How contagious is gonorrhea? Get the facts about this sexually transmitted infection, including how it spreads, common symptoms, and prevention methods. Discover the latest information from medical experts.

Understanding Gonorrhea: The Basics

Gonorrhea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. This infection can target various parts of the body, including the urethra, cervix, rectum, and throat, as well as the membranes covering the front part of the eye (conjunctiva and cornea). Gonorrhea is primarily spread through sexual contact, although it can also be transmitted from a pregnant woman to her newborn during childbirth.

Contagiousness and Transmission

Gonorrhea is considered a highly contagious STI. The Centers for Disease Control and Prevention (CDC) estimates that more than 1 million new infections occur in the United States each year. The chance of transmission during a single episode of unprotected vaginal intercourse is around 20% from an infected woman to a man. The risk of transmission may be even higher from an infected man to a woman and from a man to a man.

Gonorrhea can be transmitted through various sexual activities, including vaginal, oral, and anal sex. It can also spread from a pregnant woman to her newborn during childbirth, causing conjunctivitis (eye infection) in the baby. However, this is often prevented in high-resource countries where newborns are routinely treated with medicated eye ointment after delivery.

Common Symptoms and Signs

Gonorrhea can cause a range of symptoms, depending on the site of infection. In men, common symptoms include mild discomfort in the urethra, followed by pain during urination, a yellow-green discharge from the penis, and a frequent urge to urinate. The opening of the penis may also become red and swollen, and the infection can spread to the epididymis, causing the scrotum to swell and feel tender.

In women, up to 20% may experience minimal or no symptoms, making the infection difficult to detect without routine screening. When present, symptoms may include a discharge from the vagina and a burning sensation during urination.

Complications and Risks

Untreated gonorrhea can lead to serious complications, including the spread of the infection to other parts of the body. This can result in conditions such as pelvic inflammatory disease (PID) in women, which can cause infertility, chronic pelvic pain, and ectopic pregnancy. In men, the infection can spread to the epididymis, causing pain and swelling in the scrotum.

People with gonorrhea also have an increased risk of contracting other STIs, such as chlamydia, syphilis, and HIV. This increased susceptibility is due to the inflammatory response and potential tissue damage caused by the gonorrhea infection.

Prevention and Treatment

The best way to prevent the spread of gonorrhea is to practice safe sex, including the use of condoms during all sexual activities. Regular STI screening, particularly for those with multiple partners or who engage in high-risk sexual behaviors, is also crucial for early detection and treatment.

Gonorrhea can be treated with antibiotics, but the increasing resistance to these medications is a growing concern. If left untreated, the infection can persist and lead to the complications mentioned earlier.

Seeking Medical Attention

Anyone who suspects they may have been exposed to gonorrhea or is experiencing any symptoms should seek medical attention promptly. Early diagnosis and treatment are essential to prevent the spread of the infection and avoid potential complications.

Healthcare providers can perform various tests, such as microscopic examination, culture, or DNA tests, to confirm the presence of the gonorrhea bacteria. Appropriate antibiotic treatment can then be prescribed to cure the infection.

Conclusion

Gonorrhea is a highly contagious sexually transmitted infection that can have serious consequences if left untreated. Understanding the basics of transmission, symptoms, and prevention is crucial for maintaining sexual health and preventing the spread of this common STI. By seeking prompt medical attention and practicing safe sex, individuals can take proactive steps to protect themselves and their partners.

Gonorrhea – Infections – Merck Manuals Consumer Version

By

Sheldon R. Morris

, MD, MPH, University of California San Diego

Reviewed/Revised Feb 2023

VIEW PROFESSIONAL VERSION

GET THE QUICK FACTS

Topic Resources

Gonorrhea is a sexually transmitted infection caused by the bacteria Neisseria gonorrhoeae, which infect the lining of the urethra, cervix, rectum, or throat, or the membranes that cover the front part of the eye (conjunctiva and cornea).

• Gonorrhea is usually spread through sexual contact.

• People usually have a discharge from the penis or vagina and may need to urinate more frequently and urgently.

• Microscopic examination, culture, or DNA tests of a sample of vaginal or penile discharge or DNA tests of urine can detect the infection.

• Antibiotics can cure the infection, but resistance to the antibiotics used to treat gonorrhea is becoming more common.

• Using condoms during genital sex can help prevent passing gonorrhea and other sexually transmitted infections (STIs) from one person to another.

(See also Overview of Sexually Transmitted Infections Overview of Sexually Transmitted Infections (STIs) Sexually transmitted infection (STI) refers to an infection that is passed through blood, semen, vaginal fluids, or other body fluids during oral, anal, or genital sex with an infected partner… read more .)

Gonorrhea is a very common infectious disease. The Centers for Disease Control and Prevention (CDC) estimates that more than 1 million new infections occur in the United States each year.

