Gonnorrhea

What is gonorrhea?

Gonorrhea (gon-o-RHEE-a) is caused by a kind of bacteria, Neisseria gonorrhoeae, which can infect the penis, vagina, cervix, anus, urethra, or throat. Sometimes it is called "the clap" or "the drip." Despite these funny names, untreated gonorrhea is a serious health risk. It affects about 600,000 women and men in the U.S. every year.

What are the symptoms of gonorrhea?

Often, gonorrhea has no symptoms. Eighty percent of women and 10 percent of men with gonorrhea show no symptoms. Many people are not aware that they are infected.

When symptoms do occur, they may begin one to 14 days after infection.

When women have symptoms, they commonly experience

• abdominal pain
• bleeding between menstrual cycles
• fever
• menstrual irregularities
• painful intercourse
• painful urination
• swelling or tenderness of the vulva
• the urge to urinate more than usual
• vomiting
• yellowish or yellow-green vaginal discharge

When men have symptoms, they commonly experience

• pus-like discharge from the penis
• pain or burning feeling while urinating
• more frequent urination than usual

Symptoms of gonorrhea in women and men are called gonococcal urethritis. They are like those of chlamydia. Men often don't take these symptoms seriously because the symptoms may appear only early in the day and can be very mild.

Anal discharge and itching, sometimes accompanied by painful bowel movements, can be symptoms of a rectal infection.

Itching and soreness of the throat with trouble swallowing may be symptoms of an oral infection. Ninety percent of oral infections show no symptoms at all.

Arthritis Up to three percent of women and men with untreated gonorrhea develop disseminated gonococcal infection (DGI). DGI can cause arthritis and skin lesions. Women are four times more likely than men to develop DGI. Adolescent women have the highest infection rate. Symptoms include joint pain skin rash or lesions fever When diagnosed, DGI can be easily treated. If left untreated, DGI can permanently damage joints.

How is gonorrhea spread?

Gonorrhea is spread by vaginal, anal, and oral intercourse. Gonorrhea can also be passed from mother to fetus during birth.

Oral sex on a man can transmit gonorrhea to either partner. Oral sex on a woman can transmit gonorrhea to her partner.

Is gonorrhea dangerous?

Gonorrhea is a serious health threat. In women, the infection usually begins on the cervix. It can spread to the fallopian tubes or ovaries. If left untreated, gonorrhea may cause PID, pelvic inflammatory disease. Ten to 20 percent of women with untreated gonorrhea will develop PID.

PID can scar and block the fallopian tubes. That can make a woman infertile — unable to become pregnant. Because fertilized eggs may not reach the uterus because tubes are blocked, they may develop in the tubes. This is called an ectopic pregnancy. A woman may die if a pregnancy develops outside her uterus unless it is removed with medication or surgery. Women with PID of the fallopian tubes are seven to 10 times more likely than other women to have ectopic pregnancies.

The symptoms of PID include

• longer and/or heavier periods
• more cramping during periods
• abnormal mucus discharge
• pain in lower abdomen
• tiredness, weakness
• fever
• vomiting
• pain during vaginal intercourse
• pain during pelvic exam

Gonorrhea can also make men infertile. It can spread from the urethra to the testicles. There, it can result in a condition called epididymitis. Up to 20 percent of men with untreated gonorrhea infection develop epididymitis. Acute epididymitis can cause infertility. Symptoms include fever as well as swelling and extreme pain in the scrotum.

How does gonorrhea affect pregnancy?

During pregnancy, gonorrhea infections can cause premature labor and stillbirth.

Gonorrhea can be passed from mother to fetus during birth. These infections can lead to blood, joint, and eye infections. To prevent serious eye infections that can be caused by gonorrhea, drops of antibiotics are routinely put into the eyes of newborn babies immediately after delivery. Testing and treatment during a pregnancy reduces the risk of transmission.

How is gonorrhea diagnosed?

• microscopic examination of urethral, vaginal, or anal discharges
• laboratory tests of cells from the penis, cervix, urethra, anus, or throat
• examination of urine samples

Is there a cure for gonorrhea?

Yes. Gonorrhea is easy to treat. Antibiotics kill gonorrhea bacteria. Health care providers usually prescribe a single dose of an antibiotic, such as cefpodoxime (Vantin) or ceftriaxone (Rocephin) or the fluoroquinolones — ciprofloxacin (Cipro), ofloxacin (Floxin, Ocuflox), or levofloxacin (Levaquin). Some gonorrhea infections, however, are resistant to the fluoroquinolones. Both partners must be treated at the same time to avoid re-infection.

Pregnant women and individuals under 18 should not be given ciprofloxazin or ofloxacin. Your clinician can help you decide which is the best treatment for you.

People diagnosed with gonorrhea are often treated for chlamydia at the same time.

PID is usually treated with medicine. Sometimes surgery is needed. Infertility caused by gonorrhea is often permanent.

If you are treated for gonorrhea, or any other sexually transmitted infection, remember —

• Take all the prescribed medicine. Even if the symptoms go away, the infection may still be in your body until treatment is complete.
• Make sure your partner(s) is/are treated at the same time so you don't reinfect each other.
• Do not share your medicine with anyone.
• Consult your clinician if you continue to have symptoms after treatment.

Who is most likely to get gonorrhea?

• people who don't use condoms
• people with a history of other sexually transmitted infections
• people who have a number of different sex partners
• people whose sex partners have a number of different sex partners
• sexually abused children

Young adults have the highest rates of gonorrhea.

How can people with gonorrhea avoid spreading it?

• Inform sex partners about the infection.
• Have no sex until treatment is complete.
• Be sure sex partners are screened and treated at the same time.
• Use a condom for intercourse every time.
• Use a barrier for oral sex.

Anyone with a sex partner who has a condition or symptoms described in this pamphlet should be checked for gonorrhea and other sexually transmitted infections. Since gonorrhea infection often has no symptoms, women and men who are at risk should ask to be checked for sexually transmitted infections every six to 12 months.

People who think that they or their partners have gonorrhea should tell their clinicians immediately. This is especially important for pregnant women.

How can I avoid getting gonorrhea?

• Use a condom for intercourse every time.
• Use a barrier for oral sex.
• Have routine checkups for sexually transmitted infections.
• Abstain from sexual intercourse.

Does using birth control increase my risk of getting gonorrhea?
No. Birth control does not increase the risk of infection. However, most methods of birth control do not provide any protection against gonorrhea.

Condoms offer good protection.

Women who take the pill have a lower risk of developing PID from gonorrhea than women who don't. Nonetheless, women on the pill should use a condom with partners who may have sexually transmitted infections.

Where can I get tested and treated for gonorrhea?

Planned Parenthood health centers, other clinics, doctors, and health departments offer testing, treatment, and counseling.

Written by Jessica Davis
Updated August 2004.
© 2004 Planned Parenthood Federation of America, Inc. All rights reserved.