Gonorrhea

Your likelihood of contracting gonorrhea increases if you:

• Engage in unprotected oral, anal, or vaginal sex with an infected person
• Have a weakened immune system
• Have previously been diagnosed with gonorrhea
• Have multiple sexual partners
• Are involved with a partner who has multiple sexual partners
• Are sexually active
• Work as a sex worker
• Have a sexual partner from an area with high prevalence of gonorrhea or have a history of gonorrhea or other STIs, including HIV

A lack of sexual education and low socioeconomic status can also contribute to a higher risk of gonorrhea. Additionally, if a condom breaks during sex with an infected partner, the risk of gonorrhea increases. Men who engage in sexual activity with other men (MSM) have a higher likelihood of contracting gonorrhea.

To confirm gonorrhea, laboratory tests detect the bacteria from samples taken from the urethra, rectum, throat, or eyes. In some cases, urine samples may also be used. If you experience any symptoms of gonorrhea, refrain from sexual activity until test results are confirmed as negative. The diagnostic tests include:

Physical Examination:

This involves a healthcare provider looking for visible signs of gonorrhea, such as discharge from the throat, skin rashes, eye symptoms, or abdominal pain.

Nucleic Acid Amplification Test (NAAT):

This method detects the genetic material of Neisseria gonorrhoeae from urine or swab samples. Swabs from the urethra are taken in men, while samples are taken from the vagina or cervix in women. Rectal or pharyngeal samples may also be taken.

Culture Test:

Widely used due to its high specificity, this test can identify gonorrhea from samples taken from the throat, urethra, vagina, or rectum (but not urine).

Smear Test:

Used primarily in men to diagnose uncomplicated gonorrhea by examining urethral smears under a microscope.

Since gonorrhea is spread through sexual fluids, it can be prevented by practicing safer sex, such as:

• Using condoms, dental dams, or latex/nitrile gloves during oral, anal, or vaginal sex
• Getting regular STD tests if you are sexually active
• Avoiding sexual activity with your partner until they have completed treatment for any STDs
• Washing your hands after touching your partner’s genitals
• Regularly cleaning sex toys with soap and water
• Using condoms with sex toys
• Limiting the number of sexual partners

Note: Washing the genitals, urinating, or douching after sex does not prevent gonorrhea.

Specialist to Consult

Gonorrhea can affect anyone who is sexually active. Seek medical attention immediately if you experience symptoms like genital discharge, painful urination, rashes, or other unusual skin conditions. It’s also important to consult a healthcare provider if your partner has recently been diagnosed with an STD.

Annual gonorrhea screening is recommended for:

• Young sexually active individuals
• Older individuals with risk factors, such as multiple sexual partners

Pregnant women should also undergo STD testing, including for gonorrhea, as part of routine care to reduce potential complications for the baby.

The ideal place to visit is a sexual health clinic, also known as a genitourinary medicine (GUM) clinic. Specialists who can help treat gonorrhea include:

• General physicians
• Infectious disease specialists
• Gynecologists

Gonorrhea is treatable with antibiotics. Treatment options vary depending on the symptoms or type of infection:

Urogenital Infections

For managing urogenital gonorrhea, the following antibiotics are typically prescribed:

• Ceftriaxone
• Doxycycline

If a person is allergic to ceftriaxone, alternative antibiotics may be used, such as:

• Azithromycin
• Gemifloxacin
• Gentamicin

Gonococcal Conjunctivitis

Newborns who develop gonococcal conjunctivitis are treated with ceftriaxone based on their body weight. Their eyes should be rinsed every hour with normal saline. The mother of an infected newborn should also be tested for gonorrhea and treated if necessary.

Gonorrhea During Pregnancy

For pregnant women, Erythromycin or Amoxicillin is recommended for treating gonorrhea.

Follow-Up Care

Follow-up testing is typically unnecessary for rectal and genital infections, unless symptoms persist after treatment. For throat infections, a re-evaluation is recommended 7-14 days after treatment. Additionally, a re-test is suggested after 3 months to check for possible re-infection.

Sexual Partner Management

Anyone diagnosed with gonorrhea should ensure that their sexual partner(s) are tested, especially if they had sexual activity within two months before the symptoms appeared. Sexual activity should be avoided until both the infected individual and their partner have completed treatment. For neonates diagnosed with gonococcal conjunctivitis, the mother and her sexual partner should also be tested for gonorrhea.

If untreated, gonorrhea can spread throughout the body, leading to serious complications:

Pelvic Inflammatory Disease (PID)

Gonorrhea can spread from the vagina to other parts of the female reproductive system, such as the fallopian tubes and uterus. Symptoms include fever and abdominal pain and can cause long-term complications like:

• Chronic pelvic pain
• Infertility
• Abscesses
• Endometritis
• Ectopic pregnancy

Pregnancy Complications

In pregnant women, gonorrhea increases the risk of miscarriage, premature labor, and early abortion. It can also be transmitted to the fetus, potentially causing conditions such as conjunctivitis, joint pain, blindness, and blood infections. Early treatment can reduce the likelihood of these complications.

Male Infertility

Gonorrhea can cause infections in the testicles, prostate gland, and epididymis, potentially leading to infertility in men.

Disseminated Gonococcal Infection (DGI)

If left untreated, gonorrhea can spread into the bloodstream, causing DGI, which may result in:

• Septic arthritis (joint inflammation)
• Tenosynovitis (inflammation of tendons)
• Endocarditis (heart inflammation)
• Dermatitis (skin inflammation)

Fitz-Hugh-Curtis Syndrome

This condition, also known as perihepatitis, is a result of PID and involves inflammation of the liver capsule, causing persistent pain due to adhesions in the liver.

While antibiotics are the main treatment for gonorrhea, some home remedies may support recovery:

1. Garlic: Known for its antibacterial properties, garlic may help in treating bacterial infections like gonorrhea.
2. Apple Cider Vinegar: It has natural antibacterial qualities. However, it should be consumed using a metal straw to avoid tooth damage.
3. Aloe Vera Gel: With antibacterial and anti-inflammatory properties, aloe vera helps soothe and heal skin.
4. Goldenseal: This plant has antimicrobial properties and is available in capsules or creams. Always consult a doctor for the correct dosage.
5. Echinacea: This plant, used to reduce inflammation, can be applied topically in creams or gels.

Although gonorrhea can be managed with antibiotics, the following precautions should be taken:

• Avoid Sexual Activity: Do not engage in sexual activity for at least one week after completing treatment. Wait until symptoms have fully resolved.

• Retesting: If symptoms persist after treatment or you are concerned about possible antibiotic resistance, retesting is advised.

• Testing for Other STIs: People with gonorrhea are more susceptible to other STIs, including HIV. Therefore, it’s important to get tested for other infections.