What Is Gonorrhea?
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Gonorrhea is a sexually transmitted infection (STI) caused by bacteria. It spreads through sexual fluids during various types of sexual contact.
Though gonorrhea isn’t always severe, it can become severe if left untreated. Gonorrhea that goes without treatment can lead to irreversible health conditions in both males and females, including infertility.
This article discusses the symptoms, causes, and available treatments for gonorrhea.
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Gonorrhea Symptoms
Gonorrhea is asymptomatic in some people, meaning it occurs without symptoms. Typically, females are more likely to experience no symptoms than males.
If a person contracts the bacterial infection and does develop symptoms, some of the most common include:
Abnormal discharge
Pain in the affected area
The symptoms differ depending on sex and what area of the body they affect.
Symptoms in People With Uteruses
People with uteruses are less likely to experience gonorrhea symptoms than men. Along with the symptoms mentioned above, others can include the following:
Genital pain before, during, or after sex
Pain in the lower part of the abdomen
Vaginal discharge
Symptoms in People with Penises
People with penises experience gonorrhea symptoms more often than women. When they do, clinical features of the infection can include:
Discharge from the urethra
Itching in the genital area
Pain in the testicles
Super gonorrhea is the term assigned to gonorrhea that is resistant to treatment. This type of gonorrhea can be treated using antibiotics, but the medication doesn’t always work, and the infection persists.
Related:U.S. Updates Antibiotic Resistance Plan: Here's What's New
Gonorrhea in the Throat
If a person performs oral sex on someone infected with gonorrhea, they can get the infection in their throat.
People are more likely to contract oral gonorrhea if they participate in oral-penile contact than oral-vaginal contact. A person with throat gonorrhea can also pass it on through oral sexual contact, causing genital symptoms.
According to the Centers for Disease Control and Prevention (CDC), gonorrhea of the throat is generally asymptomatic. However, it can cause a person to develop a sore throat.
Rectal Gonorrhea
Rectal gonorrhea develops when a person participates in anal sex with someone who has the infection. The symptoms, if they develop, of rectal gonorrhea include:
Discharge from the anus
Soreness in the anal area
Bleeding from the anus
Pain when having a bowel movement
Gonorrhea in the Eye
Though it is rare, gonorrhea can also infect the eye if someone touches infected bodily fluids and then touches their eyes. Symptoms of eye gonorrhea can include:
Red eyes
Eye inflammation
Swelling of the tissues that line the eyelids
Broken blood vessels in the eye
White, yellow, or brown discharge from the eyes
Because of the rarity of eye gonorrhea, it often goes undiagnosed for longer than genital gonorrhea. That delayed diagnosis can cause a severe complication to develop, known as gonococcal keratoconjunctivitis. This condition can lead to ulcerative keratitis, a severe eye disorder that can lead to blindness or vision loss.
What Causes Gonorrhea?
The Neisseria gonorrhoeae bacteria cause gonorrhea. This bacteria is spread through bodily fluids during sexual activities, including:
Genital sex
Anal sex
Oral sex
Sharing unclean sex toys with others
Though it is rarer, it can also spread through other sexual activities, such as kissing or oral-anal contact in people with the infection in their mouth or throat.
Hand play, such as fisting or fingering, can also spread gonorrhea in some cases.
Gonorrhea can spread in a variety of ways, but you will not get the infection from:
Sitting on public toilet seats
Coughing or getting coughed on by someone with gonorrhea
Sharing food or drinks with someone who has the infection
Learn More:Causes and Risk Factors of Gonorrhea
Who Has the Highest Risk of Contracting Gonorrhea?
Anyone sexually active runs the risk of contracting gonorrhea if they do not practice safer sex. However, the infection affects certain groups more than others, including:
Sexually active teenagers and young adults under the age of 25
People of any age who engage in condom-less sex with multiple partners
People of any age with sexual partners who have been diagnosed with an STI
Gonorrhea is quite common globally; roughly 86.9 million adults contract gonorrhea every year. According to the CDC, 1.6 million new gonorrhea cases occurred in the United States in 2018 alone, affecting nearly half of the country's population between the ages of 15 and 24.
Learn More:Gonorrhea Facts and Statistics: What You Need to Know
How Long Can You Have Gonorrhea Without Knowing?
People who contract gonorrhea and experience symptoms do so within two weeks of becoming infected.
As many as 40% of men and 80% of women do not experience symptoms, so it can be easy to go undiagnosed while the condition continues to affect the body.
Because it can be easily missed, you can have gonorrhea for months without noticing it until symptoms of further complications begin to develop.
How to Test for Gonorrhea
Testing for gonorrhea typically begins with a urine sample or a sample from the cervix if a pelvic exam is performed. Swab tests may also be used. Swabs can be taken from the:
Vagina
Cervix
Penis
Rectum
Mouth and throat
The swab tests take a sample of bodily fluid from the area to test for gonorrhea bacteria.