Gonorrhea is almost always spread through vaginal, oral, or anal sexual contact. After one episode of vaginal intercourse without a condom, the chance of spread from an infected woman to a man is about 20%. The chance of spread from an infected man to a woman and from a man to a man may be higher.

If a pregnant woman is infected, the bacteria can spread to the eyes of the newborn during birth, causing conjunctivitis in the newborn Conjunctivitis in Newborns Conjunctivitis is inflammation of the conjunctiva, the membrane that lines the eyelid and covers the white of the eye. Conjunctivitis is caused by bacteria, viruses, or a reaction to chemicals… read more . However, in most high-resource countries, infection is prevented because all newborns are routinely treated after delivery with medicated eye ointment.

People with gonorrhea are at increased risk of other STIs, such as chlamydia Chlamydia and Other Nongonococcal Infections Chlamydial infections include sexually transmitted infections of the urethra, cervix, and rectum that are caused by the bacteria Chlamydia trachomatis. These bacteria can also infect… read more , syphilis Syphilis Syphilis is a sexually transmitted infection caused by the bacteria Treponema pallidum. It can occur in three stages of symptoms, separated by periods of apparent good health. Syphilis… read more , or human immunodeficiency virus (HIV) infection Human Immunodeficiency Virus (HIV) Infection Human immunodeficiency virus (HIV) infection is a viral infection that progressively destroys certain white blood cells and is treated with antiretroviral medications. If untreated, it can cause… read more .

Did You Know…

Usually, gonorrhea causes symptoms only at the sites of initial infection, most commonly the cervix, penis, urethra, or throat. In a few people, infection spreads through the bloodstream to other parts of the body, especially to the skin, joints, or both.

Some men (about 25%) have minimal symptoms. Symptoms begin within about 2 to 14 days after infection. Men feel mild discomfort in the urethra (the tube that carries urine from the bladder out of the body). This discomfort is followed a few hours later by mild to severe pain during urination, a yellow-green discharge of pus from the penis, and a frequent urge to urinate. The opening at the tip of the penis may become red and swollen. The bacteria sometimes spread to the epididymis Epididymitis and Epididymo-orchitis Epididymitis is inflammation of the epididymis (the coiled tube on top of the testis that provides the space and environment for sperm to mature), and epididymo-orchitis is inflammation of the… read more (the coiled tube on top of each testis), causing the scrotum to swell and feel tender to the touch.

Some women (about 10 to 20%) have minimal or no symptoms. Thus, gonorrhea may be detected only during routine screening or after diagnosis of the infection in their partner. Symptoms typically do not begin until at least 10 days after infection. Some women feel only mild discomfort in the genital area and have a yellow or green vaginal discharge. However, other women have more severe symptoms, such as a frequent urge to urinate or pain during urination. These symptoms develop when the urethra is also infected.

The infection may spread up the reproductive tract and infect the uterus, the tubes that connect the ovaries to the uterus (fallopian tubes), and sometimes the area around the ovaries. In some women, the infection spreads to the lining of the pelvis and abdominal cavity (peritoneum), causing peritonitis. These infections are called pelvic inflammatory disease Pelvic Inflammatory Disease (PID) Pelvic inflammatory disease is an infection of the upper female reproductive organs (the cervix, uterus, fallopian tubes, and ovaries). Pelvic inflammatory disease is often caused by a sexually… read more (PID) and cause severe lower abdominal pain and sometimes fever. Sometimes infection concentrates in the area around the liver, in the upper right part of the abdomen, causing pain, fever, and vomiting—called the Fitz-Hugh-Curtis syndrome.

Anal sex with an infected partner may result in gonorrhea of the rectum (gonococcal proctitis Proctitis Proctitis is inflammation of the lining of the rectum (rectal mucosa). The inflammation has many causes ranging from infection to radiation therapy. Depending on its cause, proctitis can be… read more ). This infection usually causes no symptoms, but it may make bowel movements painful. Other symptoms include constipation, itching, bleeding, and a discharge from the rectum. The area around the anus may become red and raw, and stool may be coated with mucus and pus. When a doctor examines the rectum with a viewing tube (anoscope), mucus and pus may be visible on the wall of the rectum.

Oral sex with an infected partner may result in gonorrhea of the throat (gonococcal pharyngitis). Usually, these infections cause no symptoms, but the throat may be sore.

If infected fluids come into contact with the eyes, gonococcal conjunctivitis may develop, causing swelling of the eyelids and a discharge of pus from the eyes. In adults, often only one eye is infected. Newborns usually have infection in both eyes. Blindness may result if the infection is not treated early.

Rarely, disseminated gonococcal infection (arthritis-dermatitis syndrome) develops. It occurs when the infection spreads through the bloodstream to other parts of the body, especially the skin and joints; rarely, infection spreads to the heart. Joints become swollen, tender, and extremely painful, limiting movement. The skin over infected joints may be red and warm. People typically have a fever, feel generally ill, and develop joint pain (due to arthritis) in one or more joints. Small, red spots may appear on the skin, usually on the arms and legs. The spots are slightly painful and may be filled with pus. Joint, bloodstream, and heart infections can be treated, but recovery from arthritis may be slow.

