Sexual Health

Gonorrhea: Symptoms, treatment, and causes

Gonorrhea is a common sexually transmitted disease, sometimes referred to as “the clap.” It affects hundreds of thousands of men and women annually in the United States.

Gonorrhea is easily treated but can cause serious and sometimes permanent complications. Pelvic inflammatory disease occurs in women when the gonorrhea infection affects their uterus or fallopian tubes. The most serious complication associated with pelvic inflammatory disease is infertility.

Gonorrhea, Gonorrhea Symptoms, Gonorrhea causes, Gonorrhea treatment

Symptoms

Symptoms may be absent despite an active gonorrheal infection. Symptoms can appear anywhere from 1-14 days following exposure to the infection.

Men and women experience slightly different symptoms; these can include:

Men:

  • white, yellow, or green urethral discharge, resembling pus
  • pain in the testicles or scrotum
  • painful or frequent urination
  • anal discharge, itching, pain, bleeding, or pain when passing stools
  • itching, difficulty swallowing, or swollen neck lymph nodes
  • eye pain, light sensitivity, or eye discharge resembling pus
  • red, swollen, warm, painful joints

Women:

  • painful sexual intercourse
  • fever
  • yellow or green vaginal discharge
  • vulvar swelling
  • bleeding in-between periods
  • heavier periods
  • bleeding after intercourse
  • vomiting and abdominal or pelvic pain
  • painful or frequent urination
  • anal discharge, itching, pain, bleeding, or pain with passing bowel movements
  • sore throat, itching, difficulty swallowing, or swollen neck lymph nodes
  • eye pain, light sensitivity, and eye discharge resembling pus
  • red, swollen, warm, painful joints
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Treatment

Upon displaying symptoms, a doctor may recommend a test for gonorrhea in addition to other diseases. Testing for gonorrhea can be completed by analyzing a urine sample or a swab of an affected area. Swab samples are commonly taken from the penis, cervix, urethra, anus, and throat.

Home kits for women are also available that include vaginal swabs. These kits are sent to a laboratory and results are reported directly to the patient.

If testing is positive for a gonorrhea infection, the individual and their partner will need to undergo treatment. This typically involves:

  • Antibiotics – a doctor will likely administer both a shot (ceftriaxone) and an oral medication (azithromycin).
  • Abstaining from sexual intercourse – until treatment is complete, there is still a risk of complications and spread of infection.
  • Repeat testing in some cases – it is not always necessary to be tested to make sure the treatment has worked. However, the CDC recommends retesting for some patients, and a doctor will decide if it is necessary. Retesting should be performed 7 days after treatment.

If a woman is pregnant and infected with gonorrhea, the infant will be given an eye ointment to prevent gonorrhea transmission. However, antibiotics may be required if an eye infection develops.

Causes

Gonorrhea is an infection caused by the bacterium Neisseria gonorrhoeae. It not only affects the reproductive tract, but can also affect the mucous membranes of the mouth, throat, eyes, and rectum.

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The infection is transmitted through sexual contact with an infected person involving the penis, vagina, anus, or mouth. Men do not need to ejaculate to transmit or acquire gonorrhea.

Gonorrhea can also be passed from an infected mother to her baby during delivery.

Although all sexually active individuals are at risk for acquiring gonorrhea, the highest rates of infection occur in teenagers, young adults, and African-Americans.

Prevention

There are many ways to prevent acquiring or passing on gonorrhea; they include:

  • abstinence from sex
  • using condoms for vaginal or anal intercourse
  • using condoms or dental dams for oral intercourse
  • having sexual activity with a mutually monogamous, unaffected partner

Individuals should speak with their doctor if they or their sexual partner have been exposed to gonorrhea or if they are experiencing any symptoms of infection.

Complications

There are many serious potential complications, which highlights the need for a quick diagnosis and treatment if symptoms occur.

In women, gonorrhea can lead to:

  • pelvic inflammatory disease, a condition that can cause abscesses
  • chronic pelvic pain
  • infertility
  • ectopic pregnancies – pregnancy where the embryo attaches outside of the uterus

In men, a gonorrheal infection can lead to:

  • epididymitis – inflammation of the epididymis, which controls the production of sperm
  • infertility

Both men and women are at risk of developing a life-threatening disseminated gonococcal infection when gonorrhea is untreated. This type of infection is often characterized by:

  • fever
  • arthritis
  • tenosynovitis – inflammation and swelling around tendons
  • dermatitis
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Those infected with gonorrhea are also at a higher risk of contracting HIV or, if already HIV positive, spreading HIV in addition to gonorrhea.

Further complications of a gonorrheal infection can occur in pregnant women during delivery; it is possible to pass the infection to the child. Gonorrhea passed to an infant can cause joint infection, blindness, or a life-threatening blood infection.

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