Does chlamydia cause erectile dysfunction? This is a common concern among men diagnosed with sexually transmitted infections in the UK. Chlamydia trachomatis, the most frequently diagnosed bacterial STI in England, does not directly cause erectile dysfunction through damage to the vascular, neurological, or hormonal systems that control erections. However, the relationship between these conditions is more complex than a simple yes or no. Psychological factors following STI diagnosis—such as anxiety and relationship stress—alongside potential complications like epididymitis or prostatitis, may indirectly affect sexual function. Understanding this distinction helps patients address both conditions appropriately through evidence-based treatment pathways.

Understanding the Link Between Chlamydia and Erectile Dysfunction

Chlamydia trachomatis is the most commonly diagnosed bacterial sexually transmitted infection (STI) in England. Erectile dysfunction (ED) is a common condition affecting men in the UK, and patients frequently question whether chlamydia infection can directly cause erectile difficulties.

There is no established direct causal link between chlamydia infection and erectile dysfunction. Chlamydia does not typically affect the vascular, neurological, or hormonal mechanisms that govern erectile function. However, the relationship between these conditions is more nuanced than a simple yes or no answer.

Several indirect pathways may connect chlamydia to erectile difficulties. Psychological factors play a significant role—men diagnosed with an STI may experience anxiety, embarrassment, or relationship stress, all of which are recognised contributors to psychogenic erectile dysfunction. Additionally, untreated chlamydia can lead to complications such as epididymitis (inflammation of the tube at the back of the testicle) or, less commonly, prostatitis (inflammation of the prostate gland), which may cause pelvic discomfort during sexual activity.

The inflammation associated with chronic or recurrent chlamydia infections could theoretically affect local blood flow or nerve function in the genital area, though robust clinical evidence for this mechanism is lacking. What is clear from current medical literature is that prompt diagnosis and treatment of chlamydia prevents complications that might indirectly impact sexual function. Understanding this distinction helps patients approach both conditions appropriately—treating the infection whilst addressing erectile difficulties through established pathways rather than assuming one directly causes the other.

How Chlamydia Infections Affect Male Sexual Health

Chlamydia trachomatis primarily infects the urethra in men, but the bacterium can ascend to affect other parts of the male reproductive system. Understanding these potential complications provides important context for how chlamydia might indirectly influence sexual function and overall reproductive health.

Urethritis (inflammation of the urethra) is the most common manifestation in men, causing dysuria (painful urination) and urethral discharge. Whilst uncomfortable, urethritis itself does not impair erectile mechanisms. However, the discomfort may lead men to avoid sexual activity temporarily, and the psychological impact of STI diagnosis can create performance anxiety that persists even after successful treatment.

More significant complications include epididymitis and epididymo-orchitis, where infection spreads to the epididymis and potentially the testicle. These conditions cause testicular pain, swelling, and tenderness that can make sexual activity uncomfortable or impossible during the acute phase. Chronic epididymitis may result in persistent discomfort during ejaculation, which can secondarily affect sexual confidence and function.

Prostatitis (inflammation of the prostate gland) is an uncommon complication of chlamydia infection. Most cases of chronic pelvic pain syndrome are non-bacterial in origin. When prostatitis does occur, it can cause pelvic pain, painful ejaculation, and urinary symptoms—all of which may contribute to sexual difficulties and reduced libido.

Untreated or recurrent chlamydia infections may contribute to scarring in the reproductive tract, including the epididymis or vas deferens, which can potentially affect fertility. Whilst this does not directly cause erectile dysfunction, the psychological burden of fertility concerns can significantly impact sexual health and relationship dynamics.

NHS and UK Health Security Agency (UKHSA) guidance emphasises that early detection and complete treatment courses prevent these complications, underscoring the importance of regular STI screening for sexually active individuals. When chlamydia is diagnosed, a full STI screen (including tests for HIV, syphilis, and gonorrhoea) should be offered, and testing should be tailored to sexual practices, including rectal and pharyngeal swabs where indicated by exposure history.

Recognising Symptoms of Chlamydia in Men

One of the most challenging aspects of chlamydia control is that many men experience no symptoms whatsoever. This asymptomatic presentation means men may unknowingly carry and transmit the infection, highlighting why screening is recommended for sexually active individuals.

When symptoms do occur, they typically appear 1–3 weeks after exposure, though this incubation period can vary. The most common presenting features include:

• Urethral discharge – usually white, cloudy, or watery

• Dysuria – pain, burning, or stinging sensation when urinating

• Urethral irritation – itching or discomfort at the tip of the penis

• Testicular pain or swelling – indicating possible epididymitis (requires prompt medical attention)

Less common presentations may include rectal symptoms (pain, discharge, or bleeding) in men who have receptive anal intercourse, or conjunctivitis if the infection is transferred to the eyes. Some men report mild lower abdominal discomfort or a general sense of malaise.

It is crucial to understand that erectile dysfunction is not a recognised symptom of chlamydia infection. If you are experiencing both erectile difficulties and symptoms suggestive of an STI, these should be considered separate issues requiring individual assessment, though both warrant medical evaluation.

The National Chlamydia Screening Programme (NCSP) recommends annual screening for sexually active individuals under 25 years of age and on change of sexual partner. Those over 25 should be tested based on symptoms or risk factors. Testing is straightforward, typically involving a first-catch urine sample (the first part of urination) for men. Rectal or pharyngeal swabs are offered based on sexual practices and exposure history. Many sexual health services and GP surgeries offer free, confidential testing. In some areas, pharmacy-based testing is available through locally commissioned services. NHS online testing services may also be accessible in your area. Early detection prevents complications and onward transmission, making awareness of both typical symptoms and asymptomatic infection patterns essential for sexual health.

