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Gonorrhea

Gonorrhea is a very common sexually transmitted diseases (STDs). Gonorrhea is caused by Neisseria gonorrhoeae, a bacterium that can grow and multiply easily in the warm, moist areas of the reproductive tract, including the cervix, uterus, Fallopian tubes and in the urethra (urine canal). The bacterium can also grow in the mouth, throat, eyes, and anus.

Gonorrhea is one of the oldest known sexually transmitted diseases. It is estimated that over one million women are currently infected with gonorrhea. Among women who are infected, 25%-40% also will be infected with Chlamydia, another type of bacteria that causes another STDs. The CDC recommends that all women diagnosed with gonorrhea also receive treatment for Chlamydia.

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.

Gonorrhea

Gonorrhea

It survives only on moist surfaces within the body and is found most commonly in the vagina, and, more commonly, the cervix. It can also live in the 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.

An infected person may also spread gonorrhea from one part of their body to another by touch. Gonorrhea can be spread through all forms of sexual activity including oral, vaginal, and rectal sex. Gonorrhea may be passed to newborns if their mother is infected when childbirth occurs.

Gonorrhea risks

  • Any sexually active woman can get gonorrhea but the highest gonorrhea rate is discovered among women 15-30 year old. Women who have vaginal intercourse with infected partner have about 60-90% chance of becoming infected. At the same time men who have vaginal sex with an infected woman have a significantly lower 30-50% chance of becoming infected by this sexually transmitted disease. In the United States, the highest reported rates of infection are among sexually active teenagers, young adults, and African Americans.
  • Gonorrhea is a threat for women reproductive organs and reproductive functions. Together with Chlamydia, gonorrhea remains a major cause of pelvic inflammatory disease (PID), tubal infertility, ectopic pregnancy, and chronic pelvic pain. It is also discovered that gonococcal infections (gonorrhea) facilitate the transmission of HIV infection.
  • The Bartholin’s glands may cause problems for women with gonorrhea. The ducts can become blocked and swell until a sore is formed. If this happens the lower area of the vulva will turn red on the infected side. Bartholin cyst is a common problem for women with gonorrhea.
  • If the infection is allowed to spread, gonorrhea can affect the uterus by significantly raising the risk that pelvic inflammatory disease (PID) may occur.

Tansmission

It is spread through contact with the penis, vagina, mouth, or anus. Ejaculation does not have to occur for gonorrhea to be transmitted or acquired. Gonorrhea can also be spread from mother to baby during delivery.

People who have had gonorrhea and received treatment may get infected again if they have sexual contact with a person infected with gonorrhea.

Symptoms

In women the cervix is primarily affected by gonorrhea. However, untreated gonorrhea can spread to the uterus and fallopian tubes. Unfortunately, the symptoms of gonorrhea in women often go unnoticed. Over 50% of infected women have no symptoms, especially in the early stages of the infection. When women do experience symptoms, they may include:

  • abnormal bleeding,
  • frequent urination,
  • pain or burning sensation during urination,
  • increased yellowish vaginal discharge,
  • general irritation of the outer area of the vagina (redness and swelling of the genitals),
  • burning or itching of the vaginal area,
  • vaginal bleeding between periods.

When women experience gonorrhea infection in the throat or rectum, symptoms such as pain, swelling, itching, soreness, and discharge often occur.

Women with gonorrhea are at risk of developing serious complications from the infection, regardless of the presence or severity of symptoms. 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 (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,
  • painful intercourse.

Gonorrhea can be a cause for infertility. 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 women with conditions causing serious abnormal immune function, such as AIDS, can also be more serious.

GONORRHEA at glance

Gonorrhea is a bacterial infection that is transmitted during sexual activity.

Gonorrhea is not transmitted from toilet seats.

Women infected with gonorrhea may not have any symptoms.

Gonorrhea is treated with antibiotics.

Diagnosis

Several laboratory tests are available to diagnose this infection. Testing is done by swabbing the infected site (rectum, throat, and 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 this infection 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.

Complications

Untreated this infection can cause serious and permanent health problems in women.

  • this infection is a common cause of pelvic inflammatory disease (PID). The symptoms could be quite mild or can be very severe and can include abdominal pain and fever. PID can lead to internal abscesses (pus-filled “pockets” that are hard to cure) and long-lasting, chronic pelvic pain. PID can damage the Fallopian tubes enough to cause infertility or increase the risk of ectopic pregnancy.
  • this infection can spread to the blood or joints. This condition can be life threatening. In addition, people with this infection can more easily contract HIV, the virus that causes AIDS. HIV-infected people with gonorrhea can transmit HIV more easily.

Gonorrhea and pregnancy

Pregnant woman with this infection could transmit the infection to her baby as the baby passes through the birth canal during delivery. This can cause blindness, joint infection, or a life-threatening blood infection in the baby. Treatment of this infection as soon as it is detected in pregnant women will reduce the risk of these complications.

Treatment

Several antibiotics can successfully cure gonorrhea in adolescents and adults. However, drug-resistant strains of gonorrhea are increasing in many areas of the world and successful treatment of gonorrhea is becoming more difficult. Because many people with gonorrhea also have Chlamydia (another STD) antibiotics for both infections are usually given together. Persons with gonorrhea always should be tested for other STDs.

It is important to take all of the medication prescribed to cure this infection. Although medication will stop the infection, it will not repair any permanent damage done by the disease. People who have had gonorrhea and have been treated can get the disease again if they have sexual contact with persons infected with this infection. If a person’s symptoms continue even after receiving treatment, he or she should return to a doctor to be reevaluated.

Prevention

  • 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 this infection.
  • 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 this infection 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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