Gonococcal septic arthritis is a form of disseminated gonococcal infection that causes painful arthritis. Usually, it affects one or two large joints, such as the knees, ankles, wrists, or elbows, Symptoms often begin suddenly. People usually have a fever. Infected joints are painful and swollen, and movement is limited. The skin over the infected joints may be warm and red.

In children, gonorrhea is usually a sign of sexual abuse. In girls, the genital area (vulva) may be irritated, red, and swollen, and they may have a discharge from the vagina. If the urethra is infected, children, mainly boys, may have pain during urination.

• Usually, testing of a sample of discharge from the cervix, vagina, penis, throat, or rectum or of a sample of urine

To diagnose gonorrhea, doctors collect a sample of discharge and send it to a laboratory. Highly sensitive tests can be done to detect the DNA of gonococci and of chlamydiae (which are often also present). Laboratories can test for both infections in a single sample. For some of these tests (called nucleic acid amplification tests, or NAATS), techniques that increase the amount of the bacteria’s genetic material are used. Because these techniques make the organisms easier to detect, urine samples can be used. Thus, these tests are convenient for screening people who have no symptoms or who do not want to have samples of fluid taken from their genitals. Sometimes, the sample is also sent for culture (to grow the organisms).

For men, gonorrhea may be diagnosed rapidly (within 1 hour) by examining samples of the discharge and identifying the bacteria (gonococci), if the facility has the appropriate equipment and trained personnel. If a discharge is obvious, doctors touch a swab or slide to the end of the penis to collect the sample. If there is no obvious discharge, doctors insert a small swab a half inch or more into the urethra to collect a sample. Men are asked to refrain from urinating for at least 2 hours before the sample is collected.

Diagnosing gonorrhea in women is more difficult than in men, because identifying bacteria in a sample of discharge from the cervix is more difficult than from a penis. The bacteria in a sample taken from the cervix can be seen under the microscope in only about half of infected women.

Because people may have more than one STI, doctors may test samples of blood and genital fluids for other STIs, such as syphilis Syphilis Syphilis is a sexually transmitted infection caused by the bacteria Treponema pallidum. It can occur in three stages of symptoms, separated by periods of apparent good health. Syphilis… read more and HIV infection Human Immunodeficiency Virus (HIV) Infection Human immunodeficiency virus (HIV) infection is a viral infection that progressively destroys certain white blood cells and is treated with antiretroviral medications. If untreated, it can cause… read more .

If a joint is red and swollen, doctors draw fluid from the joint using a needle. The fluid is sent for culture and other tests.

Certain people who have no symptoms are screened for gonorrhea because they are at increased risk of this infection.

If screening is recommended, it is done even if a person uses condoms consistently. Tests are done using samples taken from the rectum, the urethra, or, if the person engaged in oral sex, the throat.

For example, women are screened annually if they are sexually active and under age 25 or if they are 25 years or older, sexually active, and have one or more of the following risk factors:

• A previous STI

• Risky sexual activities (such as having many sex partners or multiple sex partners, using condoms inconsistently when not in a mutually monogamous relationship, or engaging in sex work)

• A history of incarceration

• Have a sex partner who participates in risky sexual activities or has an STI

Pregnant women are screened during their first prenatal visit and again during their 3rd trimester if they are at high risk.

Men who have sex with women are not routinely screened, but screening is available if a person requests it and is often offered to all people at adolescent clinics, STI clinics, and correctional facilities.

Men who have sex with men are screened as follows:

• If they are sexually active: At least once a year

• If they are at increased risk (those with HIV infection Human Immunodeficiency Virus (HIV) Infection Human immunodeficiency virus (HIV) infection is a viral infection that progressively destroys certain white blood cells and is treated with antiretroviral medications. If untreated, it can cause… read more , multiple sex partners, or a partner who has multiple partners): Every 3 to 6 months

Transgender and gender diverse people are screened if they are sexually active on the basis of sexual practices and anatomy. For example, all people with a cervix who are under age 25 are screened annually. If they are 25 years or older, people with a cervix should be screened annually if at increased risk. Rectal swab screening is done on transgender and gender diverse people based on reported sexual behaviors and exposure.

Doctors usually give people with gonorrhea a single injection of the antibiotic ceftriaxone into a muscle.

If gonorrhea has spread through the bloodstream, people are usually treated in the hospital and given antibiotics intravenously or by injection into a muscle.

If symptoms recur or persist after treatment, doctors may take samples for culture to determine whether people are cured and may do tests to determine whether the gonococci are resistant to the antibiotics used.

