What is gonorrhea?
Gonorrhea is a sexually transmitted infection (STI) caused by a bacterium called Neisseria gonorrhoeae. The organism infects the mucous membrane of different parts of the reproductive tract, including the urethra, cervix, uterus, and fallopian tubes. It can also spread to the mucous membrane of the rectum, throat, eyes, and mouth.
According to the CDC, there were 616,392 reported cases of gonorrhea in 2019, in the United States only (1). That number increased by 10% in 2020. Based on the reported cases, young people between the ages of 15 and 24 are most commonly affected by the disease (3).
What is the cause of gonorrhea?
There are two ways to contract gonorrhea. The first is through sexual relations with an infected person, including vaginal, oral, and anal sex. Note that infection can happen even if ejaculation does not occur.
The second is through childbirth, meaning a mother can transmit the infection to her newborn during delivery.
What are the risk factors for gonorrhea?
Sexually active individuals risk getting gonorrhea, regardless of their age and gender. That being said, certain factors increase your risk of infection, including:
- Being under the age of 25.
- Not using condoms or dental dams with your sexual partners.
- Having more than one sexual partner.
- Being a man who has sex with other men.
- Having a previous history of STIs.
What are the signs and symptoms of gonorrhea?
Gonorrhea symptoms vary depending on whether you are male or female.
For men, symptoms may include:
- Painful, burning sensation when urinating
- Penile discharge (yellowish/white)
- Burning or itching near the urethra
- Painful and/or swollen testicles
Examples of symptoms in females include:
- Burning sensation when urinating
- Abnormal vaginal discharge
- Painful intercourse
- Pain in the lower abdomen
- Abnormal bleeding (between periods and after sex)
If the infection spreads to the rectum, you may experience:
- Anal itching
- Anal discharge
- Bleeding
- Painful bowel movements
Please note that many people with gonorrhea are unaware they are infected. For example, the symptoms in women are usually mild and can easily be mistaken for a urinary or vaginal infection. Therefore, you should get tested regularly, even without symptoms, especially if you have any of the risk factors mentioned above.
How do you diagnose gonorrhea?
We diagnose gonorrhea by performing a nucleic acid amplification test (NAAT) on a sample you provide. If you are male, the specimen of choice is urine. Your doctor may prefer to collect an endocervical sample instead of urine if you are female, which is a swab of the inside of your cervix.
If your doctor believes the infection spread to other areas of your body, like the anus or throat, they may collect a sample from there also.
If going to the doctor to get tested is too intimidating for you, you always have the option to buy an at-home STI testing kit. Each kit comes with everything you need to collect and send the sample. The process is quite simple: collect the specimen following the instructions and send it to their laboratory at the indicated address. Your results will be available a few days or weeks after you send the test, depending on the company.
Testing regularly allows you to get diagnosed early on and receive appropriate treatment. It is the best way to avoid spreading the infection to multiple partners. Early treatment is also key to avoiding complications, like pelvic inflammatory disease, ectopic pregnancy, infertility, and increased risk of contracting HIV. Disseminated gonococci infection (DGI) is another serious complication that can result in arthritis, tenosynovitis, dermatitis, and even death.
How do you treat gonorrhea?
Following your positive result, your healthcare provider will schedule a follow-up appointment to discuss treatment. If you tested positive after doing an at-home test, it is your responsibility to schedule an appointment with your doctor to receive treatment.
The current recommended treatment is a single intramuscular dose of ceftriaxone, an antibiotic. You must wait at least seven days before having sex again to avoid spreading the infection.
Although treatment is generally successful, antibiotic resistance is a growing concern. More and more strains of gonorrhea are becoming resistant to current medication. Treating the disease is getting increasingly difficult, which is why prevention is important.
How do you prevent gonorrhea?
Some of the best ways to prevent gonorrhea include:
- Practice safe sex, including using condoms or dental dams with new partners.
- Regular testing for you and your partner(s), especially if you are in a non-monogamous relationship.
- Discuss STI status with all your potential partners to make an informed decision about whether or not you want to have sex with them.
