Updated July 2025
Lymphogranuloma Venereum (LGV) is a sexually transmitted infection (STI) caused by aggressive strains of Chlamydia.
There are 3 stages of LGV infection:
Stage 1 (primary) can occur 3 to 30 days after exposure. You may notice small, painless bumps/sores at the site of the infection (rectum, penis, vagina or mouth), or you may notice nothing, as the sores can be hidden. The sores will heal on their own and might not be noticed in up to 50% of people with the infection.
Stage 2 (secondary) usually occurs 2 to 6 weeks after the first stage. You may notice fever, chills, joint pain and fatigue, along with painful swelling of the glands (lymph nodes) closest to the site of infection. If the infection is in the rectum, there may be blood, pus, pain or constipation.
Stage 3 (tertiary) occurs without treatment and is more common in females than males. You may notice extreme swelling of the genitals, and/or abscesses. There may also be scarring or tissue damage leading to the narrowing of the rectum or vagina.
The diagnosis of LGV is not simple, as the signs and symptoms are similar to other STIs. The diagnosis is often based on the sexual history, physical exam and laboratory testing.
Depending on the stage of the infection, if a lesion is present, a doctor or nurse will collect a swab from the site of the infection (rectal, vaginal, throat or penis). They may also examine the inside of your anus, rectum and lower part of the large intestine (with anoscopy, sigmoidoscopy, proctoscopy) to look for inflammation, swelling, bleeding or pus.
LGV chlamydia strains are more invasive than non-LGV ones. If the infection progresses to the third stage, tissue damage of the vagina, rectum or site of infection can occur, as the bacteria can lead to scarring. As a result, surgery may be required to repair the genital/rectal damage.
In rare cases, an untreated infection can cause damage to the spinal cord, brain and the surrounding membranes (meningoencephalitis). Untreated LGV can even lead to death.
Anyone who is sexually active, or sharing sex toys, can become infected with LGV. In Canada, gay, bisexual and other men who have sex with men (gbMSM) are more likely to become infected with LGV than the general sexually active population. gbMSM who are also infected with hepatitis C, HIV or other STIs and have unprotected oral or anal sex are more likely to become infected with LGV.
LGV is treated with 3 weeks of antibiotics. Follow-up should continue until chlamydia tests are negative and symptoms have cleared.
It is easier to get or give HIV if you have untreated LGV because of the bleeding and sores. You may also be at higher risk for getting other STIs. Because of higher chances of having another STI, testing for HIV, syphilis, herpes, gonorrhea, hepatitis B and hepatitis C is recommended.
Here are a few important points to remember:
Getting tested regularly for STIs is an important part of maintaining your overall sexual health. Encourage your partner(s) to get tested regularly too.
Chlamydia infection (including LGV) is reportable to your local public health department. Your health information will be kept confidential. A public health nurse will work closely with your health care provider in order to ensure you are aware of your infection, receive the correct treatment, answer any questions you have and discuss notifying your partners. If you do not want to tell your partner(s), a public health nurse can notify them for you. Your name will be kept confidential.
LGV can be passed on through unprotected oral, vaginal or anal sex from a person who is infected. It can also be transmitted through fisting, sharing sex toys and having a new or multiple partners.
It is important to inform all of your sexual partners within the past 60 days, so that they can be tested and treated, regardless of whether they have symptoms. If you have not had sex in the past 2 months, then your last sexual partner should be tested and treated. Tell your partner(s) that having no symptoms does not mean there is no infection.
Call the Sexual Health Infoline Ontario at 416-392-2437 (1-800-668-2437) or visit toronto.ca/health
Safer sex: To reduce your risk of getting a sexually transmitted infection (STI), use a condom every time you have vaginal, anal or oral sex.