LGV (Lymphogranuloma Venereum)

LGV symptoms often develop in stages and may vary depending on where the infection is located.

Early symptoms may include a small, painless sore or blister on the genitals or around the rectum. This usually heals quickly and is often unnoticed.

As the infection progresses, symptoms may include:

• Painful, swollen lymph nodes in the groin
• Rectal pain, bleeding, or discharge
• A frequent urge to open your bowels
• Fever, chills, fatigue, or joint pain

Because LGV symptoms can be similar to other conditions, testing is important for an accurate diagnosis and prompt treatment.

Yes. LGV can cause no noticeable symptoms, especially in its early stages. A small painless sore may heal quickly and go unnoticed, and some people have rectal or throat infections without any symptoms.

If you have been diagnosed with chlamydia or think you may have been exposed to LGV, testing is recommended even if you feel well. Early diagnosis ensures you receive the correct treatment and helps prevent complications.

Without treatment, LGV can cause long-term inflammation that may lead to permanent damage.

Possible complications include:

• Scarring and narrowing of the rectum or anus (strictures)
• Fistulas (abnormal tunnels between the rectum and nearby tissues)
• Persistent swelling of the genitals due to lymphatic damage
• Painful swollen lymph nodes that may form abscesses or chronic sores

Early diagnosis and treatment can prevent most of these complications.

LGV symptoms usually develop in stages.

The first symptoms typically appear 3 to 30 days after exposure and may include a small, painless sore or blister that often goes unnoticed.

More noticeable symptoms usually develop 2 to 6 weeks later, such as painful swollen lymph nodes in the groin or rectal symptoms including pain, discharge, or bleeding.

If you develop symptoms or think you may have been exposed to LGV, you should arrange testing as soon as possible.

LGV is caused by specific strains (L1, L2, and L3) of the Chlamydia trachomatis bacteria. These strains are more invasive than those that cause standard chlamydia and can affect the lymphatic system.

LGV is spread through unprotected anal, vaginal, or oral sex with an infected person. It can also be passed on by sharing sex toys that have not been cleaned or covered with a new condom between users.

Because LGV requires different treatment from standard chlamydia, accurate testing is important.

LGV is more likely if you:

• Have unprotected anal, vaginal, or oral sex
• Have multiple or new sexual partners
• Share sex toys without cleaning them or using a new condom between users
• Have another sexually transmitted infection (STI)

In the UK, LGV is most commonly diagnosed in men who have sex with men, particularly those living with HIV.

Regular STI testing helps detect LGV early, especially if you have new or multiple partners.

You can reduce your risk of LGV by:

• Using condoms for anal and vaginal sex
• Cleaning sex toys thoroughly or using a new condom between users
• Using a fresh glove for each partner during fisting
• Having regular STI tests, particularly if you have new or multiple partners

These measures reduce the risk of infection and help identify LGV early if you are exposed.

Yes. Condoms significantly reduce the risk of LGV but do not provide complete protection.

LGV can spread through contact with infected skin or mucous membranes that are not covered by a condom. Using condoms consistently remains one of the most effective ways to reduce your risk.

If you develop symptoms or think you may have been exposed, arrange testing as soon as possible.

It is very unlikely. LGV is spread through sexual contact involving the genitals, rectum, or throat, not through saliva or social kissing.

Although the bacteria can infect the throat, kissing is not considered a recognised route of transmission.

No. LGV is not spread through sharing everyday personal items such as towels, toilet seats, or cutlery.

The infection is transmitted through direct sexual contact with an infected person. While transmission from contaminated personal items is theoretically possible, it is considered extremely rare.

No. LGV is not transmitted through blood transfusions.

It is spread through sexual contact, not through blood. Blood donations are also carefully screened to ensure the blood supply remains safe.

LGV is diagnosed using a combination of laboratory testing, your symptoms, and a clinical assessment.

A swab is usually taken from the affected area, such as the rectum, genitals, or throat, and tested for chlamydia. If the result is positive, the laboratory performs a second test to determine whether it is the specific strains (L1, L2, or L3) that cause LGV.

Because LGV requires different treatment from standard chlamydia, confirming the strain is important.

The main test used to diagnose LGV is a nucleic acid amplification test (NAAT).

This usually involves taking a swab from the affected area, such as the rectum, urethra, throat, or a sore. If chlamydia is detected, the sample is then tested to identify whether it is an LGV strain.

This two-step testing process ensures the correct diagnosis and treatment.