At-Home Gonorrhea Tests
Because of its prevalence, many medical companies have made at-home gonorrhea testing available for more accessible diagnostics.
The tests are sent to your home, and you will self-collect a sample of your urine or a swab from the area you believe to be infected.
Many people who may suspect they have an STI wait a certain period before going to the doctor to get tested. This delay in diagnostics can play a role in more severe health outcomes in people who have gonorrhea. Using at-home testing provides people with an affordable and accessible alternative to staying on top of their sexual health.
When to Get Tested
Anyone who is sexually active should get regular STI screenings done. The time between tests will depend on a person’s own personal circumstances and lifestyle.
According to the CDC, gay and bisexual men should get tested for gonorrhea once per year, and sexually active women who are younger than 25 or have multiple sexual partners should also get tested once per year.
If you are sexually active and begin to experience any symptoms of gonorrhea, it’s vital to get tested immediately. This can ensure you don’t inadvertently pass the infection on to someone else and reduce your risk of developing severe health consequences caused by gonorrhea.
Gonorrhea Treatment
Because gonorrhea is a bacterial infection, it needs antibiotic treatment. The first-line treatment for the STI is a single-dose injection of ceftriaxone.
If someone cannot take these medications due to an allergy or they have a case of antibiotic-resistant gonorrhea, they will have to try alternatives, such as:
Doxycycline oral
Ofloxacin
Cefixime
Spectinomycin
When Can You Have Sex Again After Treatment?
After you begin treatment, you should wait at least seven days before having sex again.
If both you and your partner were diagnosed with gonorrhea, you should wait until after you have completed any treatments given to you by a healthcare provider and wait until your symptoms have gone.
To ensure that you have recovered from the gonorrhea infection and that the bacteria is out of your body, you should do a follow-up gonorrhea test three months after treatment. Gonorrhea can recur if you have sex with a person who has it.
Gonorrhea is curable with the proper medication. However, because some cases of gonorrhea are resistant to antibiotics, the need for more than one course of therapy is possible.
Learn More:Gonorrhea Treatment: What to Expect
Complications of Untreated Gonorrhea
There are several known complications associated with an untreated gonorrhea infection. The long-term effects of an untreated infection with gonorrhea can differ for people with male versus female reproductive organs. However, some are the same, such as:
Infertility
An increased risk of contracting HIV
Long-term pain and inflammation
In people with uteruses, other complications can include:
Ectopic pregnancy, which occurs when a fertilized egg implants outside the uterus
Chronic pain
Scar tissue formation that blocks the fallopian tubes
People with penises with untreated gonorrhea are at risk of:
Inflammation of the tube that carries sperm from the testicles (epididymitis)
Disseminated gonococcal infection, a potentially life-threatening condition characterized by arthritis, dermatitis, and/or tenosynovitis
Learn More:Long-Term Effects of Gonorrhea
What if You Get Gonorrhea While Pregnant?
Having gonorrhea while pregnant can lead to transmission of the infection to the unborn child during delivery.
Gonorrhea infections in newborns can lead to devastating consequences, such as:
Blindness
Joint infections
Life-threatening blood infections
Meningitis (swelling of mucous membranes around the brain and spinal cord)
Rhinitis (nasal congestion, runny nose, sneezing)
Vaginitis (inflammation and infection of the vagina)
Urethritis (inflammation and infection of the urethra)
Scalp infections
Practicing safer sex and always using condoms while pregnant can help lower your risk of gonorrhea. That said, if you do become pregnant, the best way to ensure that you are not infected and will not pass it on to your unborn child is by:
Getting tested for gonorrhea during your first prenatal visit
Getting treated for gonorrhea if you test positive
Retesting for gonorrhea throughout your pregnancy roughly every three months and then again at delivery
How to Prevent Gonorrhea
The only way to prevent contracting gonorrhea is by avoiding all types of sexual activity.
However, because that is unreasonable for many people, practicing safer sex and always wearing condoms during all sex acts is essential.
Otherwise, you can reduce your risk of contracting gonorrhea by:
Getting tested regularly if you engage in sexual activities with more than one partner
Only have sex with someone you’re in a committed and monogamous relationship with, and you have both been tested
Avoid sexual contact with partners who have tested positive for gonorrhea until after they have finished their treatment and their symptoms have subsided
Outlook for Gonorrhea
Gonorrhea is often stigmatized because of its transmission process. However, the infection is very common. There is nothing to be ashamed or embarrassed about if you contract it.
The good news is that gonorrhea is highly treatable using antibiotics, and you can cure yourself of the infection in as little as one week. It's still important to practice safer sex and prevent the spread of gonorrhea because although there is a cure, the rise in antibiotic-resistant gonorrhea cases has made curing it more difficult.
Medical providers can recommend treatment options for resistant gonorrhea, so it's important to remember that though prevention is best, treatment is possible.
