What is Gonorrhea? We answer this question and provide you with symptoms, treatments and other information on this STD.
What is Gonorrhea?
Gonorrhea is a sexually-transmitted bacterial disease that can cause loss of fertility, arthritis, and heart problems. Gonorrhea in women can cause pelvic inflammatory disease (PID), which increases the risk of ectopic pregnancy. Pregnant women with gonorrhea infections are at risk of preterm labor and stillbirth. Learn how to prevent, diagnose or treat gonorrhea.
How common is Gonorrhea?
Gonorrhea is a very common infectious disease. CDC estimates that more than 700,000 persons in the U.S. get new gonorrheal infections each year. Only about half of these infections are reported to CDC. In 2006, 358,366 cases of gonorrhea were reported to CDC. In the period from 1975 to 1997, the national gonorrhea rate declined, following the implementation of the national gonorrhea control program in the mid-1970s. After several years of stable gonorrhea rates, however, the national gonorrhea rate increased for the second consecutive year. In 2006, the rate of reported gonorrheal infections was 120.9 per 100,000 persons.
What happens if Gonorrhea is left untreated?
In untreated gonorrhea infections, the bacteria can spread up into the reproductive tract, or more rarely, can spread through the blood stream and infect the joints, heart valves, or the brain. The most common result of untreated gonorrhea is PID, a serious infection of the female reproductive tract. Gonococcal PID often appears immediately after the menstrual period. PID causes scar tissue to form in the fallopian tubes. If the tube is partially scarred, the fertilized egg may not be able to pass into the uterus. If this happens, the embryo may implant in the tube causing a tubal (ectopic) pregnancy. This serious complication may result in a miscarriage and can cause death of the mother.
Rarely, untreated gonorrhea can spread through the blood to the joints. This can cause an inflammation of the joints which is very serious.
If you are infected with gonorrhea, your risk of getting HIV infection increases (HIV, human immunodeficiency virus, causes AIDS). Therefore, it is extremely important for you to either prevent yourself from getting gonorrhea or get treated early if you already are infected with it.
Myth and Facts about Gonorrhea
Contrary to popular belief, gonorrhea cannot be transmitted from toilet seats or door handles. The bacterium that causes gonorrhea requires very specific conditions for growth and reproduction. It cannot live outside the body for more than a few seconds or minutes, nor can it live on the skin of the hands, arms, or legs. It survives only on moist surfaces within the body and is found most commonly in the vagina, and, more commonly, the cervix. (The cervix is the end of the uterus that protrudes into the vagina.) It can also live in the tube (urethra) through which urine drains from the bladder. Gonorrhea can even exist in the back of the throat (from oral-genital contact) and in the rectum.
What are the symptoms of gonorrhea?
Over 50% of infected women have no symptoms, especially in the early stages of the infection. Symptoms of gonorrhea include burning or frequent urination, a yellowish vaginal discharge, redness and swelling of the genitals, and a burning or itching of the vaginal area. If untreated, gonorrhea can lead to a severe pelvic infection with inflammation of the Fallopian tubes and ovaries. Gonorrheal infection of the Fallopian tubes can lead to a serious, painful infection of the pelvis known as pelvic inflammatory disease or PID. PID occurs in 10%-40% of women with gonorrheal infection of the uterine cervix. Symptoms of pelvic infection include fever, pelvic cramping, abdominal pain, or pain with intercourse. Pelvic infection can lead to difficulty in becoming pregnant or even sterility. Occasionally, if the infection is severe enough, a localized area of infection and pus (an abscess) forms, and major surgery may be necessary and even lifesaving. Gonorrhea infection in people with conditions causing serious abnormal immune function, such as AIDS, can also be more serious.
How is gonorrhea diagnosed?
Testing for gonorrhea is done by swabbing the infected site (rectum, throat, cervix) and identifying the bacteria in the laboratory either through culturing of the material from the swab (growing the bacteria) or identification of the genetic material from the bacteria. Sometimes the tests do not show bacteria because of sampling errors (the sampled area does not contain bacteria) or other technical difficulties, even when the woman has an infection. Newer tests to diagnose gonorrhea involve the use of DNA probes or amplification techniques (for example, polymerase chain reaction, or PCR) to identify the genetic material of the bacteria. These tests are more expensive than cultures but typically yield more rapid results.
What is the treatment for gonorrhea?
In the past, the treatment of uncomplicated gonorrhea was fairly simple. A single injection of penicillin cured almost every infected person. Unfortunately, there are new strains of gonorrhea that have become resistant to various antibiotics, including penicillins, and are therefore more difficult to treat. Fortunately, gonorrhea can still be treated by other injectable or oral medications.
Uncomplicated gonococcal infections of the cervix, urethra, and rectum, are usually treated by a single injection of ceftriaxone intramuscularly or by 400mg of cefixime (Suprax) in a single oral dose. For uncomplicated gonococcal infections of the pharynx, the recommended treatment is 125 mg of ceftriaxone in a single IM dose.
Alternative regimens for uncomplicated gonococcal infections of the cervix, urethra, and rectum are 2 g of spectinomycin in nonpregnant women (not available in the United States) in a single IM dose or single doses of cephalosporins (ceftizoxime, 500 mg IM; or cefoxitin, 2 g IM, administered with probenecid (Benemid), 1 g orally; or cefotaxime, 500 mg IM).
Treatment should always include medication that will treat chlamydia [for example, azithromycin (Zithromax, Zmax) or doxycycline (Vibramycin, Oracea, Adoxa, Atridox and others)] as well as gonorrhea, because gonorrhea and chlamydia frequently exist together in the same person. The sexual partners of women who have had either gonorrhea or chlamydia must receive treatment for both infections since their partners may be infected as well. Treating the partners also prevents reinfection of the woman. Women suffering from PID require more aggressive treatment that is effective against the bacteria that cause gonorrhea as well as against other organisms. These women often require intravenous administration of antibiotics.
It is important to note that doxycycline, one of the recommended drugs for treatment of PID, is not recommended for use in pregnant women.
Gonorrhea is one of the easier STDs to prevent because the bacterium that causes the infection can survive only under certain conditions. The use of condoms protects against gonorrhea infection. Since the organism can live in the throat, condoms should be used during oral-genital contact as well.
How can Gonorrhea be prevented?
The surest way to avoid transmission of STDs is to abstain from sexual intercourse, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. Latex condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea.
Any genital symptoms such as discharge or burning during urination or unusual sore or rash should be a signal to stop having sex and to see a doctor immediately. If a person has been diagnosed and treated for gonorrhea, he or she should notify all recent sex partners so they can see a health care provider and be treated. This will reduce the risk that the sex partners will develop serious complications from gonorrhea and will also reduce the person’s risk of becoming re-infected. The person and all of his or her sex partners must avoid sex until they have completed their treatment for gonorrhea.
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