A correct diagnosis is based on several factors:

• Your symptoms, such as rectal pain, discharge, bleeding, or swollen lymph nodes
• Testing the correct site, for example a rectal swab if rectal symptoms are present
• Laboratory testing to identify the specific LGV strains
• Your sexual history and any known exposure to LGV

These factors help ensure you receive the appropriate treatment.

Yes. LGV can cause symptoms similar to several other conditions, including:

• Standard chlamydia
• Gonorrhoea
• Syphilis
• Genital herpes
• Inflammatory bowel disease (such as Crohn's disease or ulcerative colitis)

Because treatment differs from these conditions, laboratory testing is needed to confirm the diagnosis.

Laboratory testing of a swab is the most reliable way to diagnose LGV.

In some cases, a healthcare professional may suspect LGV based on your symptoms and examination, particularly if you have severe rectal inflammation or swollen lymph nodes and a known exposure. Blood tests may occasionally be used, but they are less reliable and are not routinely used to diagnose LGV.

No. A physical examination can identify signs that suggest LGV, but it cannot confirm the diagnosis.

Laboratory testing is needed to detect chlamydia and determine whether it is the specific strains that cause LGV.

No. LGV cannot be diagnosed at home.

Although home chlamydia tests are available, they do not usually identify the specific strains that cause LGV. If chlamydia is detected and LGV is suspected, additional laboratory testing is needed to confirm the diagnosis and ensure you receive the correct treatment.

The long-term outlook is generally excellent if LGV is diagnosed and treated early. Most people recover fully after completing the recommended course of antibiotics.

Without treatment, LGV can cause permanent complications, including scarring of the rectum, chronic swelling of the genitals, or damage to the lymphatic system. Early treatment greatly reduces the risk of these problems.

No. Having LGV does not provide immunity, so you can become infected again if you are exposed in the future.

To reduce the risk of reinfection, make sure your recent sexual partners are tested and treated, and avoid sex until treatment has been completed by everyone involved.

Yes. You can reduce the risk of reinfection by:

• Completing your full course of antibiotics
• Ensuring recent sexual partners are tested and treated
• Avoiding sex until treatment is complete
• Using condoms consistently
• Having regular STI testing if you have new or multiple partners

If you develop symptoms again or think you have been exposed, arrange testing promptly.

Yes. If you have been diagnosed with LGV, you should inform your recent sexual partners so they can be tested and treated if necessary.

Partner notification helps prevent reinfection and reduces the spread of the infection. If you are uncomfortable telling partners yourself, many sexual health services can notify them anonymously.

Yes. To reduce the risk of passing LGV to others:

• Complete your full course of antibiotics
• Avoid all sexual contact until treatment is complete and your symptoms have resolved
• Ensure recent sexual partners are tested and treated
• Use condoms during sex
• Do not share sex toys, or clean them thoroughly and use a new condom between users

These steps help prevent transmission and reduce the risk of reinfection.

Yes. If you have an active LGV infection during pregnancy, it can be passed to your baby during vaginal childbirth.

Although uncommon, exposure during birth can lead to eye infections (neonatal conjunctivitis) or, less commonly, pneumonia in the baby. Getting tested and treated during pregnancy greatly reduces this risk.

If left untreated, LGV may increase the risk of pregnancy complications, including inflammation that could contribute to preterm birth or premature rupture of the membranes.

There is also a risk of passing the infection to the baby during vaginal delivery. Early diagnosis and treatment help reduce these risks.

LGV is very rare during pregnancy in the UK.

It is not routinely screened for during pregnancy unless you have symptoms, have tested positive for chlamydia with suspected LGV, or have other risk factors. If LGV is diagnosed, it can be treated safely during pregnancy.

Yes. LGV can be treated during pregnancy using antibiotics that are considered safe for both you and your baby.

The usual treatment for LGV (doxycycline) is generally avoided during pregnancy. Instead, your healthcare professional will prescribe a suitable alternative. It is important to complete the full course of treatment and attend any recommended follow-up appointments.

You can reduce your risk by:

• Using condoms during sex
• Getting tested if you have symptoms or think you have been exposed
• Completing treatment if you are diagnosed
• Ensuring sexual partners are tested and treated to prevent reinfection

If you have any concerns during pregnancy, speak to your midwife, GP, or sexual health clinic promptly.

LGV itself is not known to be transmitted through breast milk.

If you develop LGV after giving birth, prompt treatment is important to prevent complications and support your recovery. If you are breastfeeding, your healthcare professional will prescribe an antibiotic that is appropriate for you and your baby.