HEALTH ministers and experts are alarmed that cases of the sexually transmitted disease chlamydia have doubled.

It is a disease which rarely shows symptoms and can rob young women of motherhood. Here Irma Heger reports on the latest findings and opinions of Bolton experts on what could be a potential threat to our fertility.

MANY young women in the Bolton area may never be able to experience motherhood because of a "silent" sexually transmitted disease which could make them infertile.

Chlamydia -- an infection which shows hardly any symptoms -- is spreading rapidly. Cases have doubled over the past six years.

Almost one in 10 sexually-active women under 25 are believed to have the disease and experts blame it for one-third of all infertility cases.

There are now growing fears that it represents a time bomb for the fertility of the nation.

Consultant obstetrician and gynaecologist Karen Bancroft from the Royal Bolton Hospital said: "We certainly see a lot more chlamydia now in young women in their late teens and early 20s."

She said that the hospital "commonly" sees chlamydia in patients who are admitted for an abortion. "We are aware it is a common problem in that group," she said.

"The increase in cases is thought to be due to sexual behaviour and people using the contraceptive pill rather than condoms.

"The contraceptive pill generally doesn't offer protection against sexually transmitted diseases."

Elaine Phillips, centre co-ordinator for Marie Stopes in Manchester, is not surprised at the alarming increase in cases. "The figures have been rising for quite some time now," she said.

Elaine also blamed sexual promiscuity and unsafe sex for the increase.

"In this day and age, people are having unprotected sex and more than one partner -- so it is going to spread," she said.

Family campaigners have said the over-the-counter availability of the morning after pill is partly to blame for the increase in chlamydia as doctors do not have a chance to examine women.

Dr Bancroft is not convinced about this. She said patients who go to their GP for the morning after pill would not routinely be offered chlamydia testing. But Elaine said Marie Stopes' doctors at the clinic in St John Street, Manchester, examine patients before prescribing the morning after pill and she added: "We offer chlamydia testing to everybody that comes to our clinic.

"If the test comes back positive it is quite easily dealt with by a short treatment with antibiotics.

"But if you are positive, your partner needs to be treated as well."

Emile Morgan, consultant physician at the Bolton Centre for Sexual Health, said chlamydia sufferers are often sexually active girls aged 16 to 19 -- though some are as young as 14.

Many are girls with a new partner. They are on the pill and do not use condoms.

Dr Morgan always urges women with a new partner to have the test.

"It's the most common sexually transmitted infection that's curable," he said.

Dr Morgan said many women panic when chlamydia is diagnosed but he stressed infertility is usually due to untreated and recurring cases of the disease.

"I want to stress the importance of treating it," he said.

Dr Bancroft agreed. "It is much more likely to lead to infertility if it isn't diagnosed and treated properly."

Dr Morgan said the Bolton centre's approach of confidential appointments without the need for a GP referral -- for testing and advice -- is cheaper than treating women for infertility later on.

Later this year, the Department of Health is to launch a multi-million pound information campaign about safe sex and a screening programme. Routine tests are likely to be carried out at GP surgeries and family planning clinics. Community screening programmes -- alongside cervical smear tests -- are to be encouraged.

Dr Morgan believes routine testing by GPs for chlamydia may be impractical and instead emphasises the importance of raising awareness of the disease and the existence of clinics such as the Bolton centre.

Between 1995 and 2000, reported cases of chlamydia soared from just under 31,000 to 64,000 -- but this may be just the tip of the iceberg.

The explosion in cases of chlamydia is mirrored by other diseases -- cases of gonorrhoea and syphilis have doubled.

Dr Morgan said that today's sexual freedom should be matched by an end to the stigma of sexually transmitted diseases.

WHAT IS CHLAMYDIA?

Chlamydia is a sexually transmitted, bacterial infection.

WHAT ARE THE SYMPTOMS?

Seventy per cent of cases show no symptoms. In other cases, lower abdominal pain, a discharge or burning when passing water can point to the infection.

WHAT ARE THE CONSEQUENCES?

If left untreated, the infection can spread to the genital tract and affect the lining of the uterus and tubes and spread to the pelvic organs, causing pelvic inflammatory disease and chronic pelvic pain. This can result in infertility or ectopic pregnancy. Undiagnosed chlamydia can remain active in the body for over a year.

HOW ARE TESTS CARRIED OUT?

A urine test can be carried out to detect the infection (especially in men), but a cervical swab (similar to a smear test) is likely to be more reliable.

HOW IS IT TREATED?

Chlamydia can easily be treated with a course of antibiotic tablets. Sex is not recommended until the course is finished. Partners also need to be treated.

USEFUL NUMBERS:

Bolton Centre for Sexual Health (based at Royal Bolton Hospital): 01204 390771

CHILD The National Infertility Support Network 24-hour helpline: 01424 732361

Family Planning Association Information Service: 0845 3101334

Marie Stopes: 0845 3008090