Gonorrhea is a sexually transmitted infection (STI) caused by bacteria. Sexually transmitted infections, also known as STIs, STDs, or venereal diseases, are infections primarily spread through sexual contact involving genitals or bodily fluids. These infections can be caused by bacteria, viruses, or parasites.
The bacterium responsible for gonorrhea, Neisseria gonorrhoeae, can infect various parts of the body, including the urethra, rectum, cervix, throat, mouth, and eyes. It is most commonly transmitted during vaginal, oral, or anal sex. Additionally, newborns can contract gonorrhea from their mothers during childbirth, most frequently affecting their eyes.
Abstaining from sexual activity is the most effective way to prevent gonorrhea. For those who are sexually active, consistent condom use during every sexual encounter significantly reduces the risk of transmission. Maintaining a mutually monogamous relationship with a partner who is not infected and only has sex with you also minimizes the risk of gonorrhea.
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Symptoms of Gonorrhea
In many instances, gonorrhea infections may not produce noticeable symptoms, especially in women. However, when symptoms do appear, they can vary depending on the site of infection. Gonorrhea primarily affects the genital tract but can also manifest in other areas of the body.
Gonorrhea Symptoms in the Genital Tract
Male Reproductive System
The male reproductive system is responsible for producing, storing, and transporting sperm. The testicles generate sperm, which then mixes with fluids from the seminal vesicles and prostate gland to form semen. During sexual activity, semen is ejaculated through the penis. Gonorrhea infection in men can significantly affect these organs, leading to noticeable symptoms.
Male Symptoms of Gonorrhea:
- Painful Urination (Dysuria): A burning sensation or pain while urinating is a common symptom in men with gonorrhea.
- Pus-like Discharge from the Penis: An abnormal discharge from the tip of the penis, often white, yellow, or green in color, is another hallmark symptom.
- Testicular Pain or Swelling: Pain or swelling, typically in only one testicle, can occur due to inflammation.
Female Reproductive System
The female reproductive system comprises the ovaries, fallopian tubes, uterus, cervix, and vagina. Gonorrhea can infect these organs, leading to a range of symptoms. Often, symptoms in women are milder or can be mistaken for other infections, leading to delayed diagnosis and treatment.
Female Symptoms of Gonorrhea:
- Increased Vaginal Discharge: A change in the amount, color, or odor of vaginal discharge can be an indicator of gonorrhea.
- Painful Urination (Dysuria): Similar to men, women can experience pain or burning during urination.
- Vaginal Bleeding Between Periods: Bleeding between menstrual cycles, especially after sexual intercourse, can be a symptom.
- Abdominal or Pelvic Pain: Lower abdominal or pelvic pain can occur, sometimes indicating pelvic inflammatory disease (PID), a serious complication of untreated gonorrhea.
Gonorrhea Symptoms in Other Body Sites
Beyond the genital tract, gonorrhea can also affect other areas of the body due to the spread of bacteria.
- Rectal Gonorrhea: Infection of the rectum can cause:
- Anal itching
- Pus-like discharge from the rectum
- Bright red blood on toilet paper
- Straining during bowel movements
- Ocular Gonorrhea (Gonorrhea of the Eyes): Gonorrhea affecting the eyes can lead to:
- Eye pain
- Sensitivity to light (Photophobia)
- Pus-like discharge from one or both eyes
- Pharyngeal Gonorrhea (Gonorrhea of the Throat): Throat infections may present with:
- Sore throat
- Swollen lymph nodes in the neck
- Disseminated Gonococcal Infection (DGI) – Gonorrhea in the Joints: In rare cases, gonorrhea bacteria can spread through the bloodstream and infect joints, leading to septic arthritis. Symptoms may include:
- Warmth, redness, and swelling in affected joints
- Severe joint pain, especially during movement
- Fever
- Rash
- Skin sores
When to Seek Medical Attention
It is crucial to consult a healthcare professional if you experience any symptoms suggestive of gonorrhea. These include:
- Burning sensation during urination.
- Pus-like discharge from the penis, vagina, or rectum.
- Unusual vaginal bleeding.
- Pelvic or abdominal pain.
- Eye pain or discharge.
- Sore throat that doesn’t improve.
- Joint pain, swelling, or redness.
Furthermore, if your sexual partner has been diagnosed with gonorrhea, it is essential to get tested and treated, even if you do not have any symptoms. Untreated gonorrhea can lead to serious health complications and can result in re-infection of your partner even after they have completed treatment.
Causes of Gonorrhea
Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. This bacterium is primarily transmitted through sexual contact. The most common modes of transmission include:
- Vaginal intercourse: Bacteria can pass from the vagina to the penis or vice versa.
