Chlamydia in women often causes no signs at all. Here’s what to look out for, what it tends to get mistaken for, and when it’s worth getting tested, even if you feel perfectly well.
Part of our Chlamydia condition guide.
Get urgent help first. Go to A&E or call 999 for sudden, severe pain in a testicle, or severe pain low in your tummy with a fever, fainting or any chance you could be pregnant. Contact NHS 111 (NHS 24 on 111 in Scotland) or your GP the same day for pelvic pain, pain during sex, bleeding between periods or after sex, or a fever with genital symptoms. Online treatment is not suitable in these situations.
Key fact: Most women with chlamydia have no symptoms at all. When they do turn up, they’re usually mild and easy to pass off as thrush, a urine infection or period pain, which is why a test is the only way to know.
Tested Positive for Chlamydia? Get Treated Online
Access Doctor is a GPhC-registered pharmacy (#9011198). If you’ve tested positive for chlamydia, or a sexual partner has, a pharmacist independent prescriber reviews your online consultation and prescribes treatment if it’s suitable for you. Dispensed from our UK pharmacy. Approved before 3pm, Monday to Friday? Dispatched the same day, by Royal Mail Tracked 48, Tracked 24 or Special Delivery guaranteed by 1pm next working day: you choose.
Start Chlamydia Consultation →Adults only online. Access Doctor’s online chlamydia service is for adults aged 18 and over who are not pregnant or breastfeeding. If you’re under 18, pregnant or breastfeeding, an NHS sexual health clinic or your GP can test and treat you free and in confidence, and under 25s can also get help from Brook.
Most
Women with chlamydia notice no symptoms (NHS)
1 week+
Symptoms, if any, can start from 1 week to several months after infection (NHS)
Free
NHS testing, including home kits in many areas
Most women have no symptoms
Feeling fine is not the same as being clear. Chlamydia usually settles in the cervix, the neck of the womb, and an inflamed cervix often causes nothing you’d notice. Plenty of women carry it for months without a clue.
If it’s left alone, the infection can travel upwards into the womb, fallopian tubes and ovaries and cause pelvic inflammatory disease (PID). That’s the reason the NHS advises testing to a schedule rather than waiting for symptoms: once a year if you’re under 25 and sexually active, and any time you have a new partner.
Symptoms when they do happen
Some women do get symptoms, and they can show up anywhere from about a week to several months after you’re infected. The usual ones are:
Unusual vaginal discharge
More than usual, or a change in colour, such as a yellowish tint. Often mild enough to blame on hormones or thrush.
Pain when peeing
A burning or stinging feeling, easy to mistake for cystitis. A urine dipstick for a UTI won’t pick up chlamydia.
Bleeding between periods
Spotting between periods, caused by an inflamed cervix that bleeds more easily than usual.
Bleeding after sex
An inflamed cervix can bleed when it’s touched during sex. Bleeding after sex should always be checked.
Pain during sex
Discomfort during or after sex, especially deep inside. It can be a sign the infection has moved further up.
Tummy or pelvic pain
A dull ache low in the tummy. Severe pain, or pain with a fever, needs medical attention quickly.
Chlamydia can also infect the rectum after anal sex, or the throat after oral sex. Those infections almost never cause symptoms, so it’s worth telling whoever arranges your test what kind of sex you’ve had.
Why the cervix matters
In women, chlamydia mainly infects the cells lining the inside of the cervix, and that leads to inflammation, known as cervicitis. A clinician may spot it during an examination, but you don’t need one to be diagnosed: a self-taken vaginal swab is just as accurate. The infection can also sit in the urethra, the tube you pee through, which is what causes that stinging sensation.
Mistaken for a urine infection? If you’ve had “cystitis” symptoms that didn’t clear with antibiotics, or a urine test that grew no bacteria, ask about a chlamydia test. The antibiotics most often used for urine infections, nitrofurantoin and trimethoprim, don’t treat chlamydia.
What chlamydia gets mistaken for
| Condition | Shared symptoms | What’s different |
|---|---|---|
| Urine infection (UTI) | Stinging when peeing, needing to go often | A UTI usually shows on a urine test; chlamydia needs a specific chlamydia test. |
| Bacterial vaginosis (BV) | Change in discharge | BV often causes a thin, grey discharge with a fishy smell. |
| Thrush | Change in discharge, discomfort | Thrush usually causes itching and thick, white discharge. |
| Period pain | Pain low in the tummy | Period pain follows your cycle; pain from chlamydia may not. |
| Endometriosis | Pelvic pain, pain during sex, irregular bleeding | Needs specialist assessment, but a chlamydia test is a simple first step. |
You can’t tell these apart from symptoms alone, and it’s perfectly possible to have more than one at once. A test is the only way to confirm chlamydia.
Signs the infection may have spread
When chlamydia moves up into the womb and fallopian tubes it causes pelvic inflammatory disease (PID), which needs a longer course of different antibiotics.
Get medical help the same day (GP, NHS 111, NHS 24 on 111 in Scotland, or a sexual health clinic) if you have pain low in your tummy, pain deep inside during sex, a fever of 38°C or above, or pain under your ribs on the right side. Go to A&E or call 999 if the pain is severe, you feel faint, or there’s any chance you could be pregnant: one-sided pain in early pregnancy can be a sign of an ectopic pregnancy.
