Introduction
Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrheoae. Gonorrhea affects both men and women and can infect the cervix, urethra, rectum, anus and throat. Gonorrhea is one of the most common sexually transmitted diseases (STDs) and the global gonorrhea statistics show that an estimated 62 million cases of gonorrhea occur each year, affecting more women than men. Gonorrhea is easily curable but if left untreated it can cause serious health problems such as pelvic inflammatory disease (PID), which can lead to abdominal pain and ectopic pregnancy in women. Untreated, gonorrhea can also lead to infertility, meningitis and septicaemia.Gonorrhea symptoms
Symptoms of gonorrhea infection may appear 1 to 14 days after exposure, although it is possible to be infected with gonorrhea and have no symptoms. Men are far more likely to notice symptoms as they are more apparent. It is estimated that nearly half of the women who become infected with gonorrhea experience no symptoms, or have non-specific symptoms such as a bladder infection.
Gonorrhea symptoms can include:
Symptoms of gonorrhea infection may appear 1 to 14 days after exposure, although it is possible to be infected with gonorrhea and have no symptoms. Men are far more likely to notice symptoms as they are more apparent. It is estimated that nearly half of the women who become infected with gonorrhea experience no symptoms, or have non-specific symptoms such as a bladder infection.
Gonorrhea symptoms can include:
In Women
- A change in vaginal discharge; it may appear in abundance, change to a yellow or greenish colour, and develop a strong smell.
- A burning sensation or pain whilst passing urine.
- Irritation and/or discharge from the anus.
In Men
- A white or yellow discharge from the penis.
- A burning sensation or pain whilst passing urine.
- Irritation and/or discharge from the anus.
Route of transmission of gonorrhea
- vaginal sex
- anal sex
- oral sex - oral sex can either transmit gonorrhea from the genitals to the throat of the person giving the stimulation, or it can pass an infection from the throat to the genitals of the person receiving stimulation.
Less often it can be transmitted by:
- a person using their mouth and tongue to lick or suck another person's anus;
- a person putting fingers into the vagina, anus or mouth of someone infected with gonorrhea, then touching their own mouth, genitals or anus without washing their hands in between.
Where to go for help
If you have any symptoms or you are worried you may have been infected with gonorrhea, you should discuss your worries with a doctor. They may be able to run tests or offer you treatment themselves, or else will refer you to someone who can.Tests for gonorrhea
To test for gonorrhea an examination of the genital area will be carried out by a doctor or nurse and samples will be taken, using a cotton wool swab or sponge, from any infected areas - the cervix, urethra, anus or throat. Women will also be given an internal pelvic examination, similar to a smear test. A sample of urine may be taken.None of these tests are painful, but they may cause minor discomfort. If a person has had anal sex, it is important they tell the doctor so that a swab can be taken from the rectum. They should also tell the doctor if they have had oral sex so swabs can be taken from the throat.
Gonorrhea diagnosis and treatment
Samples taken during the examination will be sent to a laboratory to be tested for the bacterium Neisseria gonorrheae and will usually be available within a week. This may vary depending on which country the patient is in. Some sexual health clinics have rapid testing services to provide immediate results. In these clinics the doctor will check the sample for gonorrhea bacteria under a microscope to confirm an infection straight away.Treatment is easy and essential. The patient will be given an antibiotic in tablet, liquid or injection form.
If the patient is allergic to any antibiotics, or if there is any possibility that they may be pregnant, it is very important that the doctor is informed as this may affect treatment options. Once a course of treatment is started it is important to complete it, even if symptoms diminish, to ensure the infection is cured.
The doctor or health advisor will discuss the gonorrhea infection and answer any questions. They will also want to know about any partners the patient has had sexual contact with as they will also be at risk of having gonorrhea and should be tested.
The patient should not have penetrative sex until they have returned to the clinic and it is confirmed that the infection is gone. The doctor or health adviser will inform the patient which sexual activities are safe.
Follow-up
Once the patient has completed the course of treatment for gonorrhea, they should return to the clinic or their doctor for a check-up.
Some types of gonorrhea are resistant to certain antibiotics. Further tests will be done to ensure the infection has cleared. If it has not then different, usually stronger, antibiotics will be prescribed.
Complications
In Women
- Gonorrhea can cause Pelvic Inflammatory Disease (PID), an inflammation of the fallopian tubes (the tubes along which an egg passes to get to the womb), which increases the future risk of ectopic pregnancy (a pregnancy outside the womb) or premature birth.
- If a woman is pregnant and has gonorrhea when giving birth, the infection may be passed on to her child. The baby could be born with a gonoccocal eye infection, which must be treated with antibiotics as it can cause blindness. It is better for the woman to get treatment before giving birth.
In Men
- Gonorrhea can cause painful inflammation of the testicles and the prostate gland, potentially leading to epididymitus, which can cause infertility.
- Without treatment, a narrowing of the urethra or abscesses can develop after time. This causes considerable pain and problems whilst urinating.
Once gonorrhea has been successfully treated it will not come back unless the person becomes reinfected.
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