Gonorrhoea

Gonorrhoea affects millions of people worldwide each year. This common sexually transmitted infection can have serious consequences if left untreated. The causative factor of gonorrhoea is bacteria, and it spreads through sexual contact, making it a significant public health concern. Understanding the symptoms, causes, and treatment options for gonorrhoea is crucial for prevention and timely medical intervention. 

This article explores the key aspects of gonorrhoea, including gonorrhoea symptoms in men and women, the underlying causes, and risk factors. 

What is Gonorrhoea? 

Gonorrhoea is ranked among the most common sexually transmitted infections (STIs). Bacterium Neisseria gonorrhoeae is the main organism responsible for gonorrhoea. This ancient disease, with references dating back to biblical times, has been known by various names, including 'the clap'. Gonorrhoea primarily affects sexually active individuals and can be transmitted through vaginal, oral, or anal sexual contact. 

The infection typically manifests as urethritis in men and cervicitis in women. However, gonorrhoea can also affect other body parts, including the rectum, throat, and eyes. It's important to note that many people with gonorrhoea may not experience any symptoms, making it easy to spread the infection to sexual partners unknowingly. 

Symptoms of Gonorrhoea 

Gonorrhoea often presents differently in men and women, with many cases being asymptomatic. 
In women, gonorrhoea symptoms can include: 

• An unusual vaginal discharge that may be yellow, green, or pus-like 
• Pain or a burning sensation when urinating 
• Lower abdominal discomfort 
• Bleeding between periods 

Symptoms in men are: 

• White, yellow, or green fluid discharge from the penis 
• Pain or burning when urinating 
• Testicular pain or swelling 

Gonorrhoea can also affect other body parts, such as: 

• Rectal infections may cause itching, discharge, or pain during bowel movements. 
• Throat infections often produce no symptoms but can occasionally lead to a sore throat or difficulty swallowing. 
• Eye infections may result in pain, sensitivity to light, and discharge. 

Causes of Gonorrhoea 

The primary causative pathogen for gonorrhoea is the bacterium Neisseria gonorrhoeae, which is an obligate human pathogen. This means that the bacteria can only survive and reproduce within the human body, making it entirely dependent on human hosts for its existence. The infection is primarily transmitted through: 

• The bacteria that cause gonorrhoea are present in sexual fluids, such as semen and vaginal discharge. When these fluids come into contact with the mucous membranes of the body, such as those in the cervix, urethra, rectum, throat, or eyes, infection can occur. It's important to note that ejaculation is not necessary for the bacteria to spread. 
• Gonorrhoea can also be transmitted through the sharing of unwashed sex toys or those not covered with a new condom between uses. 
• Close genital-to-genital contact without penetration can also lead to exposure. 
• Pregnant women with gonorrhoea can pass the infection to their babies during childbirth. This can have severe consequences for the newborn, potentially causing eye infections that, if left untreated, may lead to permanent blindness. 

Risk Factors 

Several factors increase the likelihood of contracting gonorrhoea. These may include: 

• Individuals under 25 years old are at a higher risk, particularly sexually active women in this age group. Men who have sex with men also face an elevated risk of infection. 
• Having multiple sexual partners or infected sexual partners increases the chances of exposure to gonorrhoea. 
• People with a history of sexually transmitted infections (STIs) are more susceptible to contracting gonorrhoea. 
• Inconsistent use of barrier methods during sexual activities, such as condoms or dental dams, puts individuals at greater risk. 
• Engaging in sexual activities with partners who haven't recently tested negative for gonorrhoea also increases the likelihood of infection. 
• Socioeconomic factors may also influence gonorrhoea risk. Lower socioeconomic status, potentially linked to limited access to healthcare and reduced awareness of STIs, has been associated with higher rates of reported gonorrhoea cases. 

Complications of Gonorrhoea 

Untreated gonorrhoea can have serious consequences for both men and women. 

• In women, this bacterial infection can spread to the uterus & fallopian tubes, resulting in pelvic inflammatory disease (PID). PID can cause permanent impairment of the reproductive tract, leading to infertility and chronic pelvic pain. 
• Women may develop asymptomatic or minimally symptomatic salpingitis, which can also cause tubal damage. 
• Men with untreated gonorrhoea may develop epididymitis. In rare cases, epididymitis may lead to infertility. 
• Both men and women are at risk of disseminated gonococcal infection (DGI) if gonorrhoea is left untreated. DGI occurs when the infection spreads to the bloodstream, potentially affecting the skin, joints, and internal organs. 
• Pregnant women with gonorrhoea can pass the infection to their newborn babies during childbirth, potentially causing eye infections in newborns. If left untreated, these infections may lead to blindness. 
• Significantly, having gonorrhoea increases the risk of contracting and transmitting HIV. 