People with gonorrhea should abstain from sexual activity until treatment is completed to avoid infecting sex partners.

All sex partners who have had sexual contact with infected people in the past 60 days should be tested for gonorrhea and other STIs and, if the tests are positive, should be treated. If sex partners were exposed to gonorrhea within the past 2 weeks, they are treated for it without waiting for test results.

Expedited partner therapy is an option doctors sometimes use to make it easier for sex partners to be treated. This approach involves giving people with gonorrhea a prescription or medications to give to their partner. Thus, the sex partner is treated, even if they have not yet seen a doctor. Seeing a doctor is better because then the doctor can check for allergies to medications and the presence of other STIs. However, if the partner is unlikely to see a doctor, expedited partner therapy is useful.

The following general measures can help prevent gonorrhea (and other STIs):

• Safer sex practices, including using a condom Condoms Barrier contraceptives physically block the sperm’s access to a woman’s uterus. They include condoms, diaphragms, cervical caps, contraceptive gels, contraceptive sponges, and spermicides (foams… read more every time for oral, anal, or genital sex

• Decreased risk of exposure to STIs by reducing the number of sex partners, not having high-risk sex partners (people with many sex partners or who do not practice safer sex), or practicing mutual monogamy or abstinence

• Prompt diagnosis and treatment of the infection (to prevent spread to other people)

• Identification of the sexual contacts of infected people, followed by counseling or treatment of these contacts

The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

• Centers for Disease Control and Prevention: Gonorrhea

NOTE:


This is the Consumer Version.


DOCTORS:



VIEW PROFESSIONAL VERSION

VIEW PROFESSIONAL VERSION

Copyright © 2023 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. All rights reserved.

Test your knowledge

Take a Quiz!

Detailed STD Facts – Gonorrhea

What is gonorrhea?

Gonorrhea is a sexually transmitted disease (STD) caused by infection with the Neisseria gonorrhoeae bacterium. N. gonorrhoeae infects the mucous membranes of the reproductive tract, including the cervix, uterus, and fallopian tubes in women, and the urethra in women and men. N. gonorrhoeae can also infect the mucous membranes of the mouth, throat, eyes, and rectum.

How common is gonorrhea?

Gonorrhea is a very common infectious disease. CDC estimates that approximately 1.6 million new gonococcal infections occurred in the United States in 2018, and more than half occur among young people aged 15-24.¹ Gonorrhea is the second most commonly reported bacterial sexually transmitted infection in the United States.²  However, many infections are asymptomatic, so reported cases only capture a fraction of the true burden.

How do people get gonorrhea?

Gonorrhea is transmitted through sexual contact with the penis, vagina, mouth, or anus of an infected partner. Ejaculation does not have to occur for gonorrhea to be transmitted or acquired. Gonorrhea can also be spread perinatally from mother to baby during childbirth.

People who have had gonorrhea and received treatment may be reinfected if they have sexual contact with a person infected with gonorrhea.

Who is at risk for gonorrhea?

Any sexually active person can be infected with gonorrhea. In the United States, the highest reported rates of infection are among sexually active teenagers, young adults, and African Americans ².

What are the signs and symptoms of gonorrhea?

Many men with gonorrhea are asymptomatic ^{3, 4}. When present, signs and symptoms of urethral infection in men include dysuria or a white, yellow, or green urethral discharge that usually appears one to fourteen days after infection ⁵. In cases where urethral infection is complicated by epididymitis, men with gonorrhea may also complain of testicular or scrotal pain.

Most women with gonorrhea are asymptomatic ^{6, 7}. Even when a woman has symptoms, they are often so mild and nonspecific that they are mistaken for a bladder or vaginal infection ^{8, 9}. The initial symptoms and signs in women include dysuria, increased vaginal discharge, or vaginal bleeding between periods. Women with gonorrhea are at risk of developing serious complications from the infection, regardless of the presence or severity of symptoms.

Symptoms of rectal infection in both men and women may include discharge, anal itching, soreness, bleeding, or painful bowel movements ¹⁰. Rectal infection also may be asymptomatic. Pharyngeal infection may cause a sore throat, but usually is asymptomatic ^{11, 12}.

What are the complications of gonorrhea?

Untreated gonorrhea can cause serious and permanent health problems in both women and men.

In women, gonorrhea can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease (PID). The symptoms may be quite mild or can be very severe and can include abdominal pain and fever ¹³. PID can lead to internal abscesses and chronic pelvic pain. PID can also damage the fallopian tubes enough to cause infertility or increase the risk of ectopic pregnancy.

In men, gonorrhea may be complicated by epididymitis. In rare cases, this may lead to infertility ¹⁴.

If left untreated, gonorrhea can also spread to the blood and cause disseminated gonococcal infection (DGI). DGI is usually characterized by arthritis, tenosynovitis, and/or dermatitis ¹⁵. This condition can be life threatening.

