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GONORRHEA

Gonorrhea is an infection caused by a sexually transmitted bacterium that can infect both males and females. Gonorrhea most often affects the urethra, rectum or throat. In females, gonorrhea can also infect the cervix.

Gonorrhea is most commonly spread during sex. But babies can be infected during childbirth if their mothers are infected. In babies, gonorrhea most commonly affects the eyes.

Gonorrhea is a common infection that, in many cases, causes no symptoms. You may not even know that you're infected. Abstaining from sex, using a condom if you do have sex and being in a mutually monogamous relationship are the best ways to prevent sexually transmitted infections.

Symptoms

In many cases, gonorrhea infection causes no symptoms. When symptoms do appear, gonorrhea infection can affect multiple sites in your body, but it commonly appears in the genital tract.

Gonorrhea affecting the genital tract

Signs and symptoms of gonorrhea infection in men include:

  • Painful urination
  • Pus-like discharge from the tip of the penis
  • Pain or swelling in one testicle

Signs and symptoms of gonorrhea infection in women include:

  • Increased vaginal discharge
  • Painful urination
  • Vaginal bleeding between periods, such as after vaginal intercourse
  • Abdominal pain
  • Pelvic pain

Gonorrhea at other sites in the body

Gonorrhea can also affect these parts of the body:

  • Rectum. Signs and symptoms include anal itching, pus-like discharge from the rectum, spots of bright red blood on toilet tissue and having to strain during bowel movements.
  • Eyes. Gonorrhea that affects your eyes may cause eye pain, sensitivity to light, and pus-like discharge from one or both eyes.
  • Throat. Signs and symptoms of a throat infection may include a sore throat and swollen lymph nodes in the neck.
  • Joints. If one or more joints become infected by bacteria (septic arthritis), the affected joints may be warm, red, swollen and extremely painful, especially when you move an affected joint.

Causes

Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. The gonorrhea bacteria are most often passed from one person to another during sexual contact, including oral, anal or vaginal intercourse.

Diagnosis

To determine whether the gonorrhea bacterium is present in your body, your doctor will analyze a sample of cells. Samples can be collected by:

  • Urine test. This may help identify bacteria in your urethra.
  • Swab of affected area. A swab of your throat, urethra, vagina or rectum may collect bacteria that can be identified in a laboratory.

For women, home testing kits are available for gonorrhea. Home testing kits include vaginal swabs for self-testing that are sent to a specified lab for testing. If you prefer, you can choose to be notified by email or text message when your results are ready. You may then view your results online or receive them by calling a toll-free hotline.

Testing for other sexually transmitted infections

Your doctor may recommend tests for other sexually transmitted infections. Gonorrhea increases your risk of these infections, particularly chlamydia, which often accompanies gonorrhea. Testing for HIV also is recommended for anyone diagnosed with a sexually transmitted infection. Depending on your risk factors, tests for additional sexually transmitted infections could be beneficial as well.

Preventions

Take steps to reduce your risk of gonorrhea:

  • Use a condom if you choose to have sex. Abstaining from sex is the surest way to prevent gonorrhea. But if you choose to have sex, use a condom during any type of sexual contact, including anal sex, oral sex or vaginal sex.
  • Ask your partner to be tested for sexually transmitted infections. Find out whether your partner has been tested for sexually transmitted infections, including gonorrhea. If not, ask whether he or she would be willing to be tested.
  • Don't have sex with someone who has any unusual symptoms. If your partner has signs or symptoms of a sexually transmitted infection, such as burning during urination or a genital rash or sore, don't have sex with that person.
  • Consider regular gonorrhea screening if you have an increased risk. Talk to your doctor about regular gonorrhea screening if you have an increased risk of infection. You may be at increased risk of gonorrhea if you have had gonorrhea or other sexually transmitted infections in the past, if you have a new sex partner, or if you have multiple sex partners.

Risk Factors

Factors that may increase your risk of gonorrhea infection include:

  • Younger age
  • A new sex partner
  • Multiple sex partners
  • Previous gonorrhea diagnosis
  • Having other sexually transmitted infections

Complications

Untreated gonorrhea can lead to significant complications, such as:

  • Infertility in women. Untreated gonorrhea can spread into the uterus and fallopian tubes, causing pelvic inflammatory disease (PID), which may result in scarring of the tubes, greater risk of pregnancy complications and infertility. PID is a serious infection that requires immediate treatment.
  • Infertility in men. Men with untreated gonorrhea can experience epididymitis — inflammation of a small, coiled tube in the rear portion of the testicles where the sperm ducts are located (epididymis). Epididymitis is treatable, but if left untreated, it may lead to infertility.
  • Infection that spreads to the joints and other areas of your body. The bacterium that causes gonorrhea can spread through the bloodstream and infect other parts of your body, including your joints. Fever, rash, skin sores, joint pain, swelling and stiffness are possible results.
  • Increased risk of HIV/AIDS. Having gonorrhea makes you more susceptible to infection with human immunodeficiency virus (HIV), the virus that leads to AIDS. People who have both gonorrhea and HIV are able to pass both diseases more readily to their partners.
  • Complications in babies. Babies who contract gonorrhea from their mothers during birth can develop blindness, sores on the scalp and infections.

Treatment

Gonorrhea treatment in adults

Adults with gonorrhea are treated with antibiotics. Due to emerging strains of drug-resistant Neisseria gonorrhoeae, the Centers for Disease Control and Prevention recommends that uncomplicated gonorrhea be treated only with the antibiotic ceftriaxone (Rocephin) — given as an injection — in combination with either azithromycin (Zithromax, Zmax) or doxycycline (Monodox, Oracea,Vibramycin) — two antibiotics that are taken orally.

Some research indicates that oral gemifloxacin (Factive) or injectable gentamicin, combined with oral azithromycin, is highly successful in treating gonorrhea. This treatment may be helpful in treating people who are allergic to cephalosporin antibiotics, such as ceftriaxone.

Gonorrhea treatment for partners

Your partner also should undergo testing and treatment for gonorrhea, even if he or she has no signs or symptoms. Your partner receives the same treatment you do. Even if you've been treated for gonorrhea, you can be reinfected if your partner isn't treated.

Gonorrhea treatment for babies

Babies born to mothers with gonorrhea receive a medication in their eyes soon after birth to prevent infection. If an eye infection develops, babies can be treated with antibiotics.