The differences between chlamydia and candida and how to treat them

The differences between chlamydia and candida and how to treat them

Publication date: 24-05-2024

Updated on: 24-05-2024

Topic: Sexual health, Gynaecology

Estimated reading time: 1 min

Chlamydia is among the most common and widespread sexually transmitted infections, particularly in the 15-25 age group where it reaches 7.7 percent compared to 5.5 percent in the general population. It is often confused with another very common infection: candida, which over a lifetime affects about 2/3 of all women of childbearing age with one or more episodes. 

Symptoms related to the 2 diseases are not always easily attributable by the person to either condition, so Dr. Giada Almirante, a specialist in Gynecology at Casa di Cura La Madonnina and Ospedale San Raffaele, helps us better understand the difference between these 2 types of infection and how they are treated.

What are chlamydia and candida

Chlamydia is a bacterium (Chlamydia Trachomatis) that causes an infection in the urogenital system.

Candida, on the other hand, is a mycete (fungus, the most common strain is Candida Albicans) normally present within the skin and mucous membranes of the human body (e.g., at the level of the oral cavity, vagina, intestines) that, due to imbalances in the body's microflora, may come to overproliferate, leading to infection.

How they are transmitted

Chlamydia is classified as a sexually transmitted infection (STI, also known as Sexually Transmitted Diseases, STDs), which is an infection that can be transmitted through sexual intercourse (vaginal, oral, or anal) without a condom and through contact with genital fluids and objects that have come in contact with these.

Candida can be generated by imbalances independent of a sexually active life (antibiotic therapies, stress, immune deficiencies, etc.), but it can be sexually transmitted to one's partner.

In addition, infants can contract both diseases from their mother:

  • through childbirth, for chlamydia;
  • through breastfeeding, due to direct contact of the mycete with the infant's oral cavity, for candida.

Symptoms of chlamydia and candida

"The National Institute of Health estimates that about 70 to 80 percent of women and 50 percent of men with chlamydia have no symptoms. For candida, asymptomatic forms are less common but, at any rate, not uncommon," Dr. Almirante explains.

Regarding chlamydia, if present, the main symptoms are:

  • pain during urination;
  • abnormal discharge from penis, vagina, or rectum;
  • genital pain and inflammation for men;
  • deep dyspareunia in women (pain on deep penetration);
  • presence of abnormal bleeding during/after intercourse or outside the cycle, for women.

If the infection progresses, the tubes and ovaries may be affected, with the formation of inflammatory processes against them (hydrosalpinx, tubal abscess, adhesion syndromes) and exacerbation of symptoms (abdominal pain, fever, diarrhea, nausea). Such inflammatory processes can lead to an increased risk of infertility.

For candida, however, the symptoms are generally more specific:

  • whitish, often thick vaginal discharge;
  • redness and itching in the genital area;
  • burning during urination;
  • pain during sexual intercourse;
  • presence of a white patina on the tongue and oral cavity, in the case of oral forms called thrush;
  • retrosternal burning, meteorism, and abdominal pain may be clinical manifestations in cases of candida at the gastro-intestinal level.

What are the risks

These are conditions that in both cases are not worrisome, but if not treated in a timely manner, can lead to even significant health risks.

Untreated chlamydia can cause:

  • infertility, both for affected men and women;
  • sexually acquired reactive arthritis, which results in joint inflammation and is more common in men;
  • pelvic inflammatory disease, which manifests with the same symptoms as chlamydia, where present, and is generated by the spread of infection to the uterus, ovaries and fallopian tubes;
  • chronic pelvic pain and risk of extrauterine pregnancy for women (caused by tubal adhesions);
  • during pregnancy, conjunctivitis and pneumonia in the baby or increased risk of premature birth and miscarriage.

Candida, on the other hand, can cause:

  • a perennial inflammatory state of the mucosa with damage and injury to the tissue of the infected parts;
  • in cases of chronic immunodeficiency, the infection can spread throughout the body.

How the diagnosis takes place

Chlamydia can be identified with:

  • swab taking material in vagina, male urethra, anus or throat;
  • urine culture test.

Candida can be detected by the physician:

  • by careful objective examination;
  • by a culture examination performed with a swab.

Generalized and invasive forms are diagnosed with specialized examinations and specific instrumental tests, in some cases during surgery (presence of Fitz Hugh Curtis syndrome in case of Chlamydia, i.e. presence of liver adhesions).

How to treat

Chlamydia is commonly treated with antibiotic therapy, usually by:

  • azithromycin, in cases of pregnancy;
  • doxycycline, in all cases outside of pregnancy. 

The specialist, depending on the severity of the infection, will consider whether to prescribe a single daily dose or whether treatment is to be followed for a longer period (7-10 days for chronic or more severe infections). Antibiotic can eradicate the infection, but not eliminate the organ damage created by the microorganism. It is advisable to avoid risky sexual intercourse from the time of the diagnostic swab until 7 days after the conclusion of antibiotic treatment to avoid possible transmission of the infection, and it is always recommended that the treatment also be given to the partner.

Candida, on the other hand, is treated with antifungal drugs:

  • taken locally (creams, ovules, vaginal candles, etc.);
  • taken systemically (orally) in cases of somewhat more important or widespread candida.

In cases of severe multi-organ candidiasis, injections and other therapies may also be required. In addition to antifungal therapy, taking probiotics, especially lactobacilli, is also indicated to restore the balance of intestinal flora and prevent the uncontrolled proliferation of candida.

How to prevent

"To prevent a local candida infection, it is necessary to keep appropriate habits, both from a hygienic point of view, avoiding overly aggressive products that go to alter the genital ecosystem, and following a healthy lifestyle, limiting smoking, alcohol and avoiding situations of prolonged psychophysical stress that weaken the immune system. To prevent or treat candida, it is good to follow a diet low in: refined flours, yeast, dairy products, and foods high in sugar; as these foods seem to promote candida overgrowth.

For both diseases, it remains, then, essential to practice a proper sex life, having protected sex, especially with casual partners, and undergoing periodic checkups with a gynecologist and andrologist," doctor concludes.

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