What about gonorrhea and HIV?

Untreated gonorrhea can increase a person’s risk of acquiring or transmitting HIV, the virus that causes AIDS ¹⁶.

How does gonorrhea affect a pregnant woman and her baby?

If a pregnant woman has gonorrhea, she may give the infection to her baby as the baby passes through the birth canal during delivery. This can cause blindness, joint infection, or a life-threatening blood infection in the baby ¹⁷. Treatment of gonorrhea as soon as it is detected in pregnant women will reduce the risk of these complications. Pregnant women should consult a health care provider for appropriate examination, testing, and treatment, as necessary.

Who should be tested for gonorrhea?

Any sexually active person can be infected with gonorrhea. Anyone with genital symptoms such as discharge, burning during urination, unusual sores, or rash should stop having sex and see a health care provider immediately.

Also, anyone with an oral, anal, or vaginal sex partner who has been recently diagnosed with an STD should see a health care provider for evaluation.

Some people should be tested (screened) for gonorrhea even if they do not have symptoms or know of a sex partner who has gonorrhea ¹⁸. Anyone who is sexually active should discuss his or her risk factors with a health care provider and ask whether he or she should be tested for gonorrhea or other STDs.

CDC recommends yearly gonorrhea screening for all sexually active women younger than 25 years, as well as older women with risk factors such as new or multiple sex partners, or a sex partner who has a sexually transmitted infection.

People who have gonorrhea should also be tested for other STDs.

How is gonorrhea diagnosed?

Urogenital gonorrhea can be diagnosed by testing urine, urethral (for men), or endocervical or vaginal (for women) specimens using nucleic acid amplification testing (NAAT) ¹⁹. It can also be diagnosed using gonorrhea culture, which requires endocervical or urethral swab specimens.

FDA-cleared rectal and oral diagnostic tests for gonorrhea (as well as chlamydia) have been validated for clinical use ²⁰.

What is the treatment for gonorrhea?

Gonorrhea can be cured with the right treatment. CDC now recommends a single 500 mg intramuscular dose of ceftriaxone for the treatment of gonorrhea. Alternative regimens are available when ceftriaxone cannot be used to treat urogenital or rectal gonorrhea. Although medication will stop the infection, it will not repair any permanent damage done by the disease. Antimicrobial resistance in gonorrhea is of increasing concern, and successful treatment of gonorrhea is becoming more difficult ²¹. A test-of-cure – follow-up testing to be sure the infection was treated successfully – is not needed for genital and rectal infections; however, if a person’s symptoms continue for more than a few days after receiving treatment, he or she should return to a health care provider to be reevaluated. A test-of-cure is needed 7-14 days after treatment for people who are treated for pharyngeal (infection of the throat) gonorrhea.

Because re-infection is common, men and women with gonorrhea should be retested three months after treatment of the initial infection, regardless of whether they believe that their sex partners were successfully treated.

Healthcare providers and health departments can report suspected gonorrhea cephalosporin treatment failure or any N. gonorrhoeae specimen with decreased cephalosporin susceptibility through the Suspected Gonorrhea Treatment Failure Consultation Form.

What about partners?

If a person has been diagnosed and treated for gonorrhea, he or she should tell all recent anal, vaginal, or oral sex partners so they can see a health provider and be treated ²⁰. This will reduce the risk that the sex partners will develop serious complications from gonorrhea and will also reduce the person’s risk of becoming reinfected. A person with gonorrhea and all of his or her sex partners must avoid having sex until they have completed their treatment for gonorrhea and until they no longer have symptoms. For tips on talking to partners about sex and STD testing, visit http://www.gytnow.org/talking-to-your-partner.

How can gonorrhea be prevented?

Latex condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea ²². The surest way to avoid transmission of gonorrhea or other STDs is to abstain from vaginal, anal, and oral sex, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.

