About half of men with chlamydia have no symptoms at all. That’s what makes this infection so easy to spread and so important to test for. When symptoms do appear, they typically show up one to three weeks after exposure, though some men don’t notice anything for months. The most common signs involve the urethra, but chlamydia can also affect the rectum, throat, and, if left untreated, the testicles.
Urethral Symptoms
The urethra, the tube that carries urine out of the body, is the most common site of chlamydia infection in men. The two hallmark symptoms are discharge from the penis and a burning sensation during urination. The discharge is often clear or slightly cloudy and tends to be lighter in volume than what you’d see with gonorrhea, though the two infections can look similar enough that testing is the only reliable way to tell them apart.
Some men describe the burning as mild, more of an irritation than sharp pain. Others feel a persistent itch or tingling at the tip of the penis, especially in the morning before urinating. These symptoms can be subtle enough to dismiss, which is one reason chlamydia spreads so efficiently. Even mild or occasional discomfort during urination after unprotected sex is worth getting tested for.
Rectal and Throat Infections
Chlamydia doesn’t only infect the urethra. Men who have receptive anal sex can develop a rectal infection, which causes rectal pain, discharge, and sometimes bleeding. These symptoms often overlap with other conditions, so they’re easy to misattribute. In some cases, rectal chlamydia causes no symptoms at all.
Throat infections from oral sex are also possible, though they rarely produce noticeable symptoms. When they do, you might experience a mild sore throat. Because pharyngeal chlamydia is usually silent, it’s worth mentioning your sexual practices when getting tested so your provider can swab the right sites.
Why So Many Cases Are Silent
According to CDC data, 50 percent of men with chlamydia are completely asymptomatic. They feel fine, have no discharge, and experience no pain. This is a problem because the infection is still transmissible during this time, and it can still cause damage if it goes untreated for months.
Men do tend to develop symptoms more often than women (75 percent of women with chlamydia have no symptoms), which means men are somewhat more likely to seek treatment on their own. But “somewhat more likely” still leaves half of all infected men unaware they’re carrying the bacteria. Routine screening is the only way to catch these silent infections, especially if you’ve had a new partner or unprotected sex.
What Happens Without Treatment
Left untreated, chlamydia can spread from the urethra to the epididymis, the coiled tube behind each testicle where sperm matures. This condition, called epididymitis, typically causes pain and tenderness on one side of the scrotum. You may notice swelling that starts at the back of the testicle and gradually spreads. The spermatic cord, which runs from the testicle up into the abdomen, can also become tender and swollen.
Epididymitis from chlamydia is treatable with antibiotics, but if it’s ignored long enough, it can lead to chronic pain or, in rare cases, affect fertility. The inflammation can also cause fluid to build up around the testicle, creating visible swelling in the scrotum. Any new, one-sided testicular pain in a sexually active man should prompt testing for chlamydia and gonorrhea.
Chlamydia can also trigger reactive arthritis in some men, causing joint pain, eye inflammation, and urinary symptoms that persist even after the infection itself is cleared. This complication is uncommon but worth knowing about if you develop joint symptoms after a chlamydia diagnosis.
How Chlamydia Is Diagnosed
Testing for chlamydia in men is simple. The standard method is a urine sample, specifically the first part of the stream (called a “first catch” sample). This is analyzed using a nucleic acid amplification test, which detects the bacteria’s genetic material. Research has shown that urine samples perform as well as, and sometimes better than, urethral swabs for detecting the infection. No swab is needed for a standard urethral screening.
If you’ve had receptive anal or oral sex, a swab of the rectum or throat may be necessary, since a urine test won’t pick up infections at those sites. These swabs are quick and only mildly uncomfortable.
How Chlamydia Differs From Gonorrhea
Chlamydia and gonorrhea infect the same sites and produce similar symptoms, which is why doctors almost always test for both at the same time. In general, gonorrhea tends to cause heavier, more yellow-green discharge and more intense burning, while chlamydia produces lighter, clearer discharge and milder discomfort. But these differences aren’t reliable enough to distinguish the two without a lab test. The infections also frequently occur together: having one increases the odds that you have the other.
Treatment and Recovery
Chlamydia is curable with antibiotics. The standard treatment is a seven-day course of oral antibiotics taken twice daily. A single-dose alternative exists for situations where completing a week-long course is a concern. Both options are highly effective when taken as directed.
You should avoid sexual contact for seven days after completing treatment (or seven days after a single-dose regimen) to prevent passing the infection to a partner. Any recent sexual partners need to be notified and tested as well, since reinfection from an untreated partner is one of the most common reasons people test positive again. Retesting three months after treatment is recommended to confirm you haven’t been reinfected.