What to know about gonorrhea
In 2017, there were 555,608 diagnoses of gonorrhea in the United States.
Gonorrhea is a notifiable disease, which means that a doctor must report all diagnoses to the National Notifiable Diseases Surveillance System (NNDSS). This information enables health authorities to plan treatment and prevention strategies.
Gonorrhea is usually easy to treat, but delaying treatment can result in serious, and sometimes permanent, complications. For example, pelvic inflammatory disease occurs in females when the gonorrhea infection affects the uterus or fallopian tubes, and this can lead to infertility.
Effective treatment for gonorrhea is available if a person receives an early diagnosis.
Many people with gonorrhea do not notice any symptoms.
Those who do experience symptoms may have a burning sensation during urination.
Males may also notice:
- a white, green, or yellow discharge from the penis
- pain or swelling in the testicles
- inflammation or swelling of the foreskin
Females may also experience increased vaginal discharge and intermenstrual bleeding.
Rectal symptoms may also occur if a person has anal sex. These may include:
- itching around the anus
- pain during bowel movements
If gonorrhea results from oral sex, the person may have a throat infection, but they might not notice any symptoms.
If infected semen or vaginal fluid enters the eye, the person may develop conjunctivitis.
A person may go to the doctor due to experiencing symptoms or because they believe that they have had exposure to gonorrhea.
The doctor will ask the person about their symptoms and their medical history. They will also carry out a test, such as a urine sample or a swab of a potentially affected area — usually the penis, cervix, urethra, anus, or throat.
Home testing kits are also available for purchase online.
The individual can send a sample to a laboratory, and they will receive the results directly. If the result is positive, however, the person will need to see a doctor for treatment, and the doctor may wish to do another test to confirm the result.
It is crucial to use the kit exactly as the instructions explain, or the result may not be accurate. Different tests may also vary in accuracy, so it is better to see a healthcare professional if possible.
If one person has a diagnosis of gonorrhea, their sexual partner or partners should also undergo testing.
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If the test result is positive for gonorrhea infection, the individual and potentially any sexual partners will need to undergo treatment.
Treatment can stop the infection from progressing, but it cannot repair any permanent damage that has already occurred. For this reason, it is important to seek treatment as soon as possible.
Treatment typically involves antibiotics.
The Centers for Disease Control and Prevention (CDC) recommend a single dose of 250 milligrams of intramuscular ceftriaxone (Rocephin) and 1 gram of oral azithromycin (Zithromax). They urge people to take all of the medication that a doctor prescribes and to avoid sharing it with anyone else.
However, Neisseria gonorrhoeae, the bacteria that cause gonorrhea, have developed resistance to nearly all of the antibiotics that doctors have traditionally used to treat it.
This resistance is making gonorrhea more and more difficult to treat. If a person does not notice any improvement in their symptoms after several days of treatment, they should return to their healthcare provider. They may need further testing to determine whether the treatment is working.
A person should also attend any follow-up appointments and avoid having sex until a healthcare provider says that it is safe to do so.
If gonorrhea occurs during pregnancy, it is essential to let the healthcare team know. It is possible to pass the infection on to a baby during delivery, so the newborn will usually need antibiotics straight after birth.
Some newborns develop conjunctivitis after they are born. There are various possible causes, one of which is gonorrhea infection. Symptoms usually appear 2–4 days after birth and include red eyes, thick pus in the eyes, and swollen eyelids.
Anyone who notices these symptoms in a newborn should seek medical care at once as they can also be a sign of a more serious condition, such as meningitis or bacteremia.
The bacterium N. gonorrhoeae is responsible for gonorrhea infection. These bacteria thrive in a warm, moist environment. As a result, the infection can affect any of the mucous membranes, including those in the genital area, mouth, throat, eyes, and rectum.
A person transmits the infection to another individual through sexual contact that involves the penis, vagina, anus, or mouth. Males do not need to ejaculate to pass on or get gonorrhea.
A pregnant woman can also pass the infection on to the baby during delivery.
All sexually active individuals are at risk of having a gonorrhea infection, but in the U.S., it is most common among adolescents and young adults.
Gonorrhea can lead to a number of severe complications. For this reason, it is important to seek early diagnosis and treatment if an infection may be present.
In females, gonorrhea can lead to:
- pelvic inflammatory disease, a condition that can cause abscesses and other complications
- chronic pelvic pain
- ectopic pregnancy, in which the embryo attaches outside of the uterus
Further complications of a gonorrhea infection can occur during pregnancy and delivery. It is possible to pass the infection to the child, which can result in joint infection, loss of vision, or bacteremia — a life threatening blood infection.
There is also a higher risk of preterm labor or stillbirth if a pregnant woman leaves gonorrhea untreated.
In males, a gonorrhea infection can lead to epididymitis. Males with epididymitis may experience fertility issues.
In both males and females, untreated gonorrhea can lead to disseminated gonococcal infection, a life threatening condition that can cause:
People who have a gonorrhea infection also have a higher risk of contracting or transmitting HIV. One reason for this is that an infection can lead to open sores, and when there is a break in the skin, it is easier for another type of bacteria or a virus to enter the body.
Ways of preventing a gonorrhea infection include:
- avoiding sexual activity if there is a possibility of infection
- using condoms during vaginal or anal intercourse
- using condoms or dental dams for oral intercourse
- having sexual activity only with a mutually monogamous, unaffected partner
Learn more here about common STIs and how people get them.
I recently finished a relationship because I found out that my partner had been unfaithful with someone I know. Until then, I think we were both monogamous. Should I have a test? Will a home test be enough?
If you are concerned that your partner has had sexual intercourse with another person, it is a good idea to undergo testing for STIs. STI testing encompasses checking for gonorrhea, chlamydia, HIV, syphilis, herpes, and, for some patients, trichomoniasis, hepatitis B, and hepatitis C. A doctor can advise which tests are right for you.
Some of these tests require body fluid samples, and some are blood tests, which a healthcare professional will perform in the office or lab. If any of these come back positive, you (and perhaps your partner) will need medical treatment. Your doctor can explain the treatment and also help with informing your partner anonymously.
Depending on the timing, your doctor may also initiate a discussion about a follow-up, as some of these infections have a longer incubation period, and the initial test results may not be fully accurate.Carolyn Kay, M.D. Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.