LGV progresses through 3 stages. The first stage is mild and appears as a small red bump or ulceration where the bacteria penetrate the skin, typically on the head of the penis, on the foreskin, or inside the anus depending on whether you were topping or bottoming. The lesion appears within 2-14 days of contracting the infection and heals on its own a few days later. During the second stage, the bacteria spread and symptoms become more severe. This typically occurs within 2-4 weeks. If the serovar L Chlamydia is transmitted to the penis, it will spread to the lymph nodes in your groin causing them to swell and become painful. If the bacteria are in the anus, the anus and rectum will become inflamed causing pain, constipation, and anal discharge and bleeding. If untreated, LGV will progress to the third stage, which involves scarring of infected tissue. This will result in water retention in the penis and scrotum causing them to swell. In the rectum, scarring can result in incontinence.

The diagnosis of serovar L Chlamydia requires special tests. Your doctor or nurse may collect a urine sample and insert a swab into your anus. If Chlamydia is detected, the samples can be sent to the National Laboratory in Winnipeg to determine if the Chlamydia is the serovar L type.