Gonorrhea is a sexually transmitted infection (STI). It is caused by infection with the bacterium Neisseria gonorrhoeae. It infects warm, moist areas of the body, including:
- the urethra (the tube that drains urine from the urinary bladder)
- the eyes
- reproductive tract (the fallopian tubes, cervix, and uterus in women)
Gonorrhea is transmitted by unprotected oral, anal, or vaginal sex. People who have multiple sexual partners and who do not use a condom are at greatest risk of infection. The best protection against infection is abstinence, monogamy (having only one sexual partner), or condom use. Behaviors that make a person more likely to engage in unprotected sex also increase the likelihood of infection. These include alcohol abuse or abuse of illegal drugs.
Symptoms may occur within two to five days after exposure. However, men may not develop noticeable symptoms for several weeks, and some may never develop symptoms.
Symptoms in women tend to be mild or similar to other infections. A person with gonorrhea who doesn’t have symptoms is still contagious. A person is more likely to spread the infection to other partners when symptoms remain “silent” like this.
In men, the first noticeable symptom is often a burning or painful sensation during urination. Other symptoms may include:
- greater frequency or urgency of urination
- a pus-like discharge from the penis (white, yellow, or greenish)
- swelling or redness at the opening of the penis
- swelling or pain in the testicles
- a persistent sore throat
In women, symptoms may be more difficult to identify. Gonorrhea infection is often mistaken for common vaginal yeast or bacterial infections. Symptoms include:
- discharge from the vagina
- pain or burning sensation while urinating
- the need to urinate more frequently
- sore throat
- pain upon engaging in sexual intercourse
- sharp pain in the lower abdomen
Untreated infection with gonorrhea may also result in the infection spreading to the bloodstream. In this case, rash, fever, or pain in the joints may eventually develop.
Healthcare professionals can diagnose gonorrhea infection in several ways. They will probably take a sample of penis or vaginal discharge. This sample will be smeared on a glass slide. A type of stain is added, then the slide is examined under a microscope. If cells react to the stain, the specimen is probably gonorrhea. This method is relatively quick and easy. However, it does not provide absolutely certainty.
A second method involves taking a sample, smearing it on a special dish, and incubating it under ideal growth conditions for several days. If gonorrhea is present, a colony of gonorrhea bacteria will grow.
A preliminary result may be ready within 24 hours. A final result will take up to three days. The sample may be taken from the throat, anus, vagina, tip of the penis, blood, or joint fluid. Blood or joint fluid are removed by inserting a needle and removing a small amount of fluid. Specimens from other sites are taken by using a cotton-tipped swab.
Generally, women are at greater risk of long-term complications from untreated infections. They may develop scarring of the fallopian tubes, which can prevent future pregnancy.
Infection can also lead to pelvic inflammatory disease (PID). This may involve ongoing pelvic pain, ectopic pregnancy (in which the fetus begins to grow outside the uterus), and infertility. Gonorrhea infection may be passed to a newborn infant during delivery.
Men may experience scarring of the urethra (the tube that allows urine to drain from the body). Men may also develop a painful abscess in the interior of the penis. When gonorrhea infection spreads to the bloodstream, both men and women can experience arthritis, heart valve damage, or inflammation of the lining of the brain or spinal cord. These are rare but serious conditions.
Modern antibiotics make it possible to cure gonorrhea infection in most instances. The emergence of drug-resistant strains of gonorrhea is a growing challenge. Most states provide free diagnosis and treatment at state-sponsored health clinics. Healthcare professionals will usually give an injection of strong antibiotic upon diagnosis. Some follow-up may also be necessary.
Healthcare professionals are required by law to report the infection. Public health officials will identify, contact, test, and treat any partners of the affected person who may have been infected to help prevent the spread of the infection. Other people these individuals may have had sexual contact with will also be notified.
Some strains of gonorrhea have developed resistance to common antibiotics. These cases may require more extensive treatment (usually with more expensive antibiotics) or combinations of antibiotics. Scientists are working to develop vaccines to prevent gonorrhea infection.