), a vaginal self-swab (women, more sensitive than urine) and, where indicated, a throat or anal swab. A reliable result is possible from about two weeks after the risk contact; the GP guideline (NHG) uses three weeks for certainty and otherwise advises a repeat test.
Treatment
Since the 2022 revision of the NHG guideline, doxycycline 100 mg twice daily for seven days is first-line for chlamydia. A single dose of azithromycin is no longer the standard, because doxycycline works better against a co-existing rectal infection. In pregnancy doxycycline is unsuitable and azithromycin is prescribed. Always finish the course.
Partner notification and re-testing
Notify sexual partners from roughly the past six months; steady partners are often tested and treated at the same time. Have no unprotected sex for seven days after starting treatment. A test of cure is usually unnecessary in non-pregnant adults, but a new test after three to six months is wise because reinfection is common.
Complications if left untreated
Untreated chlamydia can ascend in women and cause pelvic inflammatory disease (PID), with a raised risk of reduced fertility — especially with an infection at a young age. In men epididymitis can occur. In pregnancy there is a higher chance of premature birth and of eye or lung infection in the newborn. Recent Dutch research qualifies the previously assumed risk of ectopic pregnancy.
This information is general and was compiled with care from public sources, but it does not replace medical advice. For symptoms or doubt, always consult a doctor.
