Gonorrhoea is one of the most common sexually transmitted infections (STIs). It occurs due to bacteria, gonococcus or Neisseria gonorrhoeae. These microorganisms can easily spread from one person to another during sexual intercourse. These bacteria can infect the cervix (entrance to the uterus), urethra (the tube through which urine passes out from the body), and the rectum. In rare cases, gonorrhoea may affect the eyes and throat.
Early detection and proper treatment are vital for limiting the spread of this infection.
Improperly managed gonorrhoea may lead to severe complications and even contribute to the spread of the infection to others.
What are the causes of gonorrhoea?
Neisseria gonorrhoeae responsible for causing gonorrhoea are usually found in the vaginal fluid or the discharge from the penis. Gonorrhoea occurs when these bacteria pass from an infected person to another through unprotected sex – vaginal, oral, or anal.
It may also spread during close genital contact, which means this infection can also occur when your genitals touch, even if you have not had sex or ejaculation.
While the symptoms of gonorrhoea are more evident in the genitals, in some cases, patients may get gonorrhoea infection in the eyes. It occurs when the eye comes in contact with vaginal fluids or semen from a person suffering from gonorrhoea.
Sharing of sex toys like vibrators that have not been disinfected or washed after use by another person can cause the spread of gonorrhoea. The sex toys may get contaminated when they are used by an infected person. When another person uses the same sex toys without cleaning or washing them, the bacteria gain entry into their body and cause infections.
Using sex toys without covering them with a new condom after they have been used by another person can also contribute to the spread of gonorrhoea.
Pregnant women may pass gonorrhoea to their babies during birth. Hence, women who are pregnant or are planning to conceive are advised to get themselves tested for gonorrhoea, especially if they think they might have this infection. Presence of sores, itching, and redness in the genitals could be some signs that women should not ignore. They should consult their doctor and seek advice about how to get tested for gonorrhoea so that they can receive appropriate treatment before the baby is born. This would inhibit the risk of spread of infection to the child.
It is important to note that gonorrhoea does not spread through kissing, sharing towels, hugging, or using the same toilet as someone having the infection. Activities such as swimming in pools, sharing baths, and cutlery like cups and plates are also not known to cause the spread of this infection as these bacteria cannot survive outside of the human body for long.
How can you prevent gonorrhoea?
Just like most other STIs, gonorrhoea can be prevented by following appropriate precautionary measures during sex such as:
The use of barrier method of contraception is considered the most effective for preventing gonorrhoea. Use male or female condoms each time you have sex. The use of a vaginal condom is particularly recommended during vaginal sex and a male condom during anal sex.
Always cover your penis with a condom during oral sex. Women can use a latex or dam (plastic square) to cover the genitals during oral sex.
Avoid sharing sex toys or make sure you have disinfected or washed them well before use. Covering a sex toy that has been used by someone with a condom is also recommended to minimise the risk of spread of gonorrhoea.
Other than these, you can also undergo regular tests for STIs to assess your sexual health, especially if you have multiple partners. Also, keep in mind that contraceptive pills and the modes of contraception other than the barrier methods do not provide protection against gonorrhoea.
What are the signs and symptoms of gonorrhoea?
The symptoms of gonorrhoea often develop about 2 to 3 weeks after coming in contact with the source of infection. In some cases, patients may not develop any symptoms for several months.
It is estimated that about 1 in 10 men and 5 in 10 women infected with gonorrhoea do not experience any evident symptoms. This is one of the reasons why this condition often remains undetected in most patients.
The delayed diagnosis due to the absence of symptoms can cause the infection to spread to others as it prevents the person from taking necessary precautions. This marks the needs to get yourself tested regularly even if you do not have any symptoms.
Then common symptoms of gonorrhoea vary among men and women depending on the tissues affected.
The common symptoms in women include:
An unusual discharge from the vagina. The discharge is usually thin, watery, and greenish, or yellowish in colour
Pain while passing urine
Burning sensation during urination
Pain and tenderness in the lower abdomen
Bleeding after sex
Unusual bleeding between periods
The common symptoms in men include:
An abnormal discharge from the tip of the penis. The discharge may be whitish, yellowish, or greenish
Pain while passing urine
Burning sensation while urinating
Swelling and inflammation of the foreskin of the penis
Pain and tenderness in the testicles
Men and women may develop gonorrhoea in the rectum, eyes, and throat after having unprotected anal and oral sex.
When the infected semen or vaginal fluid comes in contact with your eyes, you may develop conjunctivitis. The symptoms, in this case, would be redness of the eyes, swelling, thick discharge from the eyes, and sticking of the eyelids to each other.
Gonorrhoea in the eyes of the babies may lead to pain, swelling, and irritation in the eyes with abnormal discharge. Newborn babies usually develop symptoms in the eyes within the first two weeks after birth.
Infection in the rectum may lead to pain, discomfort, and discharge from the anus. Patients who develop an infection in the throat may not experience any symptoms.
Who should get tested for gonorrhoea?
It’s important to get tested for gonorrhoea regularly, especially if you have multiple partners or when you think there is a possibility you are infected. Men and women should get themselves tested even if they do not have any obvious symptoms or when the symptoms have resolved on their own.
You should get tested for gonorrhoea if:
You or your partner have the symptoms that could be due to gonorrhoea
You have had unprotected sex – vaginal, oral, or anal – with a new partner
You or your partner had unprotected sex with any other partner
You have been diagnosed with any other STI such as chlamydia or HIV/AIDS
Your sexual partner tells he or she has an STI
You are pregnant or planning a pregnancy
During a vaginal examination, your doctor detects an abnormal discharge or tells you that the cells in your vagina or cervix look inflamed
What are the tests recommended for the diagnosis of gonorrhoea?
