Gonorrhea: Symptoms, Causes, Risks, Complications, Diagnosis, Treatment and Prevention

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A illustration of gonorrhea

1Overview

Sexually transmitted disease cases are on the rice, according to the Centers for Disease Control and Prevention (CDC). In fact, three of the most common types of STDs include syphilis, gonorrhea, and chlamydia.

The cases of gonorrhea in the United States increased with a staggering increase of cases of up to 350,000 in 2014. The increasing number of cases were seen among young individuals who are between 15 and 24 years old. An estimated 20 percent of cases were seen among teens who are 15 to 19 years old.

Gonorrhea is a sexually transmitted disease caused by a bacteria called Neisseria gonorrhoeae or gonococcus. It can infect both males and females and can infect the rectum, urethra or throat. However, in women, it can infect the cervix, too.

Though the bacteria can be passed through sexual intercourse, newborns can also be infected during childbirth if the mother is infected. In babies, gonorrhea infects the eyes, and if it’s not treated, it may lead to blindness.

Gonorrhea cannot be spread through touching surfaces, kissing and hugging.
This is because these bacteria can’t thrive outside the human body for long periods.

People with several sexual partners and those who do not practice safe sex like using condoms are at the greatest risk of being infected. Though the best way to protect oneself against infection is abstinence, there are other ways to help prevent infection such as proper condom usage and being monogamous or having just one sexual partner.

2Symptoms

The signs and symptoms of gonorrhea usually appear within two to 14 days after being exposed. However, in some cases, the person never develop noticeable symptoms.
Those with nonsymptomatic gonorrhea are still contagious and should still practice safe sex.

The typical symptoms of gonorrhea in women include:

  • Thick green or yellow (unusual) discharge from the vagina
  • Pain or burning sensation during urination
  • Bleeding between periods, heavy periods and bleeding after sex
  • Pain or tenderness in the lower abdomen.

The common symptoms in men include:

  • Unusual discharge from the penile tip can be yellow, green or white
  • Swelling or inflammation of the foreskin
  • Pain or tenderness in the testicles (rare)
  • Pain or burning sensation when passing urine

Gonorrhea can affect other parts of the body such as the rectum, eyes, throat, and joints.

3Causes

Gonorrhea is an infection caused by the bacterium Neisseria gonorrhoeae, which is usually passed during sexual contact, including vaginal, anal or oral. This condition does not only cause infection in the genital area but also in the mouth, eyes, throat and the rectum.

Risk Factors

Anyone who is sexually active can contract gonorrhea. However, some people are at a higher risk of the infection.

  • Younger age, being curious and engaging in risky activities
  • A new sex partner
  • Having other sexually transmitted infections
  • Multiple sex partners
  • Sex partner with concurrent partners
  • Previous gonorrhea diagnosis
  • Having a high-risk partner
  • Unprotected sexual contact (not using condoms)

4Complications

Gonorrhea is treatable with the appropriate medications. However, if the infection is left untreated, it may lead to long-term complications, including:

Pelvic inflammatory disease (PID) – Women with untreated gonorrhea are at a higher risk of developing pelvic inflammatory disease (PID). This means that the infection has ascended to the other parts of the reproductive tract like the uterus, fallopian tubes, and ovaries. PID causes chronic pain and damage to the reproductive organs.

Infertility in women – When gonorrhea is untreated, the infection may spread to the other reproductive tract organs such as the uterus, fallopian tubes, and ovaries. This may lead to the scarring of the fallopian tubes, increasing the risk of ectopic pregnancy or infertility.

Infertility in men – Gonorrhea can also lead to male infertility. This is because men with gonorrhea may have epididymitis, the inflammation of the epididymis, a small and coiled tube where the sperm ducts are found.

Increased risk of HIV and AIDS – Gonorrhea and other sexually transmitted diseases are at a higher risk of having human immunodeficiency virus infection (HIV) or acquired immunodeficiency syndrome (AIDS).

Infection of the joints and other parts of the body – Gonorrhea can spread to the other parts of the body through the bloodstream. The manifestations include fever, rash, joint pain, skin sores, stiffness, and swelling.

