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Symptoms, Complications and Treatment of Gonorrhea

Gonorrhea is the oldest known sexually transmitted infection, first time described already in the 14th century when it became known as the clap, a term still used today. Although the total number of cases in the US has been declining since the late 1980s, still more than 300,000 new cases are reported each year. However, it is estimated that there are as many new cases of gonorrhea each year that are not reported to the Centers for Disease Control and Prevention.

Causes of Gonorrhea

Gonorrhea infections are caused by a bacterium called Neisseria gonorrhoea, living in the cervix in women and inside the urethra in men.

Risk Factors for Gonorrhea

The highest rate of infections is among sexually active teenagers and young adults. If you or your partner have casual sexual contacts with others, you are more likely to get gonorrhea. In the US, gonorrhea rates are many times higher among African-Americans and Hispanics than among whites. Other people at high risk for gonorrhoea include those who have had past gonorrhea infections. There is a 20-25% chance that a man having unprotected sex once with a woman infected with gonorrhea will get the infection whereas the risk for a woman of contracting the disease is 80-90%.

Symptoms of Gonorrhea

Many of the symptoms of gonorrhea are similar to those of another sexually transmitted bacterial infection called chlamydia (for further information read about the symptoms of chlamydia). Women may experience increased, greenish-yellow vaginal discharge, burning sensation or pain when urinating, vaginal bleeding between periods, lower abdominal or rectal pain, pain or bleeding during intercourse, swelling of the vulva and fever. In addition, some women experience burning and swollen glands in the throat (due to oral sex), while half of all women infected with gonorrhea also suffer a gonococcal rectal infection and they may have discomfort in the anal area. The most characteristic symptoms in men include frequent urge to urinate, burning when urinating, milky or greenish-yellow discharge from the penis, swollen and painful testicles and burning and swollen glands in the throat (due to oral sex). Although only about 10% of gonorrhea-infected men are asymptomatic, nearly 70% of infected women have no symptoms. In most cases, symptoms develop within ten days of infection.

Possible Complications of Gonorrhea Infection

As is the case with chlamidia, untreated infections of gonorrhoea can lead to pelvic inflammatory disease (PID), which greatly increases the woman’s chances of having a tubal pregnancy or becoming infertile (men can also become infertile due to gonorrhea but for a different reason). Patients with gonorrhea infection are also more susceptible to the infections of the joints, heart valve damage, inflammation of the lining of the brain and spinal cord, blood poisoning, HIV/AIDS and babies of mothers with gonorrhea are more likely to be born with certain skin and eye conditions. Men may suffer scarring of the urethra and can develop a painful abscess in the interior of the penis.

Diagnosing Gonorrhea

As with chlamydia, the doctor will take a cervical swab (women) or a swab of fluid from the urethra (men) or urine specimens to check for the presence of bacteria. A swab of your throat or rectum can also be used. Since gonorrhoea increases the risk of other sexually transmitted diseases, tests for HIV, syphilis or chlamydia may be done as well.

Treatment of Gonorrhea

Gonorrhea infection is treated with oral or injectable antibiotics. Over time, some strains of gonorrhea have become resistant to many types of antibiotics. A third-generation cephalosporin called ceftriaxone (Rocephin) in form of intramuscular injection is the most effective antibiotic used to treat gonorrhoea, especially when combined with azithromycin (Zithromax) or doxycycline (Adoxa, Doryx, Monodox, Oracea, Vibramycin, etc.), though growing resistance to these drugs may also pose a problem in some cases. It is recommended to abstain from sex during treatment.

All recent sex partners (from the last thirty days) of patients with symptoms of gonorrhoea, who received treatment, should also get treatment. However, if the infection was discovered incidentally (with no apparent symptoms), all sex partners from the past sixty days should be treated.

Prevention of Gonorrhea

Use condoms to protect yourself from the gonorrhea bacteria, avoid having sexual intercourse with someone with suspicious symptoms and consider regular screenings for gonorrhoea if you or your partner have an increased risk for the disease.