Chlamydia: Symptoms, Testing and Treatment in St. Louis

Chlamydia is one of the most common bacterial infections spread through sex, and it is also one of the easiest to treat. The hard part is that it often causes no symptoms at all. That is why testing matters more than watching for signs.

This guide explains how chlamydia works, what the symptoms of chlamydia can look like, who should be screened, how testing works, and what treatment involves. It also covers free and low-cost testing in St. Louis, partner care, and Missouri law. It is written for people of every gender and orientation, with no judgment.

Table of contents

1. What chlamydia is and how it spreads
2. Symptoms of chlamydia
3. Who should be tested, and how often
4. How chlamydia testing works
5. Chlamydia treatment: is chlamydia curable?
6. Partners, retesting and Missouri law
7. Chlamydia in St. Louis: data and where to get tested
8. Common questions

What chlamydia is and how it spreads

Chlamydia is caused by a bacterium called Chlamydia trachomatis. The CDC says it spreads through vaginal, anal or oral sex with a person who has it. It can also pass from a pregnant person to a baby during birth.

You do not need to have had many partners to get chlamydia. One partner is enough. It says nothing about a person's character. It is a common infection, and it is treatable.

Where in the body it can occur

Chlamydia can infect more than one part of the body. The CDC lists the cervix, urethra, rectum, throat and eyes as possible sites. Which site is involved depends on the kind of sex a person has had.

This matters for testing. A urine sample may not detect an infection in the throat or rectum. A clinician can help decide which sites to test based on your sexual practices.

What it does not spread through

The CDC says chlamydia is not spread by hugging, sharing food, toilet seats or casual contact. Condoms and dental dams lower the chance of infection when used correctly every time, though they do not remove it completely.

Symptoms of chlamydia

The CDC states that most people with chlamydia do not have symptoms. When symptoms do appear, they usually show up one to three weeks after exposure, though some people notice them later. Many people never notice anything.

No list of symptoms can tell you whether you have chlamydia. Only a test can. Many other conditions cause the same signs, so a clinician or lab result is what gives a real answer.

Possible symptoms in people with a vagina or cervix

According to the CDC, some people notice:

• An unusual vaginal discharge
• A burning feeling when urinating
• Bleeding between periods or after sex
• Pain during sex
• Lower belly pain

Possible symptoms in people with a penis

According to the CDC, some people notice:

• Discharge from the penis
• A burning feeling when urinating
• Pain or swelling in one or both testicles, which is less common

Possible symptoms in the rectum or throat

The CDC says rectal infection can cause rectal pain, discharge or bleeding. Throat infections usually cause no symptoms. Some people have no signs at either site, which is another reason testing is useful.

When to seek care promptly

See a clinician soon if you have any of these symptoms, or if a partner tells you they tested positive. Seek care quickly for severe belly or pelvic pain, fever, or testicular pain and swelling. Those can have many causes, and a clinician can sort out which one.

Why silent infections still matter

Because chlamydia is often silent, it can go unnoticed for months. The CDC explains that untreated chlamydia in people with a cervix can lead to pelvic inflammatory disease (PID). PID can cause long-term pelvic pain, ectopic pregnancy, and trouble getting pregnant later.

In people with a penis, untreated infection can sometimes cause epididymitis, which is painful inflammation near the testicle. A pregnant person with chlamydia can pass it to the baby during birth, which can cause eye infections or pneumonia in newborns, according to the CDC.

None of this is meant to alarm you. These problems are largely preventable with testing and treatment, and that is the point of screening.

Who should be tested, and how often

Because symptoms are unreliable, national guidance is built around screening. Screening means testing people who feel fine.

What the USPSTF and CDC recommend

The U.S. Preventive Services Task Force (USPSTF) recommends screening for chlamydia in sexually active women 24 years and younger. It also recommends screening for women 25 and older who are at increased risk, such as those with a new partner or more than one partner.

The CDC STI Treatment Guidelines (2021) align with this and add more groups:

• Sexually active women under 25: at least once a year.
• Women 25 and older with risk factors, such as a new partner, more than one partner, or a partner with an STI: at least once a year.
• Gay, bisexual and other men who have sex with men: at least once a year at sites of contact, and more often (every three to six months) for those at higher risk.
• Pregnant people under 25, and older pregnant people at increased risk: at the first prenatal visit, with follow-up as a clinician advises.
• Transgender and nonbinary people: the CDC advises screening based on the body parts and sexual practices a person has, not on gender label.
• People with HIV: at the first visit, and at least yearly after that, depending on risk.

