Gonorrhea is a sexually transmitted disease (STD). 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 intravenous drug use.
Symptoms usually occur within two to 14 days after exposure. However, some people infected with gonorrhea never develop noticeable symptoms. It’s important to remember that a person with gonorrhea who doesn’t have symptoms, also called a nonsymptomatic carrier, is still contagious. A person is more likely to spread the infection to other partners when they don’t have noticeable symptoms.
Symptoms in men
Men may not develop noticeable symptoms for several weeks. Some men may never develop symptoms.
Typically, the infection begins to show symptoms a week after its transmission. The first noticeable symptom in men is often a burning or painful sensation during urination. As it progresses, 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
The infection will stay in the body for a few weeks after the symptoms have been treated. In rare instances, gonorrhea can continue to cause damage to the body, specifically the urethra and testicles. Pain may also spread to the rectum.
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 (watery, creamy, or slightly green)
- pain or burning sensation while urinating
- the need to urinate more frequently
- heavier periods or spotting
- sore throat
- pain upon engaging in sexual intercourse
- sharp pain in the lower abdomen
Healthcare professionals can diagnose gonorrhea infection in several ways. They can take a sample of fluid from the symptomatic area with a swab (penis, vagina, rectum, or throat) and place it on a glass slide. If your doctor suspects a joint or blood infection, he or she will obtain the sample by drawing blood or inserting a needle into the symptomatic joint to withdraw fluid. They will then add a stain to the sample and examine it under a microscope. If cells react to the stain, you most likely have a gonorrhea infection. This method is relatively quick and easy, but it doesn’t provide absolutely certainty. This test may also be completed by a lab technologist.
A second method involves taking the same type of 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.
Women are at greater risk of long-term complications from untreated infections. Untreated infection with gonorrhea in women may ascend up the female reproductive tract and involve the uterus, fallopian tubes, and ovaries. This condition is known as pelvic inflammatory disease (PID) and can cause severe and chronic pain and damage the female reproductive organs. PID can be caused by other sexually transmitted diseases as well. Women may also develop blocking or scarring of the fallopian tubes, which can prevent future pregnancy or cause ectopic pregnancy. 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. Men may also develop a painful abscess in the interior of the penis. The infection can cause reduced fertility or sterility.
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. Most states also provide free diagnosis and treatment at state-sponsored health clinics.
At home and over-the-counter remedies
There are no at-home remedies or over-the-counter medications that will treat an infection with gonorrhea. If you suspect that you have gonorrhea, you should seek care from a healthcare professional.
Gonorrhea is usually treated with an antibiotic injection of Ceftriaxone one time to the buttocks or a single dose of Azithromycin by mouth. Once on antibiotics, you should feel relief within days.
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.
The emergence of antibiotic-resistant strains of gonorrhea is a growing challenge. These cases may require more extensive treatment, with a seven-day course of an oral antibiotic or dual therapy with two different antibiotics, usually for a total of seven days of therapy. The antibiotics used for extended therapy are usually given once or twice a day. Some common antibiotics used include azithromycin and doxycycline. Scientists are working to develop vaccines to prevent gonorrhea infection.
The safest way to prevent gonorrhea or other STDs is through abstinence. If you do engage in sex, always use a condom. It’s important to be open with your sexual partners, get regular STD testing, and find out if they’ve been tested.
If your partner is showing signs of a possible infection, avoid any sexual contact with them. Ask them to seek medical attention to rule out any possible infection that can be passed on.
You’re at a higher risk of contracting gonorrhea if you’ve already had it or any other STDs. You’re also at a higher risk if you have multiple sexual partners or a new partner.
If you think you may have gonorrhea, you should avoid any sexual activity. You should also contact your doctor immediately.
During your doctor’s visit, be prepared to:
- detail your symptoms
- discuss your sexual history
- provide the contact info for previous sexual partners so that the doctor can contact them anonymously on your behalf
If you’re in contact with your sexual partner(s), let them know they should be tested immediately.
If you’re placed on antibiotics, it’s important to take the full course of pills to ensure that your infection is completely treated. Cutting your course of antibiotics short can make the bacteria more likely to develop resistance to the antibiotic. You also need to follow up with your doctor one to two weeks later to make sure that your infection has cleared.
If the results come back negative and your sexual partner is also clear of any infection, it’s possible to resume sexual activity.
What is the relationship between gonorrhea and chlamydia?
Gonorrhea and chlamydia are both bacteria that cause STDs. The risk factors are the same for both infections, and both cause similar symptoms. The complications of chlamydia are very similar to gonorrhea except chlamydia is much less likely to affect sites other than the reproductive tract. Diagnosis and treatment are virtually the same as well. If you think you may have an STD, you should see a healthcare professional. They can determine what type it is by testing you as described above, and then start proper treatment.Graham Rogers, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.