Chlamydia and fertility
Untreated chlamydia is one of the more common causes of fertility problems that could have been prevented. Once the infection reaches the fallopian tubes it can leave scarring, which can make it harder to conceive and raises the risk of an ectopic pregnancy. That can happen even if you never had a single symptom. Testing promptly and treating promptly brings the risk right down. Our guide to chlamydia complications goes into more detail.
When to get tested
- Every year if you’re under 25 and sexually active
- Whenever you have a new partner, at any age
- If you have symptoms, even mild ones
- If a partner tells you they have chlamydia
- After sex without a condom with someone whose status you don’t know
- Before having a coil (IUD) fitted, if you may be at risk: your clinic may offer a test
- In pregnancy, if you’re at risk: see our chlamydia in pregnancy guide
Tests are reliable from about two weeks after sex. A self-taken vaginal swab is as accurate as a test done in a clinic. NHS sexual health clinics test for free, and lots of areas offer free home test kits. Our chlamydia testing guide covers where to get one and how to take the sample.
Treatment for women
If you’re not pregnant, chlamydia is treated with exactly the same antibiotics as it is in men. UK guidance puts doxycycline 100mg twice a day for 7 days first. If you can’t take doxycycline, azithromycin is the alternative, usually as a 3-day course. Don’t have sex until you and your partner have both finished treatment.
Pregnancy is different: it needs a different antibiotic and a follow-up test, so it’s handled by your midwife, GP or a sexual health clinic. If PID is suspected you’ll need an examination and a longer course of antibiotics that covers other bacteria too, so please see your GP or a sexual health clinic rather than using an online service.
UK safety, support and free NHS options
Doxycycline and azithromycin are prescription-only in the UK. Before anything is prescribed, a GPhC-registered pharmacist independent prescriber reviews your consultation, including your allergies and any other medicines you take. Always read the patient information leaflet in the pack. Never share antibiotics with anyone else, even a partner with the same infection, and don’t save leftovers for next time: take unused tablets back to a pharmacy.
If you think a medicine has caused a side effect, tell your pharmacist or doctor. You can also report it to the MHRA through the Yellow Card scheme, which helps keep medicines safe for everyone.
NHS sexual health clinics test and treat chlamydia free of charge across the UK, and you don’t need a GP referral: use the NHS website in England, NHS inform in Scotland, Sexual Health Wales in Wales and nidirect in Northern Ireland to find one. Our private chlamydia treatment online service is an alternative for adults aged 18 and over.
If anything about how you got this infection doesn’t feel right, for example if sex wasn’t your choice or a partner pressures or controls you, you can talk to someone in confidence. See support, if you need it for free, confidential helplines. If you’re in immediate danger, call 999.
Frequently Asked Questions
What does chlamydia discharge look like?
If chlamydia changes your discharge, there may be more of it than usual, and it may look cloudy or yellowish. Many women with chlamydia have no change at all, and discharge changes have lots of other causes, such as thrush or bacterial vaginosis. A chlamydia test is the only way to be sure.
Can chlamydia cause pain during sex?
Yes. Inflammation of the cervix can make sex uncomfortable, and pain deep inside during sex can be a sign the infection has spread to the womb or fallopian tubes. Get tested, and see a GP or sexual health clinic the same day if the pain is new, severe or comes with a fever or tummy pain.
Can chlamydia cause bleeding between periods?
Yes. Chlamydia can inflame the cervix so it bleeds more easily, causing spotting between periods or bleeding after sex. It doesn’t usually change the timing of your periods. Any unexpected bleeding should be checked, even if a chlamydia test is negative.
I was treated for a urine infection. Could it have been chlamydia?
Possibly. The antibiotics usually used for urine infections, nitrofurantoin and trimethoprim, don’t treat chlamydia. If your symptoms didn’t clear, came back, or your urine test grew no bacteria, ask for a chlamydia test.
Can one chlamydia infection affect fertility?
It can. If even a single infection spreads to the fallopian tubes, it can cause scarring that affects fertility, whether or not it caused symptoms. The risk is higher with repeated infections and the longer an infection goes untreated, which is why regular testing and prompt treatment matter.
How long after chlamydia treatment can I have sex?
When you and your partner have both finished treatment and any symptoms have gone. With doxycycline, that means finishing the 7-day course. With azithromycin, wait until 7 days after your last tablet. This includes oral sex and sex with a condom.
Chlamydia treatment from Access Doctor
If you’ve tested positive for chlamydia, or a sexual partner has, and you’re not pregnant or breastfeeding, our pharmacist independent prescribers can assess you online.
Antibiotic · Rx · usual first choice
Doxycycline 100mg capsules
7-day course: one capsule twice a day. Prescribed after an online consultation.
View product →Antibiotic · Rx · if you can’t take doxycycline
Azithromycin 500mg tablets
3-day course for people allergic to, or unable to take, doxycycline. Prescribed after an online consultation.
View product →References
- NHS. Chlamydia. nhs.uk
- British Association for Sexual Health and HIV (BASHH). UK national guideline for the management of infection with Chlamydia trachomatis, 2026 (Saunders J, et al.). doi.org
- NICE Clinical Knowledge Summaries. Chlamydia – uncomplicated genital. cks.nice.org.uk
- NHS. Chlamydia: treatment. nhs.uk
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999.