Gonorrhea

Also see entry for Sexually Transmitted Infections

What It Is
Gonorrhea is a sexually transmitted infection (STI), caused by Neisseria gonorrhoeae, a bacterium that can grow and multiply easily in the warm, moist areas of the reproductive tract, including the cervix, uterus, and fallopian tubes in women, and in the urethra in both women and men. The bacterium can also grow in the mouth, throat, eyes, and anus.

Who Gets It
Gonorrhea is a very common infectious disease. The CDC estimates that more than 700,000 persons in the U.S. get new gonorrheal infections each year of which only about half are reported to the CDC. In 2006, the rate of reported gonorrheal infections was nearly 121 per 100,000 persons. 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.

Symptoms
In women, the symptoms are often mild, and most women have no symptoms. Or symptoms may be so non-specific that they’re mistaken for a bladder or vaginal infection. The initial symptoms include a painful or burning sensation when urinating, increased vaginal discharge, or vaginal bleeding between periods. Women infected with gonorrhea are at risk of developing serious complications, regardless of the presence or severity of symptoms.

Some men also have no symptoms. However, some have signs or symptoms that appear two to five days after infection; symptoms can take as long as 30 days to appear and include a burning sensation when urinating, or a white, yellow, or green discharge from the penis. Sometimes men experience painful or swollen testicles.

How It's Diagnosed/Detected
A swab from the parts of the body likely to be infected (cervix, urethra, rectum, or throat) is sent to a laboratory for analysis. Staining the sample allows the doctor to see the gonorrhea bacterium under a microscope if it’s present.

How It Affects Fertility (And Pregnancy)
In women, gonorrhea is a common cause of pelvic inflammatory disease (PID). About one million women each year in the United States develop PID. The symptoms may be quite mild or can be very severe and can include abdominal pain and fever. PID can lead to internal abscesses and chronic pelvic pain. PID can damage the fallopian tubes enough to cause infertility or increase the risk of ectopic pregnancy. In men, gonorrhea can cause epididymitis, (an inflammation of the epididymis, the tube that connects the testicle with the vas deferens); the condition can lead to infertility if left untreated.

Treatment
Several antibiotics successfully cure gonorrhea, although drug-resistant strains are increasing in many areas of the world, including the United States, and successful treatment of gonorrhea is becoming more difficult. Because many people with gonorrhea also have chlamydia, another STI, antibiotics for both infections are usually given together. Although medication will stop the infection, it will not repair any damage already done by the disease. People who have had gonorrhea and have been treated can get the disease again if they have sexual contact with persons infected with gonorrhea.

Pregnancy Prognosis
A promptly treated gonorrhea infection should not cause fertility or pregnancy problems, but left untreated the infection may lead to PID (see above). A pregnant woman with an active gonorrhea infection may pass the infection to her baby as it passes through the cervix during delivery, resulting in possible blindness, joint infection, or a life-threatening blood infection. Quick treatment of gonorrhea reduces the risk of these complications. The CDC recommends thus that pregnant women be tested for STIs early in pregnancy and again close to delivery.

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