Gonorrhea

What is gonorrhea?

Gonorrhea is a bacterial infection caused by the organism Neisseria gonorrheae that is transmitted by sexual contact.   It is one of the oldest known and most common sexually transmitted diseases.   In the U.S.  alone, an estimated one million women are infected with gonorrhea at any given time, and each year  700,000 people are infected.   It is most common in people 20 to 24 years of age.   Among the women who are infected, 25%-40% also will be infected with chlamydia, another type of bacteria that causes another STD.

Gonorrhea cannot be transmitted from toilet seats or door handles.  The bacteria that causes it can only grow in warm, moist areas.  It cannot live outside the body for more than a few seconds or minutes, nor can it live on the skin of the hands, arms, or legs.   It survives only on moist surfaces within the body and is found most commonly in the vagina, cervix, or the urethra -- the tube through which urine drains from the bladder.   Gonorrhea can exist in the back of the throat from oral-genital contact and in the rectum, and in some cases is found in the eyes. 

Symptoms and Dangers

Over 50% of infected women have no symptoms, especially in the early stages of the infection. Symptoms can include burning or frequent urination, a yellowish vaginal discharge, redness and swelling of the genitals, and a burning or itching of the vaginal area.  Abnormal vaginal bleeding as well as rectal bleeding is also common.
 Untreated, gonorrhea can lead to a severe pelvic infection with inflammation of the fallopian tubes and ovaries.    Ten to forty percent of infected women develop a  serious and painful infection of the pelvis called pelvic inflammatory disease, or PID.  Symptoms of pelvic infection include fever, pelvic cramping, abdominal pain, or pain with intercourse.  This infection can lead to difficulty in becoming pregnant or even to sterility.  

Diagnosing Gonorrhea

Testing for gonorrhea is done by swabbing the infected site, including the cervix, rectum,  or throat, and identifying the bacteria in the laboratory.  At this time, the sample is also tested for chlamydia, since the two infections are often present together.

Treatment

Gonorrhea can be treated with antibiotics.   Treatment should always include medication that will treat chlamydia as well as gonorrhea, since gonorrhea and chlamydia frequently exist together in the same person.  The sexual partners of women who have had either gonorrhea or chlamydia must receive treatment for both infections and treating the partners also prevents reinfection of the woman.  Women suffering from PID require more aggressive treatment that is effective against the bacteria that cause gonorrhea as well as against other organisms. These women often require intravenous administration of antibiotics.

Prevention

Not having sexual intercourse, or abstinence, is the only sure method of preventing gonorrhea.   A monogamous sexual relationship with an individual known to be free of any STD is generally low-risk, although condoms are still recommended.
You can greatly lower your risk of catching an STD by using a condom every time you have sex.  Condoms are available for both men and women, but are most commonly worn by the man.   It is important that the condom is used properly; otherwise it may be as ineffective as no condom at all. 

Using a Condom

Traditionally, the male partner uses the condom.  They are more effective, readily available and simple to use.  If your partner refuses to use one, there are female condoms available so that you can protect yourself.

For the male condom:

The male partner should put on a condom before his penis touches his partner’s vagina.   Care should be taken in opening the package and removing the condom, as they are easily torn by a fingernail, teeth, or other sharp object. If the condom has a small pouch at the end of it to collect the semen, begin rolling the condom onto the penis with the receptacle left empty so that semen can fill it.   Be sure to squeeze the air out of the receptacle end.   Place the condom against the tip of the penis and carefully roll the sides down the shaft of the erect penis.  The rolled ring should be on the outside of the condom. If the condom does not unroll easily, it may be upside down.   If you find you are rolling it on incorrectly, throw it away and try another so you don’t expose your sexual partner to germs.

If there is no pouch at the end, then leave a little space between the condom and the end of the penis.   Otherwise, the semen may push up the sides of the condom and come out at the base of it before the penis and condom are withdrawn.   Be sure to squeeze the air out of the tip of the condom so there is not any air between the penis and the condom.   Air left in the tip can cause the condom to break. If the penis is uncircumcised, pull the foreskin back before putting on the condom.

For the female condom:

The female condom is similar to the male condom and intended for one-time use.   They are available at most drugstores.  The condom is a sheath of polyurethane which contains two flexible rings, one at each end.   The ring at the closed end of the sheath is used to insert and anchor the condom inside the vagina.   The other ring forms the external edge of the condom and remains outside of the vagina after insertion.   By squeezing the ring between your thumb and forefinger, insert the ring into your vagina.  With your finger, push the inner ring as far into the vagina as it will go. The outer ring stays outside the vagina.

Do not have a male partner use a condom at the same time because the condoms may stick to each other, leading to slippage or displacement of either device. If you have a choice, use a male condom for better protection.

Remember

Gonorrhea is a bacterial infection that is transmitted during sexual activity.  It is usually easily treatable with antibiotics.  Women infected with gonorrhea may not have any symptoms.    The only sure way to avoid sexually transmitted diseases is by abstinence; however if you do have sexual relations always use a condom.