I worked within the NHS as a doctor for many years and did Gynaecology, GU medicine and Obstetrics jobs as part of my training as a GP. When I was a GP I developed a special interest in GU medicine and took one day a week out of my GP job & worked for many years as a clinical assistent in a local GU medicine clincs in South Yorkshire. In my gynaecology attachments I  was always amazed at how often the diagnosis of  ectopic pregnancy was missed by doctors, until it had ruptured and become any emergency. It was not until I did a GU medicine attachment in a fantastic GU department at our local district general hospital, that I learned that undiagnosed Chlamydia can be a cause of ectopic pregnancy.

Now this was 20 years ago, and I realise that there is now heightened awareness of Chlamydia, its effects on fertility and ectopic pregnancy. I think the womens magazines & the internet has a lot to do with this. Anything that we can do to spread the word and increase both public and medical awareness of this life threatening condition is a good thing, and should aid earlier diagnosis and treatment.

Chlmaydia infection can often be asymptomatic until it causes a problem which makes diagnosis more difficult. You may have it for many years asymptomatically. In recent years there have been screening programmes such as ‘The National Chlamydia Screening Programme’ for Chlamydia targeted at the younger under 25 age group in which Chlamydia is most prevalent ,and through which Chlamydia tests have been available free by post.

The GU team I worked with were passionate about spreading the word to doctors that undiagnosed Chlamydia can be a factor  in some cases of ectopic pregnancy, and that all patients entering hospital with an ectopic pregnancy should be screened for Chlamydia as part of their routine post op care. They went further and advised that all women with fertility issues should also be screened as Chlamydia can be a cause of infertility.

I wonder whether we should go one step further and screen all women of child bearing age for Chlamydia routinely as we do with the cervical smear. It would be so easy to do a Chlamydia test at the same time. Only problem with this is we would miss the younger age group as the cervical smear screening in UK does not start until age 25 currently-which always surprises me as Jade Goody was diagnosed with terminal Cervical Cancer at just 27 years of age. When I worked in the GU Clinic a cervical smear was a routine part of the GU screening process whatever the age of the patient.

Would you say that chlamydia screening is now happening in gynaecology wards & infertility clinics routinely ? Do you think this is important ? Should we screen all sexually active women for Chlamydia routinely when they have their cervical smear? Should the cervical smear screening start at a younger age since teenagers now become sexually active so much younger ?

 Let us know your thoughts in comments

For more info on the National Chlamydia Screening programme visit http://www.chlamydiascreening.nhs.uk/ps/index.html

You can also buy Chlamydia tests by post here http://www.accessdiagnostics.co.uk/acatalog/Female_Chlamydia_Home_Test.html