Dr Margaret answers emailers’ embarrassing problems
in this monthly problem page.

Chlamydia screening

Dear Dr Margaret
Is everyone going to be screened for Chlamydia in the UK? What if I don’t want to?

Yes, the UK Government is planning a screening programme for Chlamydia. As you probably know, Chlamydia is one of the commonest sexually transmitted infections, and most people with Chlamydia are not aware that they have it. In males, it can cause a discharge from the penis or discomfort passing urine, but 8 out of 10 infected males have no symptoms. In females, it can cause vaginal bleeding, slight discomfort when passing urine or discomfort in the lower abdomen (especially during sex), but 7 out of 10 infected women have no symptoms.

If a woman with Chlamydia is not treated, the infection can spread to her Fallopian tubes. Eggs from the ovary have to pass along these tubes to reach the uterus. If her tubes become damaged as a result of infection, she may have difficulty becoming pregnant. In men, chlamydial infection can sometimes spread to the tubes around the testicles, and some research suggests that Chlamydia might affect fertility in men.

Chlamydia is most common in sexually active young people, so the Chlamydia test will be offered to everyone under 25 years of age (males and females). This screening programme should be up and running nationwide by the end of 2008. You will be able to get the test at various locations, such as family planning clinics, your GP’s surgery, young people’s clinics and gynaecology departments. The test will be done on a urine sample.

Alternatively, some women will be offered the option of taking their own sample from inside the vagina, in privacy. This is very simple – much easier than inserting a tampon. You are given a tube containing two soft cotton buds attached to the lid. You unscrew the lid and rub the cotton buds just inside the opening of the vagina. Then you rotate the buds round and round, pressing them on the moist skin just inside the vagina. Then you replace them in the tube, which is sent off to the laboratory.

You will receive your result by phone or text message, or by going back to the clinic – whichever you prefer. If the test is positive, you will be given the appropriate antibiotic, and your partner will also need to be treated.

As part of this screening programme, you can now get a free Chlamydia test at Boots pharmacies in Greater London if you are aged 16–24. After a consultation with the pharmacist, you are given a special container for a urine sample. You take the container away, and return the sample to the Boots store so it can be sent away for testing. You are given the result by letter or possibly by text message.

Of course no-one will force you to be screened – it is completely voluntary. But why not have it? When the screening programme was tried out in Portsmouth and the Wirral, it turned out that one in 10 women had Chlamydia. It seems to be even more common in men – about one in 8 young men tested positive. So there is a lot of it about, and it is well worth having the test.

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