About Gonorrhea Disease &
Gonorrhea is a curable sexually transmitted infection (STI). It is the
second most commonly reported bacterial sex related disease in the USA
following chlamydia. During a recent year, 330,000 plus cases of gonorrhea
were reported to the Centers for Disease Control and Prevention (CDC).
When examining race and ethnicity, age, and gender, the highest rates
of gonorrhea were found in African Americans, 15 to 24 years of age, and
Gonorrhea can spread into the uterus and fallopian tubes, resulting
in a serious medical condition known as pelvic inflammatory disease
(PID). PID affects more than 1 million women in this country every year
and can cause tubal (ectopic) pregnancy and infertility in as many as
10 percent of infected women. In addition to gonorrhea playing a major
role in pelvic inflammatory disease, some health researchers think it
adds to the risk of getting HIV (human immunodeficiency virus) 'Aids'
CAUSE OF GONORRHEA
Gonorrhea is caused by bacteria called Neisseria gonorrhoeae. These
bacteria can infect the genital tract, mouth, and rectum of both men and
women. In women, however, the opening to the uterus (cervix) is the first
place of body infection.
SYMPTOMS OF GONORRHEA
The bacteria are carried in semen and vaginal fluids and cause a discharge
in men and women. A small number of people may be infected for several
months without showing symptoms.
For women, the early symptoms of gonorrhea often are mild. Symptoms
usually appear within 2 to 10 days after sexual contact with an infected
partner. When women have symptoms, the first ones may include
- Bleeding associated with vaginal intercourse
- Painful or burning sensations when urinating
- Yellow or bloody vaginal discharge
More advanced symptoms, which may indicate development of PID, include
cramps and pain, bleeding between menstrual periods, vomiting, or fever.
Men have symptoms more often than women, including
- White, yellow, or green pus from the penis with pain
- Burning sensations during urination that may be severe
- Swollen or painful testicles
If left untreated, men could experience prostate complications and
epididymitis (inflammation of the testicles).
Symptoms of rectal infection include discharge, anal itching, and occasional
painful bowel movements with fresh blood in the feces. Symptoms typically
appear 2 to 5 days after infection but could appear as long as 30-days.
DIAGNOSIS FOR GONORRHEA
Health care providers usually use three laboratory techniques to diagnose
- Staining samples directly for the gonorrhoeae bacterium
- Detecting bacterial genes or DNA in urine
- Growing the bacteria in laboratory cultures
Many providers prefer to use more than one test to increase the chance
of an accurate medical diagnosis.
You usually can get the staining test results while in the office or
clinic. This test is quite accurate for men but not so in women. Only
one in two women with gonorrhea has a positive stain.
More often, health care providers use urine or cervical swabs for a
new test that detects the genes of the bacteria. These tests are more
accurate than culturing the bacteria.
The laboratory culture test involves placing a sample of the bodies
discharge onto a culture plate. The health care provider also can take
a culture to detect gonorrhea in the throat. Culture also allows testing
for drug-resistant bacteria.
TREATMENT FOR GONORRHEA
Health care providers usually prescribe a single dose of one of the following
antibiotics to treat gonorrhea.
If you are pregnant, or are younger than 18-yrs old, you should not
be treated with certain types of antibiotics. Your doctor or health
care provider can prescribe the best and safest antibiotic for you.
Gonorrhea and chlamydia often infect people at the same time. Therefore,
health care providers usually prescribe a combination of antibiotics,
such as ceftriaxone and doxycycline or azithromycin, which will treat
If you have gonorrhea, all of your sexual partners should get tested
and then treated if infected, whether or not they have symptoms. Health
experts also recommend that you not have sex until your infected partners
have also been treated.
For updated information on treatment for gonorrhea, read the
CDC-STD Treatment Guidelines.
PREVENTION of GONORRHEA
The surest way to avoid transmission of STI's is to abstain from sexual
contact or be in a long-term mutually monogamous relationship with a partner
who has been tested and is not infected.
By using latex condoms correctly and consistently during vaginal or
rectal sexual activity, you can reduce your risk of getting gonorrhea
and developing complications.
COMPLICATIONS of GONORRHEA
In untreated gonorrhea infections, the bacteria can spread up into the
reproductive tract, or more rarely, can spread into the blood stream and
infect the joints, heart valves, or the brain.
The most common result of untreated gonorrhea is PID. 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.
In men, gonorrhea causes epididymitis, a painful condition of the testicles
that can lead to infertility if left untreated. Also, gonorrhea affects
the prostate gland and may cause scarring in the urine canal.
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.
Complications in newborns and children
If you are pregnant and have gonorrhea, you may give the infection
to your baby as it passes through the birth canal during delivery. A
health care provider can prevent infection of your baby's eyes by applying
silver nitrate or other medicine to the eyes immediately after birth.
Because of the risks from gonococcal infection to both you and your
baby, health experts recommend that pregnant women have at least one
test for gonorrhea during prenatal care.
When gonorrhea occurs in the genital tract, mouth, or rectum of a child,
it is due most commonly to sexual abuse.
RESEARCH FOR GONORRHEA
The National Institute of Allergy and Infectious Diseases (NIAID) continues
to support a comprehensive, multidisciplinary program of research on N.
gonorrhoeae (gonococci). Researchers are trying to understand how
gonococci infect cells while evading defenses of the human immune system.
Studies are ongoing to find
- How this bacterium attaches to host cells
- How it gets inside cells
- Gonococcal surface structures and how they can change
- Human response to infection by gonococci
Together, these efforts have led to, and will lead to, further improvements
in sexually transmitted disease diagnosis and treatment of gonorrhea.
They also may lead to development of an effective vaccine against gonorrhea
to get reproductive health benefits.
Another important area of gonorrhea research concerns antibiotic resistance.
This is particularly important because strains of N. gonorrhoeae
that are resistant to recommended antibiotic treatments have spread
from Southeast Asia to Hawaii and are now starting to appear on the
US west coast. These events add urgency to conduct research on and develop
new antibiotics and to prevent antibiotic resistance from spreading.
NIAID also supports research efforts to develop effective microbicides
(antimicrobial preparations that can be applied inside the vagina) to
prevent gonococcal infections.
Recently, scientists have determined the genetic code, or sequence,
of the N. gonorrhoeae genome. They are using this medical research
information to help us better understand how the bacterium causes human
disease and becomes resistant to antibiotics.