Table of Contents
What is Gonorrhea
A sexually transmitted disease (STD) resulting from INFECTION with the bacterium Neisseria gonorrhoeae. N. gonorrhoeae infects 350,000 Americans each year, though public health officials believe another 350,000 people have gonorrhea that goes undiagnosed because they do not know they are infected.
Gonorrhea is highly contagious and passes among sexual partners through vaginal intercourse, anal intercourse, or oral sex. People who have multiple sex partners have increased risk for gonorrhea as well as other STDs. Gonorrhea is a public health concern of great magnitude worldwide because a number of strains of N. gonorrhoeae have become resistant to the ANTIBIOTIC MEDICATIONS used to treat the infection.
Symptoms of Gonorrhea (for women and man) and Diagnostic Path
Gonorrhea has a 2- to 10-day INCUBATION PERIOD (time from exposure to symptoms) though often causes no symptoms, especially in women. Symptoms that do occur tend to be generalized and vague, such as lower abdominal discomfort, and go away in a few days to a week. When symptoms are present they typically include
- a thick, discolored (yellowish or greenish), or bloody discharge from the PENIS in men and the VAGINA in women
- burning or PAIN with URINATION (more common in men)
- pain or bleeding during SEXUAL INTERCOURSE (more common in women)
Early symptoms will go away without treatment, though the infection remains. As the N. gonorrhoeae BACTERIA multiply in the body, they cause increasing irritation to the tissues, resulting in INFLAMMATION and the formation of SCAR tissue. In men the next level of infection with untreated gonorrhea is EPIDIDYMITIS, which causes swelling and pain in the TESTICLES, and URETHRITIS, which causes intense pain with urination. In women the next level of infection with untreated gonorrhea is PELVIC INFLAMMATORY DISEASE (PID), which involves the UTERUS and FALLOPIAN TUBES. PID often causes severe ABDOMINAL PAIN. Scarring from the infection blocks the fallopian tubes, putting a woman at high risk for ECTOPIC PREGNANCY.
Diagnosis is laboratory examination of a sample of the discharge taken from the penis (men) or the CERVIX (women). A fast test done in the doctor’s office is highly accurate for men but not for women; for women, a conventional culture is the most reliable diagnostic procedure. The doctor likely will conduct diagnostic tests for other STDs as well, notably CHLAMYDIA and SYPHILIS. All sex partners should also undergo testing and receive treatment if they have gonorrhea, even if they do not have symptoms.
Gonorrhea: Treatment Options and Outlook
The current standard of treatment for gonorrhea is a single DOSE of a fluoroquinolone antibiotic, which cures the infection in most people. However, new strains of N. gonorrhoeae are showing resistance to these antibiotics, causing doctors to look to combinations of antibiotics and to stronger antibiotics to cure the infection.
Antibiotic Medications to Treat Gonorrhea
|ANTIBIOTIC MEDICATIONS TO TREAT GONORRHEA|
The debut of penicillin in the 1940s provided the first cure for gonorrhea. However, 30 years later, most strains of N. gonorrhoeae were resistant to penicillin and to tetracycline, the second-choice antibiotic. Doctors can no longer prescribe these antibiotics to treat gonorrhea. Though antibiotic medications remain the standard of treatment for gonorrhea, doctors and public health officials worry that the ability of N. gonorrhoeae to adapt will soon put gonorrhea out of reach for treatment. Researchers have recently unraveled the GENETIC CODE (DNA sequence) of the N. gonorrhoeae and are hopeful this advance will lead to new kinds of treatments.
Risk Factors and Preventive Measures
Those who are at highest risk for gonorrhea and other STDs are
- men between the ages of 20 and 24
- women between the ages of 15 and 19
- men who have sex with men
- men or women who have multiple sex partners
Monogamy (having only one sex partner) and consistent use of latex condoms are measures that can prevent N. gonorrhoeae infection. People who are sexually active should undergo regular testing for STDs. Reinfection can occur.