Gonorrhea

Gonorrhea is a highly contagious sexually transmitted disease (STD).


Causes/associated factors
Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. It's one of the most common sexually transmitted diseases in the United States. The disease can affect any age group, but most cases occur in teens and young adults. The risk of contracting gonorrhea increases with the number of sexual partners you have.

Transmission
Gonorrhea typically spreads through vaginal, oral or anal sex. If left untreated, gonorrhea is contagious for months even if you don't have symptoms.

Signs/symptoms
If symptoms develop, they usually appear within two to 10 days of exposure to the disease. Symptoms depend on the site of infection, your age, sex and how long you've had the infection.
Many women have no symptoms or symptoms so mild they don't seek treatment. The infection often goes unnoticed. Other women may experience yellowish or bloody vaginal discharge, often after intercourse, and painful urination.

Later symptoms in women may include abdominal pain, bleeding between menstrual periods, vomiting or fever.

Men usually have more noticeable symptoms, including painful urination and thick, yellowish penile discharge.

For both men and women, a gonorrhea infection in the rectum may cause rectal discharge, anal itching or painful bowel movements. An infection in the throat may cause the throat to become painful and red.
To prevent complications, consult your doctor right away if you notice any of these symptoms.


Diagnosis
First, the doctor will ask questions about your medical and sexual history and do a physical exam. Then, lab tests will be done on any abnormal discharge from the affected site. Sometimes urine samples can be used to identify the Neisseria gonorrhoeae bacterium. It's important to identify the bacterium because other STDs may have similar symptoms but require different treatment. Because you can have more than one infection at the same time, the doctor may screen you for other sexually transmitted diseases.

Treatment
Gonorrhea is treated with antibiotics. Your doctor may prescribe ceftriaxone, cefixime, ciprofloxacin or ofloxacin. Other antibiotics may be prescribed if you have medication allergies. While you're being treated for gonorrhea, your doctor may treat you for the STD chlamydia as well because the two conditions often develop together. Medications to treat chlamydia include antibiotics such as doxycycline or azithromycin.
It's important to abstain from all sexual activity until the treatment is complete and all symptoms have resolved. You must also notify your sexual partners from the past two months so they can be tested and treated.


Complications
If left untreated, gonorrhea can cause severe medical problems, especially for women. The most common complication of untreated gonorrhea for women is pelvic inflammatory disease (PID). The condition can irreversibly scar the fallopian tubes, resulting in infertility or ectopic pregnancy (when the fertilized egg develops outside the uterus). Rarely, untreated gonorrhea can cause sterility for men.
For a small percentage of people who have untreated gonorrhea, the infection spreads to other parts of the body and may cause:

joint pain
arthritis with potentially permanent joint damage
tenosynovitis (inflammation of the sheath covering a tendon)
skin lesions
meningitis (inflammation of the membranes surrounding the brain and spinal cord)
endocarditis (inflammation of the lining of the heart, which can be fatal)
perihepatitis (inflammation of the lining of the liver)
Rarely, touching fluid from infected mucous membranes and then touching your eye can result in an eye infection called conjunctivitis. This condition may lead to blindness if not treated quickly.


Pregnancy-specific information
If you're pregnant and have gonorrhea, your baby can be infected with the bacteria when passing through the infected birth canal during delivery. An infected baby may develop a condition called gonococcal ophthalmia neonatorum or other conditions, ranging from minor inflammation to serious bloodstream infections.
To prevent spreading an infection to your baby, good prenatal care is essential. Preventive therapy for ophthalmia neonatorum with silver nitrate eye drops or erythromycin or tetracycline eye ointment is recommended for all babies as soon as possible after delivery.


Senior-specific information
Growing older is not a risk factor for this condition.

Prevention
Abstinence is the most effective way to prevent gonorrhea. If you're sexually active, mutual monogamy will reduce the risk of contracting gonorrhea and other sexually transmitted diseases. If you're not in a monogamous relationship, reduce the risk of contracting gonorrhea and other STDs by:
limiting your number of sexual partners
making sure each sexual partner is tested for STDs and completes proper treatment, if necessary, before you have sexual contact
using a latex or polyurethane condom consistently during any vaginal, oral or anal sexual contact (Keep in mind that a condom doesnt effective in preventing the spread of STDs -- use only water-based lubricants. The chemicals in other lubricants may break down the latex in the condom.)