Can Chlamydia and Other STIs Come Back After Treatment?

Chlamydia, gonorrhea, syphilis, and trichomoniasis are common sexually transmitted infections (STIs) that can all be treated, and often cured, with antibiotics.

An STI can come back after treatment if you’re exposed to it again—for example, having unprotected sex with a partner or using a sex toy that’s contaminated. 

This article explains why an STI can return, what happens if you take the wrong medication for an STI, and the risk of reinfection with an STI if you are not careful about safe sex practices.

Taking the Incorrect Medication

STI treatment can fail if you're taking the wrong medication. One reason this may happen is called syndromic treatment. This approach tends to be used at STI clinics when there's concern about the cost of tests or the possibility that a person might not return for the results.

Syndromic treatment means that you're being treated for general symptoms without getting a diagnosis and treatment for a specific STI. This can create a problem because not all STIs are caused by the same infection.

Treating your STI with a medication that you've used in the past or one prescribed for your partner or a friend can also cause problems. It could not only be ineffective but also unsafe. 

It's important for your healthcare provider to correctly identify what's causing your infection. This way, you'll be sure to get the appropriate treatment instead of just taking an antibiotic and hoping it works.

Taking Medication Incorrectly

If you are prescribed a specific antibiotic by your provider, it's important that you finish the treatment and take it exactly how you are told to. You need to complete the treatment even if you feel better before you're done taking all the prescribed medication.

Failing to finish a course of antibiotics might keep your STI from being cured. It could also make it harder to treat a future STI because of antibiotic resistance. This occurs when an antibiotic drug is no longer able to fight germs that have built up an immunity against it.

Your Partner Didn't Get Treated

If you have a consistent sexual partner, it's important to tell them if you have an STI. They likely will need to get treated, too.

Once you've both been treated, you have to wait until the treatment has had time to work before you start having sex again—especially unprotected sex. Getting treated will help you avoid passing the STI back and forth to each other. 

Remember: It’s possible to spread an STI to someone else even if you don’t have any symptoms. If you think you’ve been exposed, it’s important to get tested even if you feel fine.  

Being Exposed to Another STI

Treatment for chlamydia, gonorrhea, or any other STI might work for that infection, but it won’t prevent you from getting another one. People can be repeatedly infected with STIs if they continue to have unprotected sex with a partner or partners who have untreated STIs.

STI-Specific Concerns

Certain STIs come with specific problems that can make them more likely to return.

Chlamydia

Chlamydia is caused by the bacterium Chlamydia trachomatis, which is spread through body secretions, so you're at greatest risk for chlamydia when you have unprotected vaginal, anal, and oral sex. Most people with chlamydia don't show symptoms, but the infection can cause serious complications if left untreated or if it's not properly treated.

It’s possible to get chlamydia again after you’ve been treated if you are exposed to it. For example, you could get reinfected if you have unprotected sex with a partner who has chlamydia or use a sex toy that has been contaminated with chlamydia.

As for how long chlamydia stays in your body, you might keep testing positive for a few weeks after you've been treated. According to the Centers for Disease Control and Prevention (CDC), you’ll need to be retested about three months after treatment to make sure a chlamydia infection has cleared up.

A study in animals suggested that chlamydia might be able to hide out in the gut and reemerge later on. Researchers are still trying to determine if chlamydia can hang around in the human GI tract and possibly reinfect a person who has been treated for it.

Gonorrhea

The bacterium that causes gonorrhea, Neisseria gonorrhoeae, is also transmitted via oral, vaginal, or anal intercourse. In addition, a baby can be infected during childbirth.

Many people do not know they have the infection, which is why screening is important so those that do have it are treated as early as possible to avoid complications.

Gonorrhea is treatable with antibiotics. In some cases, it is difficult to cure because antibiotic-resistant gonorrhea has emerged as a growing public health crisis. Certain tests can help determine the best way to treat a gonorrhea infection. You also may need to come back after treatment to see if it worked.

Over time, it has become harder to find affordable antibiotics that are consistent and effective when treating gonorrhea. As a result, people seeking treatment may need to use more expensive antibiotics.

Syphilis

Highly contagious, syphilis is spread through sexual contact and in some circumstances, the bacterium Treponema pallidum can even be passed on via kissing. As with other bacterial STIs, syphilis can be treated. However, there are some factors that can determine how well the treatment works including:

• The stage of a syphilis infection
• How you stay protected during sexual activity (specifically, condom use)
• Your human immunodeficiency virus (HIV) status
  

In general, treatment for syphilis is most effective if the infection is caught early. Success also is more likely if you have a healthy immune system.

Trichomoniasis

Trichomoniasis is caused by a parasite. It is spread by sexual intercourse or skin to skin contact around the penis or vagina, but it's not spread by kissing or casual contact.

Trichomoniasis will usually clear up with the standard single-dose treatment, but repeat infections are common. Research suggests that multidose treatments for trichomoniasis reduce the risk of recurrences by about half. Multidose treatment is now the standard for trichomoniasis in people with a vagina living with HIV. However, it is available for HIV-negative people as well. 

People with a penis are generally not tested—and therefore less likely to be treated—for trichomoniasis. While it's true that infections are generally less serious in people with a penis, they still need to be treated so that they don't reinfect their partners.

Symptoms of Recurrence

If you've been treated for an STI but start having symptoms again, it's possible that you may need more treatment to clear up the infection. It's also possible that you may have gotten infected again and need to start another course of treatment.

• Chlamydia: If you’ve been treated for chlamydia and start noticing symptoms like discharge from your genitals, painful intercourse, or painful urination, you may want to get tested again to find out if you’ve been reinfected. 
• Trichomoniasis: If you’ve recently been treated for trichomoniasis but you start having symptoms again (like a foul-smelling, gray-green vaginal discharge), let your provider know. You may need a different treatment. If you were re-infected, it’s important to make sure that your partner was successfully treated. 
• Gonorrhea: If you start having symptoms like vaginal or penile discharge or pain with urination or sex, it’s possible that gonorrhea has come back because the treatment didn’t help or you’ve been reinfected. Remember, gonorrhea does not always cause obvious symptoms. If you think there’s a chance that you’ve been exposed again, get tested. 
• Syphilis: If you’ve had syphilis and been treated but you notice symptoms like sores in your genitals and swollen lymph nodes, let your provider know you need to be tested—and possibly treated—again.

When to See a Provider

If you think you’ve been exposed to an STI or you have symptoms, see a provider. You won’t know for sure until you get tested. The sooner you can find out for sure and get treated, the better.

You can also go to a clinic like Planned Parenthood to get tested for STIs. You may want to make regular testing part of your healthcare routine if you think you might be more likely to be exposed to an STI. 

How to Keep STIs From Coming Back

The best way to keep STIs from coming back is to take the same safe sex steps that can help protect you from getting them in the first place. 

For example, condoms, dental dams, and other barriers are effective ways to prevent bacterial STIs. You need to be consistent and use them for all vaginal, anal, and oral intercourse.

STIs are not necessarily transmitted every time you have sex but you should always practice prevention. It’s also key to have open, honest conversations with sexual partners about safe sex and STIs. Talk about getting tested and what you each can do to reduce your risk.

Summary

Many STIs, including gonorrhea and syphilis, can be treated with antibiotics. However, STIs can return if you did not take the right antibiotic for the specific STI you have, you didn’t finish your prescribed treatment, or you were reinfected. 

The best way to keep STIs from coming back is to take the same steps you would to avoid them in the first place, which includes practicing safe sex and communicating with partners about testing.