The evidence for routine screening of heterosexual men is limited, according to the CDC. But a man with symptoms, or whose partner has chlamydia, should talk with a clinician about testing.

Other good reasons to test

Testing also makes sense after a new partner, if a partner has a diagnosis, or if you have symptoms. It makes sense if you are starting or continuing PrEP, since STI checks are part of PrEP care. A clinician can help you choose a schedule that fits your life. If you are not sure whether you fit a group above, ask. A short conversation costs nothing.

How soon after exposure

A test taken too soon after exposure may miss an infection. The CDC does not give one single number that fits every situation, so ask a clinician or the lab how long to wait based on your exposure. If you have symptoms, do not wait. Get seen.

How chlamydia testing works

The CDC recommends a nucleic acid amplification test, called a NAAT, as the preferred way to test for chlamydia. A NAAT looks for the genetic material of the bacterium. It is very sensitive and works on several kinds of samples.

What samples are used

Depending on the site, a NAAT can use:

• A urine sample
• A vaginal swab, which the CDC says is the preferred sample for women and can be collected by the patient
• A swab of the throat
• A swab of the rectum

For people with a penis, the CDC lists first-catch urine as the preferred sample. Collecting your own swab is an option at many clinics. Tell the clinician which types of sex you have had so the right sites are tested.

What to expect at the visit

You will likely be asked about your sexual health and practices. This is routine, and clinicians ask everyone. Answers are used to pick the right tests, not to judge you.

Many clinics test for other infections at the same visit, such as gonorrhea, syphilis and HIV. Ask which tests are included. You can also ask for a plan for getting your results.

Getting your results

Result times vary. The City of St. Louis says STI results from the Health Stop take five to seven business days. If your result is positive, a clinician can arrange treatment. If it is negative, ask whether you should retest later because of recent exposure.

A test result describes a moment in time. It does not rule out a new infection after a later exposure.

Home testing

The St. Louis facts that are published cover free home kits for HIV, not for chlamydia. The City of St. Louis does not list a free home chlamydia kit. Check with the health department or a clinician before relying on any at-home option, and make sure any positive result is followed up with a clinician for treatment.

Chlamydia treatment: is chlamydia curable?

Yes. Chlamydia is curable. The CDC says it is treated with antibiotics prescribed by a clinician. Most people who finish their prescription recover fully.

What treatment looks like

The CDC 2021 STI Treatment Guidelines recommend doxycycline as the preferred treatment for most adults and adolescents. Other antibiotics are options for people who cannot take it, such as during pregnancy. Which medicine you get, and how you take it, is decided by your clinician. Follow the instructions you are given exactly, and finish the full course.

Do not use leftover antibiotics or a friend's prescription. The wrong medicine may not clear chlamydia, and it can hide symptoms while the infection continues.

Sex during and after treatment

The CDC advises waiting to have sex until treatment is finished and any partners have also been treated. A clinician will tell you exactly how long to wait. Having sex too soon can lead to passing the infection on or getting it again.

Do symptoms go away right away?

Symptoms often improve within days, but the infection may take longer to fully clear. Scarring from long-untreated infection may not be reversible. This is another reason early testing helps. If symptoms last or return after treatment, go back to your clinician.

Pregnancy

Pregnant people with chlamydia can be treated safely with medicines chosen by their clinician. The CDC recommends a follow-up test about four weeks after treatment during pregnancy, and another within three months. Talk with your prenatal provider about the right plan.

Can you get it again?

Yes. Having chlamydia once does not protect you from getting it again. Reinfection is common, most often from an untreated partner or a new partner. That is why partner care and retesting are part of treatment.

Doxy-PEP

In 2024 the CDC issued guidance on doxycycline taken after sex, called doxy-PEP, to lower the chance of some bacterial STIs. The guidance is for gay, bisexual and other men who have sex with men, and transgender women, who have had a bacterial STI in the past 12 months. The CDC says doxy-PEP lowers chlamydia and syphilis infections, with less benefit for gonorrhea. It is a prescription decision made with a clinician. WashU Infectious Diseases lists doxy-PEP among the services at its Village Square clinic in Hazelwood. Call to confirm what is available.

Partners, retesting and Missouri law

Telling partners

The CDC recommends that anyone diagnosed with chlamydia tell recent sex partners so they can be tested and treated. For chlamydia, the CDC advises telling partners from the past 60 days, or the most recent partner if it has been longer than that. This conversation can feel hard. A clinician or the health department can help you plan what to say, and in many cases can help notify partners without using your name.