Sources

1. Kreisel KM, Spicknall IH, Gargano JW, Lewis FM, Lewis RM, Markowitz LE, Roberts H, Satcher Johnson A, Song R, St. Cyr SB, Weston EJ, Torrone EA, Weinstock HS. Sexually transmitted infections among US women and men: Prevalence and incidence estimates, 2018. Sex Transm Dis 2021; in press.
2. CDC. Sexually Transmitted Disease Surveillance, 2021. Atlanta, GA: Department of Health and Human Services; April 2023.
3. Handsfield HH, Lipman TO, Harnisch JP, Tronca E, Holmes KK. Asymptomatic gonorrhea in men. N Engl J Med, 290(3), 117–123 (1974).
4. Peterman T, Tian L, Metcalf C et al. High incidence of new sexually transmitted infections in the year following a sexually transmitted infection: a case for rescreening. Ann Intern Med, 145(8), 564–572 (2006).
5. Harrison WO, Hooper MR, Wiesner PJ et al. A trial of minocycline given after exposure to prevent gonorrhea. N Engl J Med, 300(19), 1074–1078 (1979).
6. Wallin J. Gonorrhea in 1972: a 1-year study of patients attending the VD unit in Uppsala. Brit J Vener Dis, 51, 41–47 (1974).
7. Platt R, Rice PA, McCormack WM. Risk of acquiring gonorrhea and prevalence of abnormal adnexal findings among women recently exposed to gonorrhea. JAMA, 250(23), 3205–3209 (1983).
8. McCormack WM, Johnson K, Stumacher RJ, Donner A, Rychwalski R. Clinical spectrum of gonococcal infection in women. Lancet, 1(8023), 1182–1185 (1977).
9. Curran J, Rendtorff R, Chandler R, Wiser W, Robinson H. Female gonorrhea: its relation to abnormal uterine bleeding, urinary tract symptoms, and cervicitis. Obstet Gynecol, 45(2), 195–198 (1975).
10. Klein EJ, Fisher LS, Chow AW, Guze LB. Anorectal gonococcal infection. Ann Intern Med, 86, 340–346 (1977).
11. Wiesner PJ, Tronca E, Bonin P, Pedersen AHB, Holmes KK. Clinical spectrum of pharyngeal gonococcal infection. N Engl J Med, 288(4), 181–185 (1973).
12. Bro-Jorgensen A, Jensen T. Gonococcal pharyngeal infections: report of 110 cases. Brit J Vener Dis, 49, 491–499 (1973).
13. Svensson L, Westrom L, Ripa K, Mardh P. Differences in some clinical and laboratory parameters in acute salpingitis related to culture and serologic findings. Am J Obstet Gynecol, 138(7), 1017–1021 (1980).
14. Berger R, Alexander E, Harnisch J et al. Etiology, manifestations and therapy of acute epididymitis: prospective study of 50 cases. J Urol, 121(6), 750–754 (1979).
15. Holmes KK, Counts GW, Beaty HN. Disseminated gonococcal infection. Ann Intern Med, 74, 979–993 (1971).
16. Fleming D, Wasserheit J. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm DIs, 75(1), 3–17 (1999).
17. Thadepalli H, Rambhatla K, Maidman J, Arce JJ, Davidson EC Jr. Gonococcal sepsis secondary to fetal monitoring. Am J Obstet Gynecol, 126(4), 510–512 (1976).
18. U.S. Preventive Services Task Force. Screening for gonorrhea: recommendation statement. Ann Fam Med, 3, 263–267 (2005).
19. Van Der Pol B, Ferrero DV, Buck-Barrington L et al. Multicenter evaluation of the BDProbeTec ET system for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in urine specimens, female endocervical swabs, and male uerthral swabs. J Clin Microbiol, 39(3), 1008–1016 (2001).
20. Workowski, KA, Bachmann, LH, Chang, PA, et. al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021; 70(No. 4): 1-187.
21. Centers for Disease Control and Prevention. Cephalosporin susceptibility among Neisseria gonorrhoeae isolates – United States, 2000–2010. MMWR, 60(26), 873–877 (2011).
22. Holmes KK, Levine R, Weaver M. Effectiveness of condoms in preventing sexually transmitted infections. Bull World Health Organ, 82(6), 454–461 (2004).

Gonorrhea: symptoms, treatment and signs

Urologist, endourologist

Mkrtchyan

Karen Gagikovich

Experience 15 years

Candidate of Medical Sciences, member of the European Association of Urology and the Russian Society of Oncourologists

Make an appointment

Gonorrhea (gonorrhea) is one of the most common sexually transmitted infections. Its causative agent is the bacterium gonococcus, which affects the mucous membranes of the human body. The chronic course of the disease causes infertility.

Symptoms and signs of gonorrhea

The symptoms of gonorrhea vary between men and women. The defeat of the male body begins with the urethra, in which itching and burning occur. Squeezing the glans penis provokes the release of pus, the process of urination becomes frequent and painful, sexual intercourse ends with the release of blood from the seminal canal. Visual examination reveals intense redness of the foreskin and head of the penis. In some cases, the inguinal lymph nodes become inflamed, pain in the prostate occurs, erection becomes difficult, and bacteria infect the seminal vesicles and testicles.

In women, the picture of the disease becomes different – up to half of the carriers of the infection do not notice its signs. The lesion begins with the urethra and cervical canal, then the vagina is involved. Pale yellow discharge appears from the urethra, reddening of the skin and cervix becomes apparent, local temperature increases, itching and burning occur. In a chronic course, the infection is fixed in the uterus and its appendages.

The incubation period of the disease is 4-4 days, with good immunity, the first signs of gonorrhea in men and women occur 4-8 weeks after infection.

Causes

Gonococcus, the causative agent of gonorrhea, is transmitted from an infected person to a healthy person only through direct contact. The most common way is genital during intercourse. Anogenital and orogenital methods of infection are common.