In most cases, a cotton swab is used to remove a sample of discharge from the vagina or the tip of the penis for testing in a laboratory.
The swab looks like a cotton bud, though it’s more rounded and smaller. It is gently wiped over the parts of the body that might be infected to pick up the samples of discharge. The procedure takes only a few seconds and causes no pain. Minimal discomfort may be felt during sample collection.
For women, the doctor may use a swab to collect the sample from the cervix or vagina. In some cases, the sample may be taken from the urethral opening. A urine sample is usually not needed to check for gonorrhoea in women as it is not a highly accurate test for them.
Men are usually asked to provide a sample of urine to test for gonorrhoea. A swab may be used to collect a sample of discharge from the tip of the penis. If you are asked to give a urine sample, do not urinate for at least 2 hours prior as it may wash away the bacteria and affect the result of the test.
In case you have developed symptoms in your eyes, rectum, or throat, the doctor may use a swab to get a sample from these parts.
The results of the gonorrhoea test are usually available within a few hours. Sometimes, patients have to wait for about 2 weeks to know the results.
How often do I need to get checked?
Routine sexual health check-ups are recommended for all men and women who are sexually active. You can get a sexual health check done for tests like gonorrhoea, syphilis, HIV, and chlamydia once a year.
The frequency of these tests depends on your risk of developing STIs.
Men should get tested every 3 to 6 months if they have sex with men or have more than 1 partner.
Sexually active women should also get tested more frequently if they have multiple partners or when they have a new sexual partner because the symptoms of gonorrhoea may not be evident until serious complications like infertility and PID develop.
What is the best treatment for gonorrhoea?
Gonorrhoea can be treated with a course of antibiotics. Antibiotics are recommended when:
The test has shown you have gonorrhoea
There is a chance that you have gonorrhoea, even though the test results are not yet available
Your partner has been diagnosed with this infection
In most cases, the treatment involves having an intramuscular injection of antibiotic, usually in the thighs or buttocks. This is followed by the use of oral antibiotics.
Patients can notice an improvement in the symptoms within a few days of using the antibiotics. It may take up to 14 days for the pain in your abdomen, pelvis, and testicles to resolve completely.
Symptoms like heavy flow and bleeding between periods might improve by the time you have next menstrual periods.
A follow-up appointment with your doctor about one or two weeks after the treatment is recommended to assess the improvement. Another test can be performed during the follow-up visit to check if the infection is cleared.
Patients are advised to avoid sex until they and their partners have been treated for gonorrhoea and the infection has been cleared. This can help to prevent the spread of infection and reduce the risk of re-infection.
If your symptoms do not subside even after the treatment or you have been re-infected, you may need further tests and treatments.
What are the complications of untreated gonorrhoea?
Untreated gonorrhoea can lead to serious complications, such as:
Infertility in women: Gonorrhoea can spread from the vagina and cervix to the uterus and fallopian tubes, leading to pelvic inflammatory disease (PID). PID can cause scarring of the fallopian tubes thus posing a risk of infertility and complications in pregnancy like miscarriage and premature labour. PID needed to be treated immediately to avoid these risks.
Infertility in men: Gonorrhoea may result in the formation of a small, coiled tube in the posterior (rear) portion of the testicles at a place where the sperm ducts called epididymis are located. This can increase the risk of inflammation of the epididymis resulting in epididymitis. Untreated epididymitis can cause infertility in men.
Joint: Gonorrhoea may spread to the joints and other parts of the body. The bacterium can travel through the bloodstream and infect these parts due to which you may develop fever, skin sores, rashes, joint pains, and stiffness.
HIV/AIDS: Having gonorrhoea can make you susceptible to other STIs like HIV/ AIDS. People with both gonorrhoea and HIV can pass both these infections to their sexual partners more readily.
Complications in babies: Newborn babies who contract gonorrhoea during labour from their mothers can develop blindness and sores on the scalp.
If detected and treated early, gonorrhoea is unlikely to cause any complications. It would ensure rapid improvement in the symptoms and enable the complete recovery of patients.
Gonorrhoea is also one of the most common STIs and again it’s on the rise, particularly in men. Just like Chlamydia, Gonorrhoea victims often present with no symptoms, but the infection can still be passed on through vaginal, oral and anal sex.
Gonorrhoea can have serious health implications for both men and women if left untreated. In women, it can cause pelvic inflammatory disease (PID), which can have severe and painful symptoms, and lead to long-term complications, including, in rare cases, infertility. Gentlemen, you don’t get off lightly either, untreated Gonorrhoea can result in an unpleasant (at best) and painful condition called epididymitis in the tubes attached to the testicles.
Without terrifying you too much more it’s important to note that Gonorrhoea can spread to the blood or joints resulting in a potentially life-threatening situation.
Some symptoms to keep an eye out for, guys and girls, again pain when urinating is not a good sign. Ladies if you experience unusual vaginal discharge or pain during intercourse it’s a smart idea to get checked, it might not be Gonorrhoea, but better to be safe. Gentlemen any unusual discharge from the urethra or anus, get checked.
Continuing its common threads with Chlamydia, Gonorrhoea is also effectively tested via a simple urine test and some fancy workings in a lab. Easy.
Again, if you think you may have contracted Gonorrhoea from oral or anal sex our Pathology Referral will allow you to be checked for this as well. You will just need to ask the Pathology Centre staff for swabs of the area in question to be taken.
Gonorrhoea is not as easily treated as Chlamydia, but in comparison to the infection itself, it’s not so bad! You’ll need to take one course of antibiotics as specified in your Stigma Health test results, but you will also need to see a GP to get an injection of antibiotics. Again it’s really not that bad in comparison to the infection!