Gonorrhea is a curable sexually transmitted infection (STI); it is the second most commonly reported bacterial STI in the United States following chlamydia. In 2006, 358,366 cases of gonorrhea were reported to the Centers for Disease Control and Prevention (CDC). When examining race and ethnicity, age, and gender, the highest rates of gonorrhea were found in African Americans, 20 to 24 years of age, and women, respectively.

 

Gonorrhea can spread into the uterus and fallopian tubes, resulting in pelvic inflammatory disease (PID). PID affects more than 1 million women in the U.S. every year and can cause tubal (ectopic) pregnancy and infertility in as many as 10% of infected women. In addition to gonorrhea playing a major role in PID, some health researchers think it adds to the risk of getting HIV infection.

 

Cause

Gonorrhea is caused by bacteria called Neisseria gonorrhoeae. These bacteria can infect the genital tract, mouth, and rectum of both men and women. In women the opening to the uterus (cervix) is the first place of infection.

 

Transmission

You can get gonorrhea during vaginal, oral, or anal sex with an infected partner. If you are pregnant and have gonorrhea, you may give the infection to your baby as it passes through your birth canal during delivery.

 

Symptoms

The bacteria are carried in semen and vaginal fluids and cause a discharge in men and women. A small number of people may be infected for several months without showing symptoms.

 

For women, the early symptoms of gonorrhea often are mild. Symptoms usually appear within 2 to 10 days after sexual contact with an infected partner. When women have symptoms, the first ones may include

 

Bleeding during vaginal intercourse

Painful or burning sensations when urinating

Yellow or bloody vaginal discharge

 

More advanced symptoms, which may indicate development of pelvic inflammatory disease (PID), include cramps and pain, bleeding between menstrual periods, vomiting, or fever.

 

Men have symptoms more often than women, including

 

White, yellow, or green pus from the penis with pain

Burning sensations during urination that may be severe

Swollen or painful testicles

 

If left untreated, men could experience prostate complications and epididymitis (inflammation of the testicles).

 

Symptoms of rectal infection include discharge, anal itching, and occasional painful bowel movements with fresh blood in the feces. Symptoms typically appear 2 to 5 days after infection but could appear as long as 30 days.

 

Diagnosis

Health care providers usually use three laboratory tests to diagnose gonorrhea.

 

Staining samples directly for the bacteria

Detecting bacterial genes or DNA in urine

Growing the bacteria in laboratory cultures

 

Many providers prefer to use more than one test to increase the chance of an accurate diagnosis.

 

You usually can get the staining test results while in your doctor's office or in a clinic. This test is quite accurate for men but not so in women. Only one in two women with gonorrhea has a positive stain.

 

More often, health care providers use urine or cervical swabs for a new test that detects the genes of the bacteria. These tests are more accurate than culturing the bacteria.

 

The laboratory culture test involves placing a sample of the discharge onto a culture plate. The health care provider also can take a culture to detect gonorrhea in the throat. Culture also allows testing for drug-resistant bacteria.

 

Treatment

Health care providers usually prescribe a single dose of one of the following antibiotics to treat gonorrhea.

 

Cefixime

Ceftriaxone

Single-dose cephalosporin regimens

 

If you are pregnant, or are younger than 18 years old, you should not be treated with certain types of antibiotics. Your health care provider can prescribe the best and safest antibiotic for you.

 

Gonorrhea and chlamydia often infect people at the same time. Therefore, health care providers usually prescribe a combination of antibiotics, which will treat both diseases.

 

If you have gonorrhea, all of your sexual partners should get tested and then treated if infected, whether or not they have symptoms. Health experts also recommend that you not have sex until your infected partners have been treated.

 

Prevention

The surest way to avoid transmission of STIs is to abstain from sexual contact or be in a long-term mutually monogamous relationship with a partner who has been tested and is not infected.

 

By using latex condoms correctly and consistently during vaginal or rectal sexual activity, you can reduce your risk of getting gonorrhea and developing complications.

 

Currently there is no vaccine against gonorrhea.