The manifestation of gonorrhea in women during pregnancy raises the risk of infection of the child, who has to pass through the birth canal of a sick mother. Infection through common household items is possible, but there is no unequivocal evidence in favor of this phenomenon – the gonococcus quickly dies in the external environment.

Ways of infection

The main channel of infection is unprotected sexual intercourse. For women, due to the peculiarities of physiology, it carries a greater risk – the probability of getting gonococcus into the body during vaginal penetration is 95%. Men risk half as much – the small size of the urethral inlet prevents bacteria from entering the mucous membranes, ejaculation or urination after proximity wash out the gonococcus.

Anogenital contacts carry similar risks, the gonococcus is fixed on the inner lining of the rectum of the penetrating partner. The likelihood of infection increases in the presence of damage to the mucous membranes or skin (anal fissures, the effects of hemorrhoids, etc.).

Orogenital contacts remain possible by infecting one of the partners. It is difficult for gonococcus to enter the human body through the tissues of the nasopharynx, but weakened immunity or tissue damage become favorable circumstances for infection.

Risk factors

A key risk factor is intimacy without the use of contraceptives, oral caress of an infected partner. These actions are highly likely to ensure that a person is infected with gonorrhea, regardless of the strength of immunity and the degree of concern for one’s own health.

Other factors:

• past diagnosis of gonorrhea;
• age up to 25 years;
• frequent change of sexual partners;
• the emergence of a new sexual partner.

Long-term observations made it possible to establish that the age group of 18-25 years is prone to the highest risk during sexual intercourse.

Complications

The greatest danger to infected men and women is potential infertility. Sometimes gonorrhea is accompanied by candidiasis, syphilis or chlamydia. The advanced form of gonorrhea – the chronic course of the disease – can lead to bacterial damage to the kidneys, bladder or other organs (including the heart).

Common complications in women are:

• fallopian tube rupture;
• pelvioperitonitis;
• menstrual disorders;
• formation of adhesions in the peritoneum.

In men, the list of potential complications includes narrowing of the urethra, impotence, prostatitis, testicular necrosis, orchiepididymitis (unilateral inflammation of the testicle or epididymis).

When to see a doctor

A visit to the doctor should be planned in three cases. The first is self-detection of the symptoms of the disease or its individual manifestations. The second is the identification of gonorrhea in a partner during tests or the suspicion that she / he has gonococcus. The third is cohabitation with an infected person.

The diagnosis and treatment of gonorrhea is carried out by a venereologist. JSC “Medicina” (clinic of Academician Roitberg) is located at 2nd Tverskoy-Yamskoy lane, building 10. The clinic is equipped with the equipment necessary for the successful diagnosis of gonorrhea in the early stages. Qualification of the staff will provide patients with effective treatment in a short time.

Preparing for a doctor’s visit

A visit of patients to a venereologist is often accompanied by sampling. To obtain correct results, you should follow a few simple rules:

• stop taking medications (antibiotics) that may interfere with screening;
• do not urinate for 1.5-2 hours before taking to ensure correct smear data;
• avoid the use of genital creams and ointments;
• do not use local baths and do not shower 6-8 hours before the appointment;
• do not eat for 3-4 hours before visiting the venereologist.

Preparation for admission according to the above scheme will provide reliable results of blood tests and smears from the urethra.

Diagnostics

Complaints and examination of the patient by a doctor do not always allow assessing the clinical picture of the disease. To accurately confirm the diagnosis of gonorrhea, a collection of secretions from the urethra, anus, vagina and cervix in women is required. Sowing secretions in a nutrient medium demonstrates to laboratory staff the manifestations of gonococcal activity and their resistance to certain types of antibiotics.

Conducting an enzyme immunoassay involves the delivery of urine. Using this method, antibodies to the bacterium that causes gonorrhea are detected. Their presence in the patient’s body confirms the diagnosis.

The general and biochemical analysis of the patient’s blood makes it possible to assess the state of the body, to verify the presence or absence of inflammatory processes and accompanying gonorrhea.

Treatment

Gonorrhea in its initial form without complications is treated on an outpatient basis – the venereologist prescribes drugs and describes to the patient the scheme for taking them. Cases with complications may require the intervention of a gynecologist or urologist for women and men, respectively.

Acute uncomplicated gonorrhea is treated for 7-10 days with oral and topical (ointment) antibiotics. Treatment is prescribed not only to the carrier of the infection, but also to his partner. The stage of therapy involves the rejection of intimacy, spicy food and alcohol. It is recommended to observe the rules of personal hygiene: washing hands after using the toilet and shower.

Treatment of the chronic form begins with a course of immunostimulating drugs, which are delivered to the patient’s body through intramuscular injections for 7-10 days. After that, the venereologist prescribes a traditional course of antibiotics. Control screening is carried out after completion of treatment and every 30 days for the next six months.

