What is gonorrhea?
Gonorrhea is a curable sexually transmitted infection (STI), also known as "the clap" caused by the bacteria Neisseria gonorrhoeae. The bacteria targets the cells of the mucous membranes including:
- The surfaces of the urethra, vagina, cervix, and endometrium
- The fallopian tubes
- The anus and rectum
- The lining of the eyelid
- The throat
How is it transmitted?
Gonorrhea is transmitted during vaginal, oral (performing or receiving), or anal sex. Transmission occurs when the mucous membrane, the soft skin covering all the openings of the body, comes into contact with the mucous membrane secretions or semen of an infected person. This can happen even if the penis or tongue does not go all the way into the vagina or anus. If the vagina, cervix, anus, penis, or mouth come in contact with infected secretions or fluids, then transmission is possible. Even if a person with gonorrhea is treated and cured, they can be re-infected if they are exposed to gonorrhea again. It can also be passed from mother to newborn as the baby passes through the infected birth canal which can result in eye infections, pneumonia, or other complications.
What are the symptoms and when do they occur?
Many men exhibit symptoms within two days to five days after exposure, with a possible range of one to 30 days. Although most women infected will remain asymptomatic (without symptoms), women who develop symptoms will usually do so within 10 days of infection.
Although some men may be asymptomatic (without symptoms), symptoms can include:
- Yellowish-white discharge from the penis
- Burning or pain when urinating
- Urinating more often than usual
- Pain or swelling of the testicles or epididymis
Women are usually asymptomatic (without symptoms) but might experience:
- Abnormal vaginal discharge that is yellow and sometimes bloody
- Vaginal itching
- Urinary burning, urgency, or frequency
- Painful intercourse
When the infection spreads to the fallopian tubes, some women still may have no signs or symptoms. Others may experience one or more of the following symptoms, which can be an indication that the infection has progressed to pelvic inflammatory disease (PID): lower abdominal pain, lower back pain, pain during intercourse, bleeding between menstrual periods, nausea, and/or fever.
Gonorrhea infections of the mouth and throat are usually without symptoms. If present, symptoms can include soreness mouth or throat, pus in the throat and lymph node swelling.
Rectal infections with gonorrhea are usually symptom free. Symptoms can include pain, rectal fullness, bleeding, or discharge.
If gonorrhea infects the eye, men and women might experience conjunctivitis (inflammation of the eyelid lining). Symptoms of conjunctivitis include redness, swelling, and discharge from the eye.
The most common symptoms in newborns include conjunctivitis and pneumonia, which usually develop 5 to 12 days after birth.
How is gonorrhea diagnosed?
Testing for gonorrhea can be performed on several different types of samples. At the health center, most men and women are tested using a urine sample. Women may also be tested using a vaginal swab. Rectal and throat swabs can also be used to detect gonorrhea in those locations. People infected with gonorrhea are often also infected with chlamydia; therefore, in patients with gonorrhea, dual treatment to cover both gonorrhea and chlamydia is recommended.
How is gonorrhea treated?
Gonorrhea is treatable with antibiotics. The CDC currently recommends combination therapy with a ceftriaxone injection, plus either oral azithromycin or doxycycline.
Here are some important points about treatment:
- All medications should be taken as directed.
- All partners from the last 60 days should be examined and treated to prevent the passing of infection back and forth between partners.
- Abstain from sexual activity for 7 days after treatment and until all sex partners are adequately treated.
A test-of-cure is not recommended for persons who receive a diagnosis and are treated for uncomplicated urogenital or rectal gonorrhea. However, a test of cure should be performed in men or women who have been previously treated for gonorrhea and were recently diagnosed with a new infection, regardless of whether their partner was treated or not.
What does it mean for my health?
There can be potential complications:
- If left untreated in women, it can lead to pelvic inflammatory disease (PID), miscarriages, and decreased fertility.
- If left untreated in men, it can lead to epididymitis, prostatitis, and decreased fertility.
- Pneumonia, as well as blindness from untreated eye infections, can occur if gonorrhea is passed from mother to newborn as the baby passes through the infected birth canal.
How can I reduce my risk?
- Abstinence (not having sex) is a sure way to eliminate risk of infection.
- Mutual monogamy (having sex with only one uninfected partner) is another way to eliminate risk.
- Using latex condoms for vaginal and anal sex will reduce risk.
- Since gonorrhea can be transmitted even if the penis or tongue does not completely enter the vagina, mouth or rectum, using latex condoms at the beginning of sexual contact until there is no longer skin contact is the best form of prevention.
- Several barrier methods can be used to reduce the risk of transmission of gonorrhea during oral sex. A non-lubricated condom can be used for mouth-to-penis contact. Household plastic wrap, a dental dam, or a latex condom cut-up and opened flat can reduce the risk of transmission during mouth-to-vulva/vagina or oral-anal (rimming) contact.
- Water-based spermicides are not recommended for the prevention of gonorrhea. Recent studies have shown that nonoxynol-9 ("N-9"), which is found in most water-based spermicides, is not effective in preventing gonorrhea.
How do I tell my partner?
Telling a partner can be hard, but keep in mind that most people with an STI don't know they have it. It's important that you talk to your partner as soon as possible so she or he can get treatment. It is possible to pass gonorrhea back and forth, so if you get treated and your partner doesn't, you may get infected again.