Diagnosis 

Diagnosing gonorrhoea requires specific testing, as symptoms alone are not sufficient for a definitive diagnosis. The most common method used is the nucleic acid amplification test (NAAT), which detects the genetic material of the Neisseria gonorrhoeae bacterium. This highly accurate test can be performed on various samples, including urine and swabs (throat, urethra, vagina or rectum). Doctors may also perform testing for other sexually transmitted diseases, as they may occur with gonorrhoea. 

Treatment for Gonorrhoea 

• Antibiotics: As per recommendation by the CDC (Centers for Disease Control and Prevention), a single intramuscular dose of ceftriaxone (500 mg) is the first-line gonorrhoea treatment. 
• Treatment for Co-infections: Since gonorrhoea often occurs with other STIs, doctors may prescribe additional antibiotics as a part of medical treatment for gonorrhoea. 
• Treatment for Partners: It's crucial that sexual partners also receive treatment to prevent reinfection or the spreading of the disease. 
• Abstinence: Doctors usually advise resting and refraining from sexual intercourse until the infection has been fully cleared. 

When to See a Doctor 

If you suspect you might have gonorrhoea, it's crucial to seek medical attention promptly. You should make an appointment with your doctor if you notice any symptoms, such as a burning sensation when urinating or a pus-like discharge from your genitals or rectum. Even if you don't have symptoms, it's essential to get a gonorrhoea test done if you've had unprotected sex with a new partner or if your current partner has been diagnosed with gonorrhoea.

Prevention 

Preventing gonorrhoea is crucial for maintaining sexual health. The most effective ways to avoid this sexually transmitted infection are: 

• Using condoms every time during a sexual activity is the best method to lower the chances of infection. This includes using condoms for vaginal, anal, and oral sex. 
• Limiting the number of sexual partners to one & being in a monogamous relationship where both partners have been tested can significantly reduce the risk of gonorrhoea. 
• Doctors advise regular screening for gonorrhoea for sexually active individuals, particularly those under 25 and those at higher risk. 
• For individuals at higher risk, such as men who have sex with men and transgender women, doxycycline may be prescribed as a preventive measure. Taking this medication within three days of sexual activity can lower the risk of gonorrhoea infection. 
• It's essential to avoid sexual contact with someone who shows symptoms of a sexually transmitted infection, such as genital sores or unusual discharge. 

Conclusion 

Gonorrhoea remains a significant health concern, affecting millions worldwide each year. This sexually transmitted infection, caused by the Neisseria gonorrhoeae bacterium, can have severe consequences if left untreated. Understanding the symptoms, along with risk factors & prevention methods, is crucial to protect oneself and others from its spread. 

Regular testing is elementary for early detection and treatment, especially for those at higher risk. Remember, many cases of gonorrhoea show no symptoms, making routine check-ups essential for sexually active individuals. By staying informed & taking proactive steps, we can work together to curb the spread of this common yet preventable infection. 

FAQS 

1. What is one of the first signs of gonorrhoea? 

One of the first signs of gonorrhoea can be a burning sensation when urinating. However, it's important to note that many people with gonorrhoea don't experience any symptoms at all. In men, early signs may include a white, yellow, or green discharge from the penis. Women might notice an unusual vaginal discharge. It can be thin or watery and green or yellow. 

2. How long does treatment take? 

Treatment for gonorrhoea typically involves a single dose of antibiotics, usually given as an injection. Symptoms often improve within a few days, but it may take up to two weeks for pain in the pelvis or testicles to disappear completely. It's crucial to complete the full course of antibiotics as your doctor prescribes. 

3. How serious is gonorrhoea? 

Gonorrhoea can be a serious infection if left untreated. It can lead to significant complications, including infertility in both men & women, pelvic inflammatory disease in women, and an elevated risk of HIV transmission. Rarely the infection can reach the bloodstream & affect other body parts, such as the joints. 

4. Can gonorrhoea be cured? 

Yes, gonorrhoea can be cured with prompt and appropriate antibiotic treatment. However, due to increasing antibiotic resistance, it's becoming more challenging to treat. Taking all prescribed medications as advised is essential to ensure the infection has cleared. 

5. How often should I get tested for gonorrhoea? 

The Centres for Disease Control & Prevention (CDC) suggests annual screening for sexually active females below 25 years and for older women who are more susceptible to getting infection. Men who have sex with men should be screened at least annually or every 3-6 months if they're at high risk. 

6. Will gonorrhoea ever go away? 

Without treatment, gonorrhoea will not go away on its own. While some studies suggest a small percentage of infections may clear spontaneously, this is not reliable or recommended. 

7. How long does gonorrhoea last in males? 

Without treatment, gonorrhoea can persist indefinitely in males. Symptoms, when present, typically appear within 2-14 days after exposure. However, even if symptoms subside, the infection remains active and can cause complications or be transmitted to partners. The infection usually clears up within 7-14 days with proper antibiotic 

Dr. Ritesh Satardey

MBBS, MS (General Surgery), MCh (Urology)
Ganga CARE Hospital Limited, Nagpur

To Book an Appointment, call:

+91 406 810 6585

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