Expedited partner therapy in Missouri

Expedited partner therapy (EPT) lets a clinician give a patient medicine or a prescription for a partner without first examining that partner. According to the CDC's legal status page for Missouri, EPT is allowed under Mo. Rev. Stat. 191.648, effective August 28, 2010. It covers chlamydia and gonorrhea, for partners who do not have an established patient relationship with the prescriber.

EPT is meant to help when a partner cannot easily get in. It is not a replacement for a partner's own visit when that is possible. A partner should still ask about testing for other infections.

Retesting at three months

The CDC recommends retesting about three months after chlamydia treatment, even if you believe your partners were treated. This is because reinfection is common. You do not need to wait for symptoms. If you cannot retest at three months, the CDC says to test whenever you next see a clinician within the first year.

Minors and consent

Under Mo. Rev. Stat. 431.061, listed by the Missouri Revisor of Statutes, a minor may consent for themselves to treatment for venereal disease. The statute states no minimum age. If you are under 18 and have questions about how a visit would work, call the clinic first and ask about privacy and billing.

Pregnancy screening in Missouri

Missouri law (Mo. Rev. Stat. 210.030) addresses blood tests for pregnant women, including syphilis, hepatitis B, hepatitis C and HIV. The statute does not list chlamydia. Chlamydia screening in pregnancy follows CDC guidance, so ask your prenatal provider whether you will be tested. The timing in the statute may change, so check with your provider for the current schedule.

HIV and other infections

Anyone being tested for chlamydia can ask about HIV, gonorrhea, syphilis and hepatitis C too. Getting a chlamydia diagnosis does not mean you have another infection. It simply means a full check is worth considering. Missouri also has a law, Mo. Rev. Stat. 191.677, about knowingly exposing another person to serious infectious diseases. It does not name chlamydia, and it is better discussed with a legal professional if you have questions.

Chlamydia in St. Louis: data and where to get tested

What local numbers show

Local numbers are only part of the story, because many infections are never reported. They still help show where testing is needed.

• The City of St. Louis Department of Health reported in an April 2022 news release that the city's reported chlamydia rate fell 15% in 2020, which it attributed to reduced testing during the pandemic. The highest rate was among women 15 to 24, at 6,071 per 100,000.
• The same release said the St. Louis County reported chlamydia rate fell 10% in 2020.
• America's Health Rankings, citing CDC AtlasPlus data, lists Missouri's 2023 chlamydia rate at 498.6 per 100,000, ranking 33rd among states.

A fall in reported cases does not necessarily mean fewer infections. It can mean fewer people were tested. The city's own news release made that point about 2020.

Note that the City of St. Louis is an independent city. The City of St. Louis Department of Health and the St. Louis County Department of Public Health are separate agencies, and they run separate clinics.

Free and low-cost testing options

For a fuller list with more detail, see our guide to where to get tested in St. Louis and what it costs. The options below are the ones most relevant to chlamydia.

Clinic	Chlamydia-related services	Cost and access
City of St. Louis Health Stop Testing and Referral Center, 1520 Market St, Suite 1625, St. Louis, MO 63103. Phone 314-657-1584.	Gonorrhea and chlamydia testing (urine, mouth swab or rectal swab), plus HIV, syphilis and hepatitis C testing.	Free. The city says no ID is necessary. Hours are Monday to Thursday, 9 a.m. to 12 p.m. and 1 p.m. to 4 p.m. Closed Fridays and city holidays. Walk-ins depend on availability.
Saint Louis County Sexual Health Clinic, 4000 Jennings Station Road, St. Louis, MO. Phone 314-615-9736.	STI prevention, testing and treatment.	Walk-in only, no appointments, per WashU Infectious Diseases. Everyone is welcome regardless of where they live or insurance status. Hours and cost are not listed, so call first.
WashU Infectious Diseases, Village Square Clinic, 1 Village Square Shopping Center, Suite 1, Hazelwood, MO 63042. Phone 314-362-9098.	STI testing and treatment, plus PrEP, PEP and doxy-PEP.	A 2024 WashU news article describes walk-in testing at no or low cost. Hours are not listed, and service details were still being worked out, so confirm by phone.
Planned Parenthood Great Rivers, Central West End Health Center, 4251 Forest Park Ave, St. Louis, MO 63108. Phone 314-531-7526.	Chlamydia, gonorrhea, syphilis, herpes and HIV testing, per the CDC GetTested listing.	Sliding scale, insurance and Medicaid accepted. The listing says an appointment is required.
CareSTL Health, Dr. Martin Luther King Health Center, 5471 Dr Martin Luther King Dr, St. Louis, MO 63112. Phone 314-367-5820.	Chlamydia, gonorrhea, syphilis and HIV testing, per the CDC GetTested listing.	Sliding scale, insurance, Medicaid and Medicare accepted. The listing says an appointment is required.

