Gonorrhea: Symptoms, Causes, Treatment

What are the symptoms of gonorrhea?

Gonorrhea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. The symptoms of gonorrhea can vary depending on the site of infection and whether the infection is in men or women. However, it’s important to note that many people infected with gonorrhea may not experience any symptoms, especially in the early stages of infection. When symptoms do occur, they can include:

In men:

1. Painful urination: A burning sensation or pain when urinating is a common symptom of gonorrhea in men.
2. Discharge from the penis: Thick, cloudy, or yellowish discharge from the penis may occur.
3. Pain or swelling in the testicles: In some cases, gonorrhea can cause pain or swelling in the testicles.
4. Rectal symptoms: If gonorrhea infects the rectum through anal intercourse, symptoms may include anal itching, discomfort, or discharge.

In women:

1. Painful urination: Similar to men, women with gonorrhea may experience a burning sensation or pain when urinating.
2. Increased vaginal discharge: Women may notice an unusual vaginal discharge that is yellowish or greenish in color.
3. Vaginal bleeding: Gonorrhea can cause vaginal bleeding between periods or after sexual intercourse.
4. Pelvic pain: Some women may experience lower abdominal or pelvic pain, which can range from mild to severe.
5. Rectal symptoms: As with men, gonorrhea can cause rectal symptoms in women who engage in anal intercourse.

It’s important to seek medical attention if you experience any symptoms of gonorrhea or if you have had unprotected sex with a partner who has been diagnosed with gonorrhea. Gonorrhea can lead to serious complications if left untreated, including pelvic inflammatory disease (PID), infertility, and increased risk of HIV transmission. Additionally, gonorrhea can be transmitted to a newborn during childbirth, leading to serious health problems for the baby.

What are the causes of gonorrhea?

Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. The infection is primarily transmitted through sexual contact. Here are the main ways gonorrhea can be spread:

1. Unprotected sexual contact: Engaging in vaginal, anal, or oral sex without using a condom or other protective barrier with an infected partner is the most common way gonorrhea is transmitted.
2. Multiple sexual partners: Having multiple sexual partners increases the risk of contracting gonorrhea, as the likelihood of encountering an infected partner is higher.
3. Sexual contact with an infected person: Any sexual contact with someone who has gonorrhea can result in transmission, even if the infected person does not show symptoms.
4. Mother-to-child transmission during childbirth: An infected mother can pass gonorrhea to her baby during vaginal delivery, which can cause serious health issues for the newborn, such as eye infections that can lead to blindness.
5. Contact with infected bodily fluids: Although less common, gonorrhea can potentially be spread by coming into contact with infected bodily fluids, such as sharing sex toys without proper cleaning or using a barrier.

It’s important to note that gonorrhea does not spread through casual contact, such as hugging, kissing, sharing utensils, or using public restrooms.

Preventing the spread of gonorrhea involves practicing safe sex, including using condoms and dental dams, reducing the number of sexual partners, and ensuring regular STI testing for sexually active individuals. Early detection and treatment are crucial to prevent complications and further transmission.

How is the diagnosis of gonorrhea made?

The diagnosis of gonorrhea is typically made through testing for the presence of the bacterium Neisseria gonorrhoeae. Here are the common methods used for diagnosing gonorrhea:

1. Nucleic acid amplification tests (NAATs): NAATs are the most commonly used and reliable tests for diagnosing gonorrhea. These tests detect the genetic material (DNA or RNA) of the gonorrhea bacterium in samples collected from the infected site. Samples may include urine, genital swabs (urethral swab for men, cervical or vaginal swab for women), or rectal swabs for individuals with symptoms or risk factors for rectal gonorrhea. NAATs are highly sensitive and specific and can detect gonorrhea even in asymptomatic individuals.
2. Culture: Culturing the bacteria from a sample collected from the infected site (e.g., urethra, cervix, throat, rectum) is another method used to diagnose gonorrhea. However, cultures are less commonly used due to their lower sensitivity compared to NAATs and the longer time required for results (typically 2-3 days).
3. Gram stain: Gram staining of urethral, cervical, or other genital swab samples can be used to detect the presence of gonorrhea bacteria under a microscope. However, this method is less sensitive than NAATs and may not detect gonorrhea in asymptomatic individuals.
4. Rapid tests: Rapid diagnostic tests for gonorrhea, such as nucleic acid hybridization assays or enzyme immunoassays (EIA), are available but are less commonly used due to their lower sensitivity compared to NAATs.

Testing for gonorrhea is recommended for sexually active individuals, especially those who engage in high-risk sexual behaviors or have symptoms suggestive of gonorrhea, such as abnormal genital discharge, pain during urination, or pelvic pain. Early detection and treatment of gonorrhea are essential to prevent complications and further transmission of the infection.

What is the treatment for gonorrhea?

The treatment for gonorrhea typically involves antibiotics, which are usually given orally or intravenously, depending on the severity of the infection and the individual’s health status. The specific antibiotic regimen may vary depending on the location and the type of gonorrhea (anorectal or pharyngeal). Here are some common treatments:

Single-dose oral antibiotics:

• Ceftriaxone (Rocephin) 250 mg plus azithromycin (Zithromax) 1 g
• Cefixime (Suprax) 400 mg plus azithromycin (Zithromax) 1 g
• Moxifloxacin (Avelox) 400 mg

Intravenous antibiotics:

• Ceftriaxone (Rocephin) 1 g
• Cefotaxime (Claforan) 1 g

Alternative treatments:

• Doxycycline (Vibramycin) 100 mg every 12 hours for 7 days
• Ciprofloxacin (Cipro) 500 mg every 12 hours for 7 days

Complicated cases:

• Patients with severe gonococcal infections, such as those with disseminated disease or those who are pregnant, may require intravenous antibiotics, such as ceftriaxone, cefotaxime, or cefepime.
• Patients who are allergic to cephalosporins may be treated with alternative antibiotics, such as doxycycline or ciprofloxacin.

Treatment for partners:

• It is recommended that all sexual partners of individuals diagnosed with gonorrhea be treated simultaneously to prevent re-infection and to prevent transmission of the infection to others.
• Partners should be treated with the same antibiotic regimen as the infected individual.

Post-treatment follow-up:

• A follow-up test should be performed after treatment to ensure that the infection has been cured.
• Repeat testing is especially important in individuals who have had multiple sexual partners or engage in high-risk sexual behavior.

It’s essential to complete the full course of antibiotics as directed to prevent relapse and reduce the risk of developing complications. If symptoms persist or worsen after treatment, it’s important to seek medical attention promptly.