Gonorrhea is a sexually-transmitted disease (STD) caused by the bacterium Neisseria gonorrhoeae. Gonorrhea is also known as the clap.
In worldwide prevalence, gonorrhea is second only to chlamydia as a sexually-transmitted infection. In the United States, an estimated 700,000 people have gonorrhea. According to the Centers for Disease Control and Prevention (CDC), about half the cases of gonorrhea in America are unreported.
Cause of Gonorrhea
The bacterium N. gonorrhoeae travels through blood, semen and saliva. The common cause of gonorrhea is vaginal, oral or anal sex with an infected partner. Infection can occur even without male ejaculation. Gonorrhea does not spread from toilet seats or other items used by infected individuals.
Men have about a 20% chance of contracting gonorrhea during a single act of vaginal sex with an infected woman. The risk of gonorrhea is higher during anal intercourse, either with men or women.
Comparatively, the risk of a woman contracting gonorrhea through a single incident of penile/vaginal sex is sixty to eighty percent. In general, women exhibit fewer symptoms than men, making the disease more difficult to recognize. A pregnant woman can transmit gonorrhea to her unborn baby.
In 30-60% percent of all cases, gonorrhea is asymptomatic, or may occur as undetected subclinical disease. In men specifically, ten percent of cases show no symptoms. Gonorrhea may exist without symptoms in the human body for many years.
Symptoms of Gonorrhea in Men
In men, gonorrhea initially infects the urethra. Symptoms of gonorrhea can develop between two and thirty days after infection. Symptoms typically appear within four to six days.
Early symptoms of gonorrhea in men include:
• thick, yellow or greenish discharge from the penis (gleet)
• frequent urination
• pain or burning while urinating
• rarely, bleeding from the penis
The infection may move into the prostate, seminal vesicles (glands producing seminal fluid), and epididymis, causing pain and fever. The epididymis is the tube carrying semen from the testicles in preparation for ejaculation.
Rectal gonorrhea is the most contagious form of gonorrhea. Early symptoms of gonorrheal infection of the anus include:
• anal discharge
• pain or tenderness of the anus
• rectal itching
• pain while defecating
Gonorrhea of the mouth or throat can cause inflammation and pain in the throat tissues. In very rare cases, an oral gonorrhea infection may be transmitted to a partner during kissing or oral sex.
Untreated gonorrhea can cause serious health problems. Later symptoms of gonorrhea in men include:
• epididymitis (infection of the tubes carrying semen from the testicles)
• abscesses in the rectum or urethra
• infection of the urethra
• bladder disease
• prostate disease
• testicular disease
Symptoms of gonorrhea may be similar to those of chlamydia in men. The penile discharge in cases of chlamydia is whitish in color, and thinner in consistency than gonorrheal discharge.
Treatment of Gonorrhea
Use of a prophylactic or condom can greatly diminish the risk of contracting gonorrhea. Lotions, creams or spermicides will not prevent gonorrhea.
A patient infected with gonorrhea or any other STD should immediately inform all sexual partners. Since gonorrhea is often asymptomatic, any person potentially exposed to infection must be tested. While in treatment, patients should abstain from sex.
Gonorrhea has evolved to resist certain antibiotics, such as tetracycline. In the United States, ceftriaxone (Rocephin) is commonly prescribed to treat gonorrhea.
Gonorrhea of the throat is difficult to treat, and the patient must return to the doctor for a throat swab about 72 hours after treatment. If the swab returns a positive result, treatment is repeated.
Although penicillin was once a popular medical treatment for gonorrhea, other antibiotics are more effective. Penicillin cannot treat rectal gonorrhea. Bacteria in the rectum manufacture β-lactamases, which destroy penicillin.
The most common treatment for gonorrhea is ceftriaxone. Other antibiotics used to treat gonorrhea include:
• amoxicillin + probenecid
• ampicillin + probenecid
• cefoxitin + probenecid
• cefpodoxime (Vantin)
Most antibiotic treatments for gonorrhea are effective within five to seven days. In up to 99% of cases, the patient makes a full recovery.