A few details to keep in mind. The City of St. Louis page says walk-ins are accepted subject to availability, while the CDC GetTested listing for the Health Stop says an appointment is required. Call 314-657-1584 before you go to avoid a wasted trip. The Health Stop also says rapid tests take about 15 minutes, which applies to HIV, not chlamydia.

The Saint Louis County Department of Public Health's John C. Murphy Health Center in Berkeley, at 6121 N Hanley Rd, is listed on the CDC GetTested directory for vaccines, including HPV, on a sliding scale with an appointment required. The listing does not show chlamydia testing there, so call 314-615-0500 before assuming it is offered.

Finding more places

The CDC runs a search tool at gettested.cdc.gov that lists testing sites by ZIP code, including free and low-cost ones. You can also call the City of St. Louis Department of Health at 314-612-5100.

Paying for care

If you have insurance, the USPSTF screening recommendation generally means many plans cover chlamydia screening without a copay, but plans vary. Ask your plan or clinic before the visit. If you are uninsured, the free and sliding-scale options above are good places to start. For clinics that list a sliding scale, ask what your cost would be before you are tested, since prices are not posted.

Common questions

Can chlamydia go away on its own?

The CDC does not recommend waiting. Some infections may linger for months without symptoms and can cause harm in the meantime. A clinician can treat it with antibiotics.

Is chlamydia curable if I have had it more than once?

Yes. Each infection can be treated. Repeat infections are common and not a reason for shame. They are a reason to make sure partners are treated and to retest.

Will I always know if a partner has it?

No. Because most people have no symptoms, a partner may not know. This is why regular testing is part of routine sexual health care.

Does a negative test mean I never need to test again?

No. A negative result applies to the day of testing, and to exposures before the window the test can detect. New partners or exposures can change things. Follow the schedule a clinician suggests.

Does chlamydia affect fertility?

The CDC says untreated chlamydia can lead to PID, which can affect the ability to become pregnant. Prompt treatment lowers this chance. If you are worried about past infections and fertility, a clinician can talk through your situation.

What if I am nervous about going?

That is very common. Clinic staff see people for sexual health every day. You can ask for a private room, ask what each test involves, and ask to be told results by phone. At the Health Stop, the city says testing is confidential and free.

What should I do next?

1. Decide if you fit a screening group, or if you have had a new exposure or symptoms.
2. Choose a clinic from the list above and call to confirm hours and whether to walk in.
3. Get tested, and ask which sites and infections are covered.
4. If treated, finish the prescription, wait to have sex as advised, and make sure partners are cared for.
5. Retest about three months later.

Testing is a routine, practical step. For most people, a positive result is followed by a short course of treatment and a return to normal life.

Sources

• CDC: Sexually Transmitted Infections Treatment Guidelines, 2021, Chlamydial Infections
• CDC: Chlamydia
• CDC: Guidelines for doxycycline postexposure prophylaxis for bacterial STI prevention (2024)
• U.S. Preventive Services Task Force: Chlamydia and Gonorrhea Screening recommendation
• CDC GetTested: National STD and HIV Testing Resource
• CDC: Legal Status of Expedited Partner Therapy in Missouri
• City of St. Louis Department of Health: Health Stop Testing and Referral Center
• City of St. Louis Department of Health news release on STI data (April 2022)
• America's Health Rankings: Chlamydia in Missouri (citing CDC AtlasPlus)
• WashU Infectious Diseases: Saint Louis County Sexual Health Clinic
• WashU Source: STI testing and treatment expanded in north St. Louis County (May 2024)
• CDC GetTested: Planned Parenthood Great Rivers listing
• CDC GetTested: CareSTL Health listing
• CDC GetTested: Saint Louis County Department of Public Health listing
• Missouri Revisor of Statutes: RSMo 431.061
• Missouri Revisor of Statutes: RSMo 210.030
• Missouri Revisor of Statutes: RSMo 191.677