Infant complications – Babies who contract gonorrhea during pregnancy and childbirth may develop certain complications such as blindness or sores on the scalp. In some cases, the child may have infections.

5Diagnosis

The diagnosis of gonorrhea starts with a complete physical examination as well as a medical history interview. The doctor will also ask some questions about the patient’s partners.

To confirm if the bacteria present is the gonorrhea type, the doctor will analyze a sample of cells which are collected through a urine test and a swab of the affected area.

There are also home tests kits for women wherein vaginal swabs are taken.
The early detection and diagnosis of gonorrhea are important because it reduces the risk of various complications like pelvic inflammatory disease (PID) or testicular infection.

Who should get tested?

  • A couple who thinks they have the symptoms of gonorrhea
  • A person who had unprotected sex with a new partner
  • Someone who had unprotected sex with other people aside from the partner
  • A person with a concurring sexually transmitted infection (STI)
  • A person who found out his or her partner has STI
  • Pregnant women or someone who’s planning to get pregnant

6Treatment

Gonorrhea is usually treated with a short course of antibiotics. The treatment is recommended if the test has shown that the person has gonorrhea, the partner was found to have gonorrhea and there is a great risk or high chance of gonorrhea.

Treating gonorrhea in adults

Antibiotics – The first line of treatment for gonorrhea is the use of antibiotics. Due to the presence of antibiotic-resistant Neisseria gonorrhoeae, health experts recommend that ceftriaxone should be used only for uncomplicated gonorrhea. This is administered through an intramuscular injection. This is in combination with doxycycline or azithromycin,
which is taken orally.

Treating gonorrhea in sexual partners

When treating gonorrhea, the partner should be treated, too. He or she should be tested before the treatment. This is because the disease is easily transmitted through intimate sexual contact. If a partner has the illness, it’s more likely that anyone he had sexual contact with also has the disease.

Treating gonorrhea in babies

Babies can get gonorrhea from their infected mothers. Babies with signs of gonorrhea at birth should be treated appropriately, to prevent serious complications such as blindness.

Treating oral gonorrhea

Gonorrhea can affect the throat. However, this type of gonorrhea is harder to treat than those that affect the genitals. The best way to treat this is to conduct a throat culture after an initial round of antibiotics. This will ascertain if the infection is gone. When the infection does not clear up, it may need a prolonged treatment.

7Prevention

By practicing safe sex, you can reduce, but not eradicate, the risk of getting gonorrhea:

Use protection during sex – The use of condoms reduces the risk of sexually transmitted diseases, including gonorrhea. Use protection even for oral and anal sex.

Know the sexual history of your partners – It is important to know the sexual history of your new partner. This is to make sure he or she is practicing safe sex and is not infected with the bacteria. Talk to each potential partner about both the sexual histories. Men who have sex with men are at the highest risk of getting gonorrhea.

Limit the number of sexual partners and do not go out with high-risk partners – Having a long-term monogamous relationship with an uninfected partner is one of the best ways to prevent acquiring STDs, particularly gonorrhea. If you don’t have a monogamous relationship, reduce your sexual partners and avoid high-risk ones.

Other ways to prevent gonorrhea:

Urinate after sexual intercourse – This may help flush the bacteria that have entered the urethra.

Avoid douching – Douching removes the helpful and protective bacteria in the vagina. When there are no bacteria in the vagina, the person is at an increased risk of contracting gonorrhea.

Wash the genital area after sexual activity – This practice helps remove the parasites and bacteria in the vagina.

Consult with your doctor regularly – Aside from gynecological examinations, always have tested for STDs to determine your status. Regular tests are important to determine if you’re infected or not. Aside from knowing and being treated early, the importance of tests like these is that they inform people of their status and how the social stigma is when it comes to STDs.

Ask your partner to get tested too – Find out whether your partner has gonorrhea or not, you should ask your partner to get tested for the sexually transmitted disease.

Do regular gonorrhea testing and screening – The annual screening is recommended for all people who are sexually active, especially those with a new partner and those who are at risk.

If your partner has unusual symptoms, do not have sex – Do not have sex with your partner if he is manifesting unusual symptoms like those stated above.