Home care

Gonorrhea is a dangerous infectious disease that should not be treated on its own. A venereologist will be able to select effective drugs in a dosage that will not cause the patient to experience side effects. Screening will allow the doctor to evaluate the course of the disease and make sure there are no co-infections or prescribe additional medications if they are detected.

Self-medication is the first step towards the transition of gonorrhea to the chronic stage. The dosage of drugs incorrectly calculated by the patient relieves the acute symptoms of the disease, but does not provide a complete recovery.

Myths about gonorrhea

The infection can be contracted through household items, personal hygiene products, dishes, handrails in public transport. No, unless these objects have contact with the urethra, rectum, or nasopharynx.

Gonorrhea can be brought into the blood during tests. Exceptions – clinics use disposable needles and syringes, which are destroyed after use.

Animals carry gonococci and can infect humans. Animals do not get gonorrhea and are not carriers of its pathogens.

Prevention

Preventive measures are very simple – avoid unprotected sex and follow the rules of hygiene. When changing a sexual partner, it is worth taking tests and asking the other side about it.

How to make an appointment with a venereologist

You can make an appointment with the dermatovenereologists of Medicina JSC (Academician Roitberg Clinic) on the website: an interactive form allows you to choose the general specialization of the doctor or the name and surname of a particular specialist. A convenient menu provides information about the days of admission and free hours for visiting specialists.

The clinic administrators are ready to accept an appointment by phone +7 (495) 775-73-60, calls are processed around the clock.

JSC “Medicina” (clinic of academician Roitberg) is located on the territory of the central administrative district of Moscow in close proximity to the metro stations Belorusskaya, Mayakovskaya, Novoslobodskaya, Chekhovskaya, Tverskaya: 2nd Tverskoy-Yamskoy per, 10.

Gonorrhea, symptoms in women and men – Treatment of gonorrhea in ON CLINIC Ryazan, price

One of the most common sexually transmitted diseases is gonorrhea. Pathogenic microorganisms – gonococci – are transmitted from one person to another through sexual contact, including anal and oral.

This disease is highly contagious – the risk of transmission of gonorrhea from one partner to another during sex is over 70%, which significantly exceeds the risk of contracting other sexually transmitted diseases. In addition, cases of self-transfer of gonorrhea pathogens from the genitals to the eyes through the hands by the patient are not uncommon.

As for the possibility of infection with gonorrhea in a domestic way – through bed linen, a towel, the surface of a toilet seat, etc. – it’s highly unlikely. This is primarily due to the fact that gonococcus outside the human body remains viable for a few minutes.

Symptoms of gonorrhea in women and men

Usually, about a week passes from the moment the gonococci enter the body until the first signs of the disease appear. Here are the characteristic signs of gonorrhea in women:

• copious discharge from the genital tract, unusual for the patient’s normal condition;
• soreness and burning in the urethra when urinating;
• in some cases – fever and pain in the lower abdomen.

In the stronger sex, unlike women, gonorrhea manifests itself as follows:

• during urination, the urethra seems to “burn” and “bake” from the inside;
• White urethral discharge.

In addition, in all patients, in the case of damage to the pharynx, soreness in the throat is noted. If the gonococci are localized in the region of the rectum, then this is accompanied by the presence in a person of such symptoms of gonorrhea as an itching sensation in the anus and rectum and discharge from it.

Finally, gonorrhea in women may not be accompanied by any symptoms at all. In addition, this happens in cases where the infection occurred during anal or oral sexual contact.

Why is gonorrhea dangerous?

If even after the disease has manifested itself in all its glory, the infected person does not seek medical help, then this can lead to the development of a number of dangerous complications:

• in men – prostatitis, orchitis, inflammation of the joints and inability to become a father;
• the consequences of the lack of treatment of gonorrhea in women are the appearance of adhesions of the fallopian tubes, inflammatory processes that affect the pelvic organs, and as a result of this, a high risk of ectopic pregnancy and the inability to conceive and bear a child.

If a pregnant woman suffers from this venereal disease, then this can lead to intrauterine infection of the baby. A characteristic symptom of the disease in such children is gonococcal conjunctivitis: extensive damage by pathogens to the organs of vision of a newborn.

Detection and treatment of gonorrhea in ON CLINIC Ryazan

It is quite easy to identify the infection – for this it is enough to take a regular smear for gonorrhea for analysis with its subsequent study in the laboratory. In our private clinic in Ryazan, tests for such sexually transmitted diseases as gonorrhea, ureaplasmosis, etc. are quickly and accurately performed. To clarify the results of the analysis, the doctor can also refer the patient to PCR diagnostics.

As for the treatment regimen for gonorrhea, it includes taking antibiotics and immunostimulants prescribed by the attending physician. In addition, a course of prostate massage procedures may be necessary, as well as the introduction of a medicinal solution into the urethra and physiotherapy.