Can chlamydia cause low libido and erectile dysfunction?

Chlamydia Infection and Sexual Function

Chlamydia infection can cause low libido and erectile dysfunction through both direct and indirect mechanisms, including psychological impact of diagnosis, inflammation, and complications of untreated infection.

Pathophysiology and Clinical Manifestations

Chlamydia trachomatis is the most common sexually transmitted bacterial pathogen in the United States, with an estimated 3 million new infections occurring annually 1. The infection primarily affects the genitourinary tract and can cause various complications in both men and women.

In men, chlamydia can cause:

• Urethritis
• Epididymitis
• Prostatitis
• Proctitis (in men who engage in receptive anal intercourse)
• Reactive arthritis (Reiter's syndrome)

Connection to Sexual Function

The relationship between chlamydia and sexual dysfunction occurs through several mechanisms:

1. Direct effects of infection:

   • Urethritis causing pain during sexual activity
   • Epididymitis potentially affecting testicular function 2
   • Chronic prostatitis potentially contributing to erectile dysfunction

2. Psychological impact:

   • Anxiety and stress related to STI diagnosis
   • Concerns about transmission to partners
   • Relationship strain

3. Research evidence:

   • A 2011 case-control study demonstrated that women with chlamydial infection had significantly lower sexual desire, lubrication, and overall sexual function compared to uninfected women 3
   • While this study focused on women, similar psychological mechanisms may affect men's sexual function

Diagnosis and Screening

Chlamydia infection is often asymptomatic, with 70-90% of women and a large percentage of men showing no symptoms 1. This makes screening particularly important for high-risk individuals.

Key diagnostic approaches:

• Nucleic acid amplification tests (NAATs) are the most sensitive and specific tests
• First-void urine samples can be used for testing in men 2
• Testing should be considered for:
  • All sexually active women under 25 years
  • Men with symptoms of urethritis or epididymitis
  • Men who have sex with men
  • Partners of infected individuals

Treatment and Management

Prompt treatment is essential to prevent complications and restore normal sexual function:

Recommended treatment regimens:

• Azithromycin 1g orally in a single dose, OR
• Doxycycline 100mg orally twice daily for 7 days 1, 2

Partner management:

• All sexual partners from the past 60 days should be evaluated and treated 1
• Abstinence from sexual activity until 7 days after treatment completion 1

Prevention of Recurrence

Reinfection is common and increases the risk of complications:

• Retesting approximately 3 months after treatment is recommended 1
• Consistent condom use reduces transmission risk
• Regular screening for those at high risk is essential

Addressing Sexual Dysfunction

For patients experiencing sexual dysfunction related to chlamydia:

1. Ensure complete eradication of the infection through appropriate antibiotic therapy
2. Address psychological factors that may persist after treatment
3. Evaluate for complications such as epididymitis or prostatitis that may contribute to ongoing sexual dysfunction
4. Consider referral to sexual health specialists if dysfunction persists after successful treatment

Important Considerations

• Sexual dysfunction may persist even after successful treatment due to psychological factors or undiagnosed complications
• Untreated chlamydia can lead to more serious conditions that further impact sexual function
• The impact on sexual function is often overlooked in clinical management but should be addressed as part of comprehensive care

Early detection and treatment of chlamydia infection is the most effective approach to preventing associated sexual dysfunction and other complications.