Gonorrhea
What is gonorrhea?
Gonorrhea is a sexually transmitted infection (STI) caused by the bacteria Neisseria gonorrhoeae. Gonorrhea is the second most prevalent STI in the United States with increasing cases worldwide. The bacteria attach to the cells of the mucous membranes which include the surfaces of the urethra, vagina, cervix, anus and rectum, eyelids and throat. If left undiagnosed and untreated, gonorrhea can cause serious health complications.
The CDC recommends at least an annual gonorrhea screening for the following people:
- Anyone of any gender using condoms inconsistently with more than one sexual partner (or sexual partners who have other partners)
- Women and people with vulvas under the age of 25
- People with previous or coexisting sexually transmitted infections
- People whose sexual partners have sexually transmitted infections
- People who exchange sex for money, drugs, goods, or services
How is it transmitted?
Gonorrhea can be transmitted during vaginal, anal and oral sex. Transmission occurs when the mucous membranes of the urethra, vagina, anus, rectum or throat come in contact with secretions and mucus membranes of a person infected with gonorrhea. 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 (or people with penises) exhibit symptoms within two days to five days after exposure, with a possible range of one to 30 days. Although most women (or people with vulvas) 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, individuals 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 people are tested using a urine sample. People with vulvas may also be tested using a vaginal swab. Rectal and throat swabs can also be used to detect gonorrhea in those locations.
How is gonorrhea treated?
Gonorrhea is treatable with antibiotics. The CDC currently recommends a one-time injection of an antibiotic called ceftriaxone.
Some important points about treatment:
- All partners from the last 60 days should be notified, tested 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 treated and any symptoms resolved.
A test-of-cure (repeat testing immediately after finishing treatment) is not recommended for persons who are diagnosed and treated for uncomplicated urogenital or rectal gonorrhea. A test-of-cure should be done 7-14 days after treatment for gonorrhea of the throat/pharynx. Additionally, all people who have been diagnosed and treated with gonorrhea should be retested for gonorrhea 3 months after treatment. This is to ensure there has been no re-infection from a new partner or a previous partner who has not adequately been treated for gonorrhea.
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.
- Infrequently, gonorrhea can spread through the body and cause inflammatory arthritis and joint infections, endocarditis (heart infection) and meningitis.
- If a newborn contacts gonorrhea during birth, the baby can develop pneumonia or an eye infection which can lead to blindness.
How can I reduce my risk?
- Abstinence (not having sex) is a sure way to eliminate risk of infection.
- Mutual monogamy (having only one sexual partner who you are their only partner) is another way to reduce 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.
- Condoms and other barrier methods (dental dams) can be used during oral sex to reduce the risk of 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.