What Is It?

Gonorrhea is a sexually transmitted disease (STD) that is caused by bacteria called Neisseria gonorrhoeae. These bacteria can be passed from person to person during sexual activity (vaginal, oral, and anal intercourse) leading to infections of the cervix, vagina, and urethra. If untreated, these “lower” gonorrhea infections can spread to higher portions of the reproductive tract, causing prostatitis (prostate inflammation) and epididymo-orchitis (inflammation of the epididymis and testes) in men, and pelvic inflammatory disease (PID) in women.

Gonorrhea also can cause gonococcal proctitis (inflammation of the anus and rectum), especially in those who practice anal intercourse. In those who practice oral sex, it may infect the throat, causing gonococcal pharyngitis.

Less commonly, gonorrhea can spread to other parts of the body through the bloodstream, causing fever, a characteristic rash and arthritis. In pregnant women with untreated gonorrhea, bacteria may spread to the eyes of their babies during childbirth, causing gonococcal ophthalmia, a severe eye infection in newborns.

Approximately 600,000 Americans are diagnosed with gonorrhea annually, but because many people with gonorrhea do not seek treatment, the total number of cases may be much higher.

Many people who are infected with gonorrhea (women more commonly than men) will develop no symptoms at all. When it does cause symptoms, they usually develop within 10 days after sexual intercourse with an infected person. Men may develop a discharge from the urethra (the opening at the end of the penis where urine comes out), redness around the urethra, frequent urination, and pain or a “burning” discomfort during urination. Women may develop pain or discomfort on urination, frequent urination, a vaginal discharge, and discomfort in the anal or rectal area. In at least 15 percent of women, the bacteria will spread to the uterus and fallopian tubes, causing pain with intercourse, abdominal pain, abnormal menstrual bleeding and fever. In cases of gonococcal pharyngitis, there may be either no symptoms or a simple sore throat.

Many patients with gonococcal proctitis have no symptoms. When symptoms are present they commonly include rectal pain or itching, a rectal discharge that contains blood, mucus, pus or tenesmus (a persistent urge to move the bowels). If gonorrhea spreads through the bloodstream, it may cause fever, pain and swelling in several joints, and a characteristic rash.

In newborns infected with gonococcal ophthalmia, symptoms appear one to four days after birth and can affect one or both eyes. Symptoms include redness of the eyes, swelling of the eyelids, and an eye discharge that is thick and contains pus. If untreated, gonococcal ophthalmia can cause blindness.

Your doctor may suspect gonorrhea based on your symptoms, sexual history and the results of physical and gynecological examinations. You doctor can confirm the diagnosis of gonococcal infection by taking a sample swab of the affected area (urethra, cervix, rectum, pharynx) and sending it to a laboratory for culture (a test to see if bacteria grow). Culture samples also can be taken from infected joint fluid or blood. A positive culture will confirm a gonococcal infection.

Other non-culture tests for gonorrhea bacteria include Gram-stained smears, DNA probes and EIA tests.

Gonorrhea infections rapidly improve with antibiotic therapy. In about 15 percent of infected women, untreated gonorrhea spreads to the fallopian tubes, where it can cause scarring and infertility.

Since gonorrhea is a STD that can be transmitted during sexual activity, you can prevent infection by:

• Practicing abstinence
• Having a monogamous relationship (only one sex partner) with an uninfected person
• Consistently using male latex condoms during sexual activity

To prevent gonococcal ophthalmia in newborns, all pregnant women should be tested and, if necessary, treated for gonorrhea. A swab for gonorrhea culture should be taken during the first prenatal visit, and women with a high risk for gonorrhea should have a repeat culture in their third trimester. As another preventive measure, newborns can be routinely treated at birth with eyedrops containing a 1-percent solution of silver nitrate. As an alternative, eye ointments containing erythromycin or tetracycline can be used.

Gonorrhea infections can be treated with antibiotics, including cefixime (Suprax), ceftriaxone (Ceclor and other brand names), ciprofloxacin (Cipro), ofloxacin (Ocuflox) or azithromycin (Zithromax).

Because certain strains of gonorrhea bacteria have become resistant to specific antibiotics, a repeat culture and an alternate antibiotic may be needed if symptoms persist in spite of a full course of treatment. All sex partners of an infected person must be treated as well.

Call your doctor if you have any of the symptoms of gonorrhea infections described above. Also call your doctor if you have participated in sexual activity with someone who has a gonorrhea infection, especially if you are pregnant.

All sexually active women should schedule a routine physical examination, including a pelvic examination every year, even if they have no symptoms of STDs.

If gonorrhea infections are diagnosed and treated quickly and correctly, there usually is complete recovery, unless pelvic inflammatory disease (PID) occurs. PID is more likely if treatment is delayed. It can cause infertility, scarred fallopian tubes (a risk for tubal pregnancy in women) and chronic abdominal pain.

Because 15 percent to 25 percent of males and 35 percent to 50 percent of females with gonorrhea have simultaneous chlamydia infections, health experts recommend that all patients treated for gonorrhea should be treated for chlamydia as well.

Diseases and Conditions Center

All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.