Gonorrhea is a common and highly contagious sexually transmitted infection (STI) caused by the bacteria Neisseria gonorrhoeae. It can affect both men and women and is typically spread through sexual contact, including vaginal, oral, and anal sex. If untreated, gonorrhea can lead to severe complications, affecting the reproductive organs, and in some cases, spreading to other parts of the body.

Symptoms of Gonorrhea

The symptoms of gonorrhea vary depending on the individual and the part of the body affected. However, many people may experience no symptoms at all, making it challenging to diagnose without testing. When symptoms do appear, they typically manifest within 2 to 14 days after exposure to the bacteria. Common symptoms of gonorrhea include:

  • In Men:

    • Painful urination

    • Discharge from the penis (usually white, yellow, or green)

    • Swelling or pain in the testicles

    • Sore throat (from oral sex)

  • In Women:

    • Painful urination

    • Increased vaginal discharge

    • Bleeding between periods

    • Pain during intercourse

    • Sore throat (from oral sex)

Gonorrhea can also infect the rectum, throat, and eyes, causing additional symptoms such as:

  • Rectal discharge or bleeding

  • Sore throat with difficulty swallowing

  • Eye redness, itching, or pus discharge

Causes of Gonorrhea

Gonorrhea is caused by the bacteria Neisseria gonorrhoeae, which primarily infects the mucous membranes of the reproductive tract, rectum, throat, and eyes. The bacteria are typically spread through unprotected sexual contact with an infected person. This can include:

  • Vaginal sex

  • Anal sex

  • Oral sex

  • Sharing sex toys

  • Childbirth (from mother to baby)

Gonorrhea is most common among sexually active individuals, particularly those between the ages of 15 and 24. It is important to note that the bacteria can be passed on even if an individual does not have symptoms.

Risk Factors for Gonorrhea

While anyone can contract gonorrhea, certain factors increase the risk of infection. These include:

  • Having multiple sexual partners

  • Not using condoms consistently or correctly

  • Having a history of STIs

  • Having a weakened immune system, such as due to HIV

  • Engaging in unprotected sex with individuals who have gonorrhea or other STIs

Young adults, particularly those under 25, are at a higher risk for gonorrhea, and people who engage in unprotected sex or share needles are also more vulnerable.

Diagnosis of Gonorrhea

Gonorrhea is diagnosed through a physical exam and laboratory tests. The healthcare provider may take a sample of the discharge from the affected area (penis, cervix, rectum, or throat) to test for the presence of Neisseria gonorrhoeae. Common diagnostic methods include:

  • Urine test: To detect the bacteria in the urine

  • Swab test: Taking a sample from the infected area (penis, cervix, throat, or rectum)

  • Blood test: In some cases, to test for complications or other infections

In many cases, testing for gonorrhea is done as part of routine STI screenings, especially for sexually active individuals or those with multiple partners.

Treatment for Gonorrhea

Gonorrhea is a treatable infection, and the main treatment for gonorrhea involves antibiotics. However, the emergence of antibiotic-resistant strains of gonorrhea is a growing concern. Standard treatments typically involve:

  • Dual antibiotic therapy: The Centers for Disease Control and Prevention (CDC) recommends a combination of two antibiotics, usually an injection of ceftriaxone and oral azithromycin. This treatment is effective for most gonorrhea cases.

  • Treatment for sexual partners: To prevent reinfection and stop the spread of gonorrhea, it’s important that all sexual partners are treated at the same time.

After completing treatment, individuals should return to their healthcare provider to ensure the infection has been cleared, and they should refrain from sexual activity until cleared by the provider.

Prevention of Gonorrhea

Preventing gonorrhea is primarily achieved through safer sexual practices. Key preventive measures include:

  • Using condoms consistently and correctly during vaginal, anal, and oral sex.

  • Getting tested regularly for STIs if you have multiple sexual partners or are sexually active.

  • Limiting the number of sexual partners and ensuring that both you and your partner get tested regularly.

  • Vaccination: While there is currently no vaccine for gonorrhea, vaccines for other STIs, like HPV, may reduce the risk of developing related cancers.

Complications of Gonorrhea

If left untreated, gonorrhea can lead to severe complications, including:

  • Pelvic Inflammatory Disease (PID): In women, untreated gonorrhea can lead to PID, which can cause infertility, ectopic pregnancy, and chronic pelvic pain.

  • Infertility: Gonorrhea can cause infertility in both men and women due to complications in the reproductive organs.

  • Disseminated Gonococcal Infection (DGI): This is a rare but serious condition where the bacteria spread through the bloodstream, affecting joints and organs and causing symptoms such as joint pain, skin lesions, and fever.

  • Increased risk of HIV: Gonorrhea increases susceptibility to HIV infection and vice versa.

Living with Gonorrhea

While gonorrhea is treatable, living with the infection can affect emotional and psychological well-being, particularly due to the stigma often attached to STIs. It's essential to follow the prescribed treatment regimen and communicate openly with sexual partners about your diagnosis to prevent the spread of the infection.

Additionally, if you experience symptoms after treatment, or if your infection does not resolve, it’s important to see your healthcare provider. Persistent gonorrhea infections may be due to antibiotic resistance, and your provider can guide you on the appropriate course of action.