Gonorrhea is a commonly occurring STD, generally referred to as ‘the clap.’ This sexually transmitted infection affects hundreds of thousands of people annually in the United States. Its rates are higher among young adults and adolescents, aged 15-24 years. Generally, an estimate of 583,405 gonorrhea cases was reported in the United States alone, back in 2018. However, the reported cases do not represent the exact number of active infections, because not everyone gives an account for and receives a diagnosis for this health issue.

Gonorrhea is a sexually transmitted infection that is curable but can cause troublesome and sometimes permanent damage to the body. If left untreated, it can lead to pelvic inflammatory disease (PID), a condition that affects the fallopian tubes or the uterus in women. A quite severe complication associated with pelvic inflammatory disease is infertility. Men with untreated or treatment-resistant gonorrhea may present with epididymitis, the inflammation of the tubes that carry the sperm. Extreme cases of gonorrhea-induced epididymitis will evolve into infertility.

Quick facts about gonorrhea

  • Gonorrhea is a common sexual infection, caused by the bacterium Neisseria gonorrhoeae.
  • It can also be passed on during birth, from the infected mother to her child.
  • Gonorrhea and Chlamydia are the two most common STDs that can happen simultaneously.
  • Gonorrhea can aggravate an individual’s risk of contracting HIV, if not treated appropriately.

What leads to gonorrhea infection?

Gonorrhea is an STD caused by the bacterium Neisseria gonorrhoeae. It primarily affects the reproductive system, in both sexes, but can also affect the mucous membranes of the rectum, eyes, throat, and mouth, if given the chance to progress.

You can contract gonorrhea via sexual contact with an infected individual involving the mouth, vagina, anus, or penis. Men do not have to ejaculate to acquire or transmit the infection to their partner. Gonorrhea can also be transmitted from an infected mother to her infant during labor.

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Are some people at higher risk than others?

All sexually active men and women are at high risk for contracting gonorrhea. However, some parameters and behavioral patterns and will increase your risk of acquiring the infection. Consecutively, you are more susceptible if:

  • You are young, between 15 to 24 years.
  • You have a new sex partner.
  • You have a sex partner that has multiple sex partners.
  • You have multiple sex partners.
  • You already had gonorrhea in the past.
  • You have other STDs.

Gonorrhea symptoms

Gonorrhea symptoms may not be visible, although the individual may suffer from an active gonorrhea infection. Gonorrhea symptoms can show up anywhere from 1 to 14 days following exposure to the bacteria.

You should keep in mind that gonorrhea symptoms in men and gonorrhea symptoms in women can be slightly different; these can include:

Gonorrhea symptoms in men

  • White, yellowish, or greenish pus-like urethral discharge.
  • Swelling or inflammation of the foreskin.
  • Frequent or painful urination.
  • Pain in the scrotum or testicles.
  • Anal pain, itching, bleeding, or discharge while passing stool.
  • Difficulty swallowing, itching, or swollen neck lymph nodes.
  • Light sensitivity, eye pain, or discharge from the eyes resembling pus.
  • Painful, warm, swollen, red joints.

Gonorrhea symptoms in women

  • Fever.
  • Painful sex.
  • Yellow or greenish vaginal discharge.
  • Heavy bleeding in-between periods.
  • Vulvar swelling.
  • Heavier periods.
  • Bleeding after sex.
  • Painful, warm, swollen, red joints.
  • Light sensitivity, pain in the eyes, and even eye discharge that resembles pus.
  • Difficulty swallowing, itching, or swollen neck lymph nodes.
  • Frequent or painful urination.
  • Pelvic, abdominal pain.
  • Vomiting.

Anal gonorrhea symptoms mainly include:

  • Pain, itching, bleeding with passing bowel movements.
  • Anal discharge.
  • A burning sensation or itching in the eyes that perhaps be an indication of conjunctivitis.
  • If the infected fluid or semen comes into contact with the eyes, an individual can develop conjunctivitis.

Gonorrhea complications

Gonorrhea is an STD that poses serious complications if poorly managed or left untreated. It requires quick and efficient diagnosis, along with proper treatment. Following are some of the most well-known gonorrhea complications everyone should be aware of:

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Gonorrhea in women can lead to:

  • Chronic pelvic pain.
  • Pelvic inflammatory disease – PID, a condition that leads to abscesses.
  • Infertility.
  • Ectopic pregnancies – Pregnancies where the embryo attaches itself outside of the uterus.

Gonorrhea in men can cause:

  • Epididymitis – A condition which controls the production of sperm.
  • Infertility.

Both women and men are at high risk of a life-threatening condition if gonorrhea remains untreated. This type of sexually transmitted infection is usually characterized by:

  • Arthritis.
  • Fever.
  • Sterility from tubal adhesions – It causes the fallopian tubes to get blocked.
  • Tenosynovitis – Swelling, and inflammation around tendons.
  • Dermatitis.
  • Meningitis – Inflammation of the brain.
  • Perihepatitis – Infection of the liver capsule.
  • Chlamydia – Another commonly occurring STD that often accompanies gonorrhea.

Individuals with active gonorrhea infection are susceptible to HIV. If they are HIV positive already, they may end up spreading HIV to their partner(s) along with gonorrhea.

Pregnant women can transmit the infection to their babies during delivery. Gonorrhea being passed on to an infant can lead to blindness, joint disturbances, or even a life-threatening blood infection. Infected women are at high risk for premature labor and stillbirth if they have unresolved gonorrhea.

Is it possible to prevent gonorrhea?

Preventing gonorrhea is feasible provided that both you and your partner(s) take the appropriate measures. The first and easiest way to prevent the infection is abstaining from having sex or any other sexual activity, such as oral sex. Also, using good quality condoms for both anal and vaginal intercourse is imperative. While using dental dams or condoms during oral sex may be undesirable and often uncomfortable for those involved, it significantly reduces the chances of transmission. It is highly recommended to avoid sexual intercourse with high-risk STD partner(s) and to have sex with a mutually monogamous, unaffected partner. Finally, it is crucial for all sexually active individuals to be tested for gonorrhea and other sexually transmitted diseases, including Chlamydia, syphilis, and HIV/AIDS before having sexual relations with them.

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Diagnosis of gonorrhea 

If gonorrhea symptoms occur and start becoming irritating, your doctor may suggest that you test yourself for other STDs as well. Testing for gonorrhea involves obtaining a swab sample of the affected area or preparing a urine sample. You should obtain a swab sample for gonorrhea from the throat, anus, urethra, cervix, and penis. At-home STD testing kits are always a quick and reliable choice. If it reveals that you are positive, you and your partner(s) should undergo treatment as soon as possible.

Treatment plan 

A treatment plan for gonorrhea generally includes taking antibiotics. Your physician will most likely administer both a shot (ceftriaxone) and an oral (azithromycin) medication. For health outcomes to be achieved, partners must abstain from sexual activity until their treatment is complete. However, some patients with resistant or persistent infections must retest. Retesting takes place a week after the initial therapy is complete. In the case of a pregnant woman with gonorrhea, the infant must receive all the appropriate care and attention to prevent the transmission of the infection.

Following up with gonorrhea

It is crucial for you to follow-up with gonorrhea infection after you have completed your treatment plan.

  • You must notify your sexual partner(s) to test for gonorrhea. They should be tested or treated for the infection so that they do not end up passing it back and forth.
  • Retest 72 hours after you completed your course of antibiotics, or if you consider reinfection occurred.
  • Get yourself tested for several other STDs, particularly HIV and chlamydia.