Gonorrhea is a sexually transmitted infection (STI) caused by the bacteria Neisseria gonorrhoeae. It can infect both men and women and typically affects one or more of the following:
Most new cases of the infection occur in women. Women who are infected with gonorrhea may also transmit the bacteria to their newborns during childbirth. Gonorrhea infections in babies typically affect their eyes.
According to the Centers for Disease Control and Prevention (CDC), there were 350,062 cases of gonorrhea reported in 2014. The CDC also reports that gonorrhea is the second most common bacterial STI in the United States. Treatment for gonorrhea is effective and available, but many cases go untreated.
Over time, the bacteria that causes gonorrhea can spread to the bloodstream and other parts of the body. This can lead to a serious medical condition known as systemic gonococcal infection or disseminated gonococcal infection (DGI).
Not everyone who’s infected with gonorrhea will have symptoms in the early stages. However, you may experience:
- thick discharge from the penis
- increased vaginal discharge
- painful urination
- spotting between menstrual periods
- swollen testicles
- painful bowel movements
- anal itching
When gonorrhea infections aren’t treated, the bacteria can spread, causing symptoms. Specific symptoms depend on the area of the body affected by the bacteria. Symptoms that commonly occur with DGI include:
- fever or chills
- feeling ill or generally unwell (malaise)
- pain in the joints
- swelling of the joints
- pain in the tendons of the wrists or heels
- a skin rash with pink or red spots that become filled with pus
Gonorrhea is an STI that can spread through vaginal, anal, or oral intercourse. DGI can develop within two weeks of being infected with gonorrhea. Once in the bloodstream, gonorrhea can affect various tissues and cause permanent damage.
Although gonorrhea is a common STI, certain groups have a higher risk for developing DGI. These include:
- people who have unprotected sex
- people with multiple sex partners
- men and women who are under the age of 25
- men and women who engage in sex work
Your doctor will check to see if you have gonorrhea or if you have symptoms of DGI. Tests for gonorrhea typically involve taking a sample, or culture, from the infected area. The sample is sent to a laboratory where it’s analyzed for the presence of bacteria. Results are often available within 24 hours.
Cultures for testing can be obtained from:
- the blood
- a skin lesion
- fluid from the joints
- the cervix
- the throat
- the anus
- the urethra
If you test positive for gonorrhea, your doctor may order additional tests to determine if you have other sexually transmitted infections. Gonorrhea is often diagnosed along with other STIs, such as chlamydia.
You should get immediate treatment if you think that you have gonorrhea. Untreated gonorrhea can spread and cause serious and irreversible complications. Systemic gonococcal infection is a complication of gonorrhea that occurs when gonorrhea bacteria enter the bloodstream.
You can develop other complications once the gonorrhea bacteria have entered the bloodstream. These may include:
- gonococcal arthritis, which involves rashes and inflammation of the joints
- gonococcal endocarditis, which is damage to the inner lining of the heart muscle
- gonococcal meningitis, which is an infection of the membranes covering the brain and spinal cord
Other complications of gonorrhea include infertility. The infection can spread to the fallopian tubes and uterus in women and cause epididymitis in men, which is inflammation and swelling of the epididymis. Untreated gonorrhea also increases the risk of getting and spreading HIV, which is the virus that causes AIDS. Gonorrhea can also be passed from mother to baby at birth. The infection can cause blindness and scalp sores in babies.
Treatment for gonorrhea and DGI typically includes the use of antibiotics. Penicillin was once the primary treatment for gonorrhea, but antibiotic-resistant strains of gonorrhea have made penicillin ineffective for treating this condition. Antibiotics called cephalosporins are often used to treat gonorrhea. Typically, these medications are administered through a vein in your arm, or intravenously, rather than by mouth.
Treatment for gonorrhea also involves identifying the source of the infection. If you have gonorrhea, your doctor will ask about your sexual partners. Your partners will need to be tested and treated if they have the infection. This can prevent the spread of the disease.
It’s more likely that you’ll make a full recovery from gonorrhea or DGI if you start treatment quickly. It’s important to seek medical attention if you develop symptoms or if you suspect an infection. This allows your doctor to diagnose and treat the infection. Symptoms typically improve within one to two days of starting treatment.
Your long-term outlook may not be as good if you don’t seek treatment for your symptoms or if you don’t follow your doctor’s recommendations for treatment. Systemic gonococcal infections that affect different areas of the body can cause permanent damage.
Prevention of DGI requires prevention of gonorrhea. Not having sex, or abstinence, is the only way to completely prevent this condition. If you’re sexually active, you can take the following steps to avoid gonorrhea:
- Have one sexual partner, and make sure this person doesn’t have an infection.
- Use a condom every time you have sex.
- Make sure your sexual partner receives treatment for gonorrhea.