Gonorrhea is a sexually transmitted infection (STI). It’s caused by infection with the bacterium Neisseria gonorrhoeae. It tends to infect warm, moist areas of the body, including the:
- urethra (the tube that drains urine from the urinary bladder)
- female reproductive tract (the fallopian tubes, cervix, and uterus)
Gonorrhea passes from person to person through unprotected oral, anal, or vaginal sex. People with numerous sexual partners or those who don’t use a condom are at greatest risk of infection. The best protections against infection are abstinence, monogamy (sex with only one partner), and proper condom usage. Behaviors that make a person more likely to engage in unprotected sex also increase the likelihood of infection. These behaviors include alcohol abuse and illegal drug abuse, particularly IV drug use.
Symptoms usually occur within two to 14 days after exposure. However, many people infected with gonorrhea may never develop noticeable symptoms. It’s important to remember that a person with gonorrhea who doesn’t have symptoms (a nonsymptomatic carrier) is still contagious. A person is more likely to spread the infection to other partners when symptoms remain “silent” like this.
Symptoms in Men
Men may not develop noticeable symptoms for several weeks. Some men may never develop symptoms.
The first noticeable symptom in men is often a burning or painful sensation during urination. Other symptoms may include:
- greater frequency or urgency of urination
- a pus-like discharge (or drip) from the penis (white, yellow, beige, or greenish)
- swelling or redness at the opening of the penis
- swelling or pain in the testicles
- a persistent sore throat
Symptoms in Women
Many women don’t develop any overt symptoms of gonorrhea. When women do develop symptoms, they tend to be mild or similar to other infections, making them more difficult to identify. Gonorrhea infections can appear much like common vaginal yeast or bacterial infections.
- 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 penile or vaginal discharge and place it on a glass slide. They will then add a stain to the sample and examine it under a microscope. (This test may instead be done by a lab technologist.) If cells react to the stain, the specimen is probably gonorrhea. This method is relatively quick and easy, but it doesn’t provide absolutely certainty.
A second method involves taking a sample and placing it on a special dish. This will be incubated under ideal growth conditions for several days. A colony of gonorrhea bacteria will grow if gonorrhea is present.
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. A healthcare professional will remove blood or joint fluid by inserting a needle and removing a small amount of fluid. A cotton-tipped swab can obtain specimens from other sites.
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, and infertility. An ectopic pregnancy is when a fertilized egg implants outside the uterus. Gonorrhea infection may pass 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 can cure most gonorrhea infections. However, the emergence of drug-resistant strains of gonorrhea is a growing challenge. Most states provide free diagnosis and treatment at state-sponsored health clinics. Doctors will usually give an injection of strong antibiotics. Some follow-up may also be necessary.
The law requires healthcare professionals to report the infection, usually to the County Public Health Department. Public health officials will identify, contact, test, and treat any sexual partners of the affected person to help prevent the spread of the infection. Health officials will also contact other people these individuals may have had sexual contact with.
Some strains of gonorrhea 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.