Gonorrhea

Definition
Gonorrhea, a highly contagious sexually transmitted disease (STD), is one of the most
common STDs in the United States.

Sometimes referred to as "the clap," gonorrhea may produce signs and symptoms
such as a burning sensation when urinating or a thick discharge from the penis or
vagina. Many people experience mild or no signs or symptoms. Left untreated,
gonorrhea can cause serious complications, especially in women.

The cause of gonorrhea is a bacterium that spreads through sexual contact. The
disease can also be passed from a mother to her child during birth.

Treatment for gonorrhea involves a course of antibiotic medications to cure the

infection. Practicing safe sex is important in preventing gonorrhea.

Symptoms

Male reproductive system

 Female reproductive system

Signs and symptoms of gonorrhea may include:

 Thick, cloudy or bloody discharge from the penis or vagina

 Pain or burning sensation when urinating
 Frequent urination
 Pain during sexual intercourse

The first gonorrhea symptoms generally appear within two to 10 days after exposure
to the bacterium. However, some people may be infected for months before signs or
symptoms occur.

How gonorrhea affects men

In men, first there's often a tingling sensation in the urethra, the passageway that
carries urine from your bladder to the outside of your body. Later, urination becomes
painful and you may notice a discharge from your penis. As the infection progresses,
urethral pain usually becomes more pronounced and the discharge becomes more
profuse and thick.

How gonorrhea affects women

In women, the signs and symptoms, if any, may be so mild you may not realize you
have the infection. Often, the only clue that you may have gonorrhea comes when
someone who you've had sexual contact with develops the disease. The infection
usually affects the cervix and other reproductive organs as well as the urethra. In
some women, gonorrhea causes frequent, urgent and painful urination along with an
abnormal discharge from the vagina or urethra.

Causes
The bacterium Neisseria gonorrhoeae, also referred to as gonococcus, causes
gonorrhea. The bacterium is spread through semen or vaginal fluids during
unprotected sexual contact, heterosexual or homosexual, with an infected partner.

Risk factors
The more sexual partners you have, the greater your risk. Casual contact, such as
kissing, doesn't spread the disease.

About three out of four reported cases of gonorrhea in the United States occur in
people younger than 30. The highest rates of infection often are present in 15- to 19-
year-old women and 20- to 24-year-old men.

When to seek medical advice

Ask your doctor to test for gonorrhea if you:

 Have a discharge from your vagina or penis or have other signs or symptoms
of gonorrhea
 Are concerned that a partner may have been exposed to the infection
 Know gonorrhea has been diagnosed in a partner
 Are pregnant and have multiple sexual partners

Testing for sexually transmitted diseases (STDs) isn't part of a routine gynecologic
exam for women or a regular physical exam for men. Talk to your doctor if you're
concerned that you may have gonorrhea or another STD.

Tests and diagnosis

To confirm a diagnosis of gonorrhea, your doctor takes samples for laboratory
analysis of any discharge noted during a physical exam. Your doctor may also test
you for other STDs, such as chlamydia, syphilis and human immunodeficiency virus
(HIV), the virus that causes AIDS. Other STDs commonly occur along with
gonorrhea.

Complications
Not receiving adequate treatment for gonorrhea may lead to complications. These
may include:

 Inflammation of the epididymis. In men, epididymitis — inflammation of

the rear portion of the testicles where the sperm ducts are located (epididymis)
— is an acute condition treatable with antibiotics and pain relievers. If
untreated, it may lead to infertility.
 Pelvic inflammatory disease. In women, the bacteria can spread into the
uterus and fallopian tubes, causing pelvic inflammatory disease (PID), which
may result in scarring of the tubes, greater risk of ectopic pregnancy and
infertility. PID may lead to abdominal pain, backache, irregular menstrual
 periods, pain during intercourse and foul-smelling vaginal discharge. It's a
serious infection that requires immediate treatment by a doctor.
 Spread of the infection during childbirth. A pregnant woman with untreated
gonorrhea may spread the infection to her baby as the baby passes through the
birth canal during delivery. In an infant, gonorrhea may cause complications
such as blindness and widespread infection of the joints and blood.
 Anorectal gonorrhea. In both sexes, anorectal gonorrhea may result from
anal intercourse with an infected person or from the infection spreading from
the genital area. It may cause some discomfort in and discharge from the anal
area, but in many cases no signs or symptoms are present.
 Irritation of your throat and tonsils. Oral sex can lead to pharyngeal
gonorrhea with a sore throat, pain on swallowing and redness of the throat and
tonsils.
 Eye inflammation. Infection may sometimes spread to the eye by touching or
rubbing the eye with your hand after it has been in contact with infected
discharge. Gonorrhea in such cases can cause a red, inflamed eye
(conjunctivitis). In babies who contract gonorrhea during childbirth,
gonorrheal eye infections can lead to blindness.
 Widespread infection in your body. Rarely, the bacterium that causes
gonorrhea can spread through the bloodstream to cause infection in other parts
of your body. Fever, rash, skin sores, joint pain, swelling and stiffness are
possible results.

Treatments and drugs

Doctors prescribe antibiotic medications for gonorrhea treatment. Because more and
more strains of gonorrhea are becoming drug resistant, it's important that you take the
full course of medication. Not taking the full course of medication may allow the
most drug-resistant organisms to survive. Although over-the-counter pain relievers
may reduce signs or symptoms, these medications won't cure gonorrhea.

Babies born to mothers with gonorrhea are treated with antibiotics, as well. The
application of silver nitrate or another medication to the baby's eyes immediately after
birth can prevent infection of the baby's eyes.

Prevention
To prevent the spread of gonorrhea, use latex condoms and avoid oral sex. Gonorrhea
is highly contagious, and yet may cause no signs or symptoms.

If you have gonorrhea, avoid sexual contact until a course of antibiotics completely
eliminates your infection. Having had gonorrhea once doesn't provide you immunity
from getting it again. Consider alerting your sexual partner or partners so that they
may be tested for the infection, as well, and help prevent further spread of the disease.
Your state health department can work with you to accomplish this.

Schedule a follow-up examination with your doctor after you've completed the course
of antibiotics. Your doctor can check to see if your infection has been completely
eliminated.