A week ago I found out that I have chlamydia, but the doctor said that it is common. I investigated it and learned that other problems (irregular menstrual bleeding, lower abdominal pain) can be directly related to it. So I wanted to know how to get a cure, because in my country three different doctors have told me that this infection is not important. I knew about my problem because a friend told me to have my discharge tested. My doctor just gave me Canesten.

A.S.

When people talk about chlamydia, they usually mean infection with the bacterium called Chlamydia trachomatis. This organism causes several important infections. One is "trachoma," a chronic eye infection that is a major cause of blindness in developing countries. In the United States and Western Europe, Chlamydia trachomatis most commonly causes genital infections, though it can also cause conjunctivitis, an eye infection that is less serious than trachoma.

Since your question is about genital infection, I will concentrate on these manifestations of chlamydia infection. In men, chlamydia typically causes a symptomless genital infection or urethritis, a syndrome of discomfort on urination and a discharge from the penis. Urethritis (infection of the urethra, the opening through which urine passes from the bladder) can also lead to infection of structures called the epididymis and prostate gland. Homosexual men sometimes develop chlamydia infection of the rectum. Although complications can occur, most of these infections are not severe.

Women often have no symptoms when infected with chlamydia. The disease typically infects the cervix (the neck of the uterus, or womb) and the urethra. With cervical infection (called cervicitis), there can be vaginal discharge, bleeding and some abdominal pain. Infection of the urethra causes pain on urination. More importantly, chlamydia can cause salpingitis, infection of the fallopian tubes that lead from the uterus to the ovaries. Salpingitis is associated with pelvic inflammatory disease, or PID. Gonorrhea infection can also lead to PID, which causes fever, lower abdominal pain and severe pain when the cervix is manipulated during a physician's pelvic examination. The consequences of PID are even more important than the acute infection. Women who have frequent or severe bouts of PID are at substantially increased risk of infertility and of ectopic pregnancy, in which a fertilized egg attaches to the fallopian tube rather than the uterus. Such a pregnancy can result in severe bleeding and even the death of the woman.

Your case, however, is confusing. In any country, I would expect physicians to know that chlamydia is a potentially serious illness. I would expect virtually all physicians to know how to treat chlamydia -- with antibiotics such as doxycycline (trade name Vibramycin), azithromycin (Zithromax), erythromycin (E-mycin) or ofloxacin (Floxin). I suspect there has been a misunderstanding between you and your doctors. Canesten is a cream containing clotrimazole, an antifungal agent used to treat candida, the cause of vaginal yeast infections. Perhaps you were diagnosed with candida, but you thought the doctor said you had chlamydia. Vaginal candida infection causes itching and a white, often cheesy discharge. While candida should definitely be treated, it does not have the same implications for PID as chlamydia infection does.