- Anal intercourse: Bacteria can be transmitted between the rectum and penis or between two rectums.
- Oral sex: Gonorrhea can spread through oral contact with the genitals or rectum.
- Mother to child during childbirth: An infected mother can transmit gonorrhea to her baby during vaginal delivery.
Gonorrhea cannot be spread through casual contact such as hugging, sharing towels, utensils, or toilet seats.
Risk Factors for Gonorrhea
Certain factors can increase the likelihood of contracting gonorrhea:
- Age: Sexually active young women under the age of 25 are at a higher risk.
- Men who have sex with men (MSM): This population group has a higher prevalence of gonorrhea.
- New sex partner: Having a new sexual partner increases the risk of exposure to STIs.
- Multiple sex partners: The more sexual partners you have, the higher your risk of contracting gonorrhea.
- Partner with multiple partners: Having a sexual partner who has other partners elevates your risk.
- History of STIs: Individuals who have had gonorrhea or other STIs in the past are at increased risk of reinfection.
- Inconsistent condom use: Not using condoms consistently during sexual activity significantly increases the risk of STI transmission.
Complications of Untreated Gonorrhea
If left untreated, gonorrhea can lead to severe and long-term health complications in both men and women.
- Pelvic Inflammatory Disease (PID) in Women: Gonorrhea can spread to the uterus and fallopian tubes, causing PID. PID can result in:
- Scarring of the fallopian tubes, leading to ectopic pregnancy and infertility.
- Chronic pelvic pain.
- Increased risk of future pregnancy complications.
- PID often requires prompt antibiotic treatment, sometimes hospitalization.
- Epididymitis in Men: Gonorrhea can inflame the epididymis, the coiled tube located at the back of the testicles that stores and transports sperm. Epididymitis can cause:
- Pain and swelling in the testicles.
- Infertility if left untreated.
- Disseminated Gonococcal Infection (DGI): The bacteria can spread through the bloodstream and infect other parts of the body, leading to DGI. DGI can cause:
- Septic arthritis (joint infection).
- Skin lesions.
- Fever.
- In rare cases, endocarditis (infection of the heart valves) or meningitis (infection of the brain and spinal cord).
- Increased Risk of HIV/AIDS: Gonorrhea infection increases susceptibility to HIV infection. Individuals with gonorrhea are more likely to contract HIV if exposed, and those with both gonorrhea and HIV are more likely to transmit both infections to their partners.
- Complications in Newborns: Babies born to mothers with gonorrhea can develop:
- Ophthalmia neonatorum: severe eye infection that can lead to blindness if untreated.
- Scalp sores.
- Systemic infections.
Prevention of Gonorrhea
Preventing gonorrhea and other STIs is crucial for maintaining sexual health. Effective prevention strategies include:
- Abstinence: The most reliable way to prevent gonorrhea is to abstain from sexual activity.
- Condom Use: Consistent and correct use of condoms during every sexual encounter (vaginal, anal, or oral sex) significantly reduces the risk of gonorrhea transmission.
- Limit Number of Sexual Partners: Reducing the number of sexual partners decreases the risk of exposure to gonorrhea. Mutual monogamy, where both partners only have sex with each other and are uninfected, is a low-risk practice.
- Regular STI Testing: Getting tested for STIs, including gonorrhea, is essential, especially for sexually active individuals and those with risk factors. Discuss testing frequency with your healthcare provider. Sharing test results with partners before engaging in sexual activity promotes informed decision-making.
- Avoid Sex with Symptomatic Partners: Refrain from sexual contact with anyone who has symptoms of an STI, such as genital discharge, sores, or pain during urination.
- Regular Gonorrhea Screening: Routine gonorrhea screening is recommended for:
- Sexually active women under 25 years old.
- Older women with increased risk factors (new partners, multiple partners, partners with multiple partners, or partners with STIs).
- Men who have sex with men (MSM).
- Partners of individuals in these high-risk groups should also be tested.
- Post-Exposure Prophylaxis (PEP) with Doxycycline: In certain high-risk groups, such as men who have sex with men and transgender women, taking doxycycline within 72 hours of unprotected sex may be considered as post-exposure prophylaxis (PEP) to reduce the risk of gonorrhea and other bacterial STIs. Discuss PEP options with your healthcare provider to determine if it is appropriate for you.
- Treatment and Partner Notification: If diagnosed with gonorrhea, it is crucial to complete the prescribed treatment regimen and inform all recent sexual partners so they can also get tested and treated to prevent further spread and reinfection. Avoid sexual activity until you and your partners have completed treatment and are symptom-free.
By Mayo Clinic Staff
