What is gonorrhea?
Gonorrhea is a curable sexually transmitted infection (STD) caused
by a bacterium called Neisseria gonorrhoeae. These bacteria can
infect the genital tract, the mouth, and the rectum. In women, the
opening to the uterus, the cervix, is the first place of infection.
The disease however can spread into the uterus and fallopian
tubes, resulting in pelvic inflammatory disease (PID). PID affects
more than 1 million women in this country every year and can cause
infertility in as many as 10 percent of infected women and tubal
In 2010, 309,341 cases of gonorrhea were reported to the U.S.
Centers for Disease Control and Prevention (CDC). In the United
States, approximately 75 percent of all reported cases of gonorrhea
are found in younger persons aged 15 to 29 years. The highest rates of
infection are usually found in 15- to 19-year old women and 20- to
24-year-old men. Health economists estimate that the annual cost of
gonorrhea and its complications is close to $1.1 billion.
Gonorrhea is spread during sexual intercourse. Infected women also
can pass gonorrhea to their newborn infants during delivery, causing
eye infections in their babies. This complication is rare because
newborn babies receive eye medicine to prevent infection. When the
infection occurs in the genital tract, mouth, or rectum of a child,
it is due most commonly to sexual abuse.
What are the symptoms of gonorrhea?
The early symptoms of gonorrhea often are mild. Symptoms usually
appear within 2 to 10 days after sexual contact with an infected
partner. A small number of people may be infected for several months
without showing symptoms.
When women have symptoms, the first ones may include
- Bleeding associated with vaginal intercourse
- Painful or burning sensations when urinating
- Vaginal discharge that is yellow or bloody
More advanced symptoms, which may indicate development of PID,
include cramps and pain, bleeding between menstrual periods,
vomiting, or fever.
Men have symptoms more often than women, including
Symptoms of rectal infection include discharge, anal itching, and
occasional painful bowel movements with fresh blood on the feces.
How is gonorrhea diagnosed?
Doctors or other health care workers usually use three laboratory
techniques to diagnose gonorrhea: staining samples directly for the
bacterium, detection of bacterial genes or DNA in urine, and growing
the bacteria in laboratory cultures. Many doctors prefer to use more
than one test to increase the chance of an accurate diagnosis.
The staining test involves placing a smear of the discharge from
the penis or the cervix on a slide and staining the smear with a dye.
Then the doctor uses a microscope to look for bacteria on the slide.
You usually can get the test results while in the office or clinic.
This test is quite accurate for men but is not good in women. Only
one in two women with gonorrhea have a positive stain.
More often, doctors use urine or cervical swabs for a new test
that detects the genes of the bacteria. These tests are as accurate
or more so than culturing the bacteria, and many doctors use them.
The culture test involves placing a sample of the discharge onto a
culture plate and incubating it up to 2 days to allow the bacteria to
grow. The sensitivity of this test depends on the site from which the
sample is taken. Cultures of cervical samples detect infection
approximately 90 percent of the time. The doctor also can take a
culture to detect gonorrhea in the throat. Culture allows testing for
How is gonorrhea treated?
Doctors usually prescribe a single dose of one of the following
antibiotics to treat gonorrhea:
If you have gonorrhea and are pregnant or are younger than 18
years old, you should not take ciprofloxacin or ofloxacin. Your
doctor can prescribe the best and safest antibiotic for you.
Gonorrhea and chlamydial infection, another common STD, often
infect people at the same time. Therefore, doctors usually prescribe
a combination of antibiotics, such as ceftriaxone and doxycycline or
azithromycin, which will treat both diseases.
If you have gonorrhea, all of your sexual partners should get
tested and then treated if infected, whether or not they have
symptoms of infection.
What can happen if gonorrhea is not treated?
In untreated gonorrhea infections, the bacteria can spread up into
the reproductive tract, or more rarely, can spread through the blood
stream and infect the joints, heart valves, or the brain.
The most common result of untreated gonorrhea is PID, a serious
infection of the female reproductive tract. Gonococcal PID often
appears immediately after the menstrual period. PID causes scar
tissue to form in the fallopian tubes. If the tube is partially
scarred, the fertilized egg may not be able to pass into the uterus.
If this happens, the embryo may implant in the tube causing a tubal
(ectopic) pregnancy. This serious complication may result in a
miscarriage and can cause death of the mother.
Rarely, untreated gonorrhea can spread through the blood to the
joints. This can cause an inflammation of the joints which is very
If you are infected with gonorrhea, your risk of getting HIV
infection increases (HIV, human immunodeficiency virus, causes AIDS).
Therefore, it is extremely important for you to either prevent
yourself from getting gonorrhea or get treated early if you already
are infected with it.
Can gonorrhea affect a newborn baby?
If you are pregnant and have gonorrhea, you may give the infection
to your baby as it passes through the birth canal during delivery. A
doctor can prevent infection of your baby's eyes by applying silver
nitrate or other medications to the eyes immediately after birth.
Because of the risks from gonococcal infection to both you and your
baby, doctors recommend that pregnant women have at least one test
for gonorrhea during pregnancy.
Note: All information is based upon materials published by the National
Institute of Allergy and Infectious Diseases (NIAD).and the
U.S. Centers for Disease Control.