Gonorrhea

Gonorrhea is almost always sexually transmitted. Genital sex will cause gonorrhea of the genitals. Anal sex can transmit gonorrhea to the rectum. Oral sex can cause gonorrhea of the throat. Gonorrheal eye infections are usually found in infants who have picked it up in the birth canal, but adults may get eye infections if they touch the infected area and then rub their eyes.

Gonorrhea is far more likely to cause symptoms in men than in women. In men, symptoms typically appear after 2 to 14 days, but occasionally appear months after infection. There is a discharge of yellow or greenish pus from the penis and a frequent need to urinate. Urinating often causes burning pain that can be severe. The opening of the penis may be red and swollen.

Most women don't have symptoms unless there are complications. A few may experience pain on urination. A few have a noticeable vaginal discharge, which may actually be coming from the cervix. The discharge is usually yellow or green, but it may also contain blood. It often has an unpleasant odour. Symptoms in women appear later if they appear at all, usually 7 to 21 days after infection. Most women are diagnosed only when their partner seeks treatment.

While women feel fewer symptoms, they are far more vulnerable to serious complications of gonorrhea. Left untreated, gonorrhea can work its way up the urethra and cervix to other pelvic organs. The result is pelvic inflammatory disease (PID), a very common condition that strikes well over a million North American women every year and can cause infertility. The main complication in men is epididymitis (inflammation of the part of the testicles where sperm is stored), which can cause infertility if not treated.

Other complications of gonorrhea occur when the bacteria get into the bloodstream. They can cause inflammation and pain in the joints (arthritis) and liver (perihepatitis) and a potentially serious infection of the heart valves (endocarditis).

Gonorrhea of the throat is usually asymptomatic but sometimes causes a sore throat and difficulty swallowing. Gonorrhea in the eyes is serious – it can cause blindness if left untreated.

Some people with gonorrhea have symptoms involving the rectum such as itching and discharge or possibly painful bowel movements.

Your doctor will ask you questions about your symptoms and may perform a physical exam. They will then take swabs from the affected areas or a urine sample. The samples will be tested to see if they contain the bacteria that cause gonorrhea. Your doctor may also recommend that you be tested for other sexually transmitted infections, since people who have a sexually transmitted infection often have more than one.

Gonorrhea is treated with antibiotics. A variety of treatments are available for gonorrhea that usually involve a single injection or a single dose of oral medication (pills). The pills are used if your doctor suspects you also have chlamydia. People with gonorrhea often have chlamydia as well. Usually a single dose of a medication such as ceftriaxone* or cefixime, along with azithromycin, is used to treat gonorrhea.

Fluoroquinolones, penicillins, or tetracyclines used to be effective therapies, but many of the strains today have developed resistance to these antibiotics. It is very important to take medications exactly as prescribed and to have a follow-up test 1 to 3 weeks (depending on the test used; ask your doctor when to return for a follow-up) after treatment.

Symptoms sometimes remain for a while after treatment. Men can suffer from postgonococcal urethritis (inflammation of the urethra, the tube running down the centre of the penis). This condition is usually caused by chlamydia that didn't respond to an earlier treatment. Treatment with different antibiotics will usually solve this problem.

You can prevent gonorrhea in the same way you prevent any sexually transmitted infection. Wear condoms and choose your partners carefully. If you think you might already have a sexually transmitted infection, you should avoid sex until you've talked to your doctor. Sexual partners should be referred to a doctor for evaluation even if they do not have any symptoms.

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