Treatment Options for Chlamydia and Sexual Function Recovery

Chlamydia is highly treatable with appropriate antibiotic therapy, and cure rates exceed 95% with correct treatment and adherence. The standard first-line treatment recommended by the British Association for Sexual Health and HIV (BASHH) is doxycycline 100 mg twice daily for seven days. This regimen is effective for urethral, rectal, and pharyngeal infection. Azithromycin is generally reserved for situations where doxycycline is contraindicated, such as in pregnancy, and should not be used for rectal infection.

Patients prescribed doxycycline should be advised to:

• Complete the full seven-day course even if symptoms resolve earlier

• Avoid all sexual contact (including oral sex) for seven days after starting treatment and until all partners have been treated

• Ensure recent sexual partners are notified and treated (typically contacts within the previous six months, or the most recent partner if longer)

• Take capsules with a full glass of water whilst sitting or standing, and remain upright for at least 30 minutes to reduce the risk of oesophageal irritation

• Avoid taking doxycycline with dairy products, antacids, or iron supplements, which can reduce absorption

• Avoid excessive sun exposure, as doxycycline increases photosensitivity

For men who have developed epididymo-orchitis where an STI is likely, BASHH recommends ceftriaxone 1 g intramuscular injection as a single dose plus doxycycline 100 mg twice daily for 14 days. Additional symptomatic management may include analgesia, scrotal support, and rest. In cases of severe epididymo-orchitis, hospital admission may be necessary.

A full STI screen should be offered at the time of chlamydia diagnosis, including tests for HIV, syphilis, and gonorrhoea. Testing should be tailored to sexual practices.

Regarding erectile function recovery, if erectile difficulties were related to the psychological impact of diagnosis or physical discomfort from infection, these typically resolve following successful treatment and reassurance. However, if erectile dysfunction persists beyond treatment completion, this suggests alternative underlying causes that require separate evaluation.

Erectile dysfunction has numerous potential causes including:

• Vascular factors – hypertension, diabetes, high cholesterol

• Psychological factors – anxiety, depression, relationship issues

• Hormonal imbalances – low testosterone

• Medications – certain antihypertensives, antidepressants

• Lifestyle factors – smoking, excessive alcohol, obesity

NICE guidance recommends that persistent erectile dysfunction warrants comprehensive assessment including cardiovascular risk evaluation, as ED can be an early marker of cardiovascular disease. Treatment options range from lifestyle modifications and psychological therapy to pharmacological interventions such as phosphodiesterase type-5 (PDE5) inhibitors (e.g., sildenafil). PDE5 inhibitors are contraindicated in men taking nitrates due to the risk of severe hypotension.

A test-of-cure for chlamydia is not routinely recommended unless symptoms persist, the patient is pregnant (test around six weeks post-treatment), or adherence was uncertain. However, re-screening is advised three months after treatment due to high reinfection rates, particularly in younger age groups.

If you experience a suspected side effect from any medication, you can report it via the MHRA Yellow Card scheme at https://yellowcard.mhra.gov.uk.

When to Seek Medical Advice for Erectile Difficulties

Erectile dysfunction and potential STI symptoms require timely medical evaluation, though the urgency and appropriate service differ depending on presenting features. Understanding when and where to seek help ensures both conditions receive appropriate attention.

Seek same-day or urgent medical advice if you experience:

• Severe testicular pain or swelling – may indicate epididymitis, orchitis, or testicular torsion (the latter is a medical emergency requiring immediate Emergency Department assessment)

• High fever with genital symptoms – suggests systemic infection requiring prompt treatment

• Inability to urinate or severe urinary retention

• Painful, prolonged erection (priapism) unrelated to sexual stimulation – a urological emergency

For these presentations, contact your GP for an urgent appointment, attend a sexual health clinic, visit an Urgent Treatment Centre, or call NHS 111 for advice. Testicular torsion specifically requires Emergency Department assessment.

Arrange a routine appointment with your GP or sexual health clinic if:

• You have symptoms suggestive of an STI (discharge, dysuria, genital discomfort)

• You have had unprotected sexual contact with a new or casual partner

• You have been notified by a partner of potential STI exposure

• You experience persistent erectile difficulties (generally defined as problems lasting more than three months)

• Erectile dysfunction is causing significant distress or relationship difficulties

Many men feel embarrassed discussing sexual health concerns, but healthcare professionals routinely address these issues in a confidential, non-judgemental manner. Sexual health clinics offer specialist STI services including testing, treatment, and partner notification support, often with walk-in availability and guaranteed confidentiality.

For erectile dysfunction specifically, your GP will typically:

• Take a comprehensive medical and sexual history

• Perform relevant physical examination

• Arrange blood tests (glucose, lipids, morning total testosterone, thyroid function)

• Assess cardiovascular risk factors

• Discuss psychological contributors and relationship factors

• Review current medications that might contribute to ED

• Consider referral to urology, endocrinology, or sexual medicine services based on findings

The NHS provides accessible pathways for both STI management and erectile dysfunction treatment. Early presentation improves outcomes for both conditions—chlamydia treatment prevents complications and onward transmission, whilst ED evaluation may identify important underlying health conditions such as diabetes or cardiovascular disease. Remember that experiencing one condition does not preclude having another; if you have concerns about both potential STI exposure and erectile function, both warrant professional assessment rather than assuming they are necessarily connected.

Frequently Asked Questions