What is Gonorrhea?
Gonorrhea is a sexually transmitted disease caused by the bacteria Neisseria Gonorrhea. Although it predominantly infects the urethra (in both men and women) and the vaginal tract, it can also infect the throat and in severe cases can also spread to other parts of the body such as the skin and joints. After Chlamydia, Gonorrhea is the most common STD in Singapore.
How do I get Gonorrhea?
Gonorrhea in adults is always transmitted by sexual contact.
Gonorrhea is transmitted by penetrative sex (vaginal and anal), as well as by oral sex (both giving and receiving).
Gonorrhea can also be transmitted by sharing sex toys.
Like most infectious diseases, coming into contact with any body fluids (vaginal secretions/ semen/ discharge) increases your chances of getting infected. Hence if someone comes into contact with the infected body fluid and touches their eyes or nose, there is a chance that the infection can be passed onto that person. This is seen in “vertical transmission” where infected mothers pass the bacteria onto their child during childbirth. The child passes down the birth canal infected with Gonorrhea, leading to an infection of the eyes. This known as Ophthalmia Neonatorum.
What are the signs of Gonorrhea?
It is especially important to note that there is a significant proportion of patients (up to 10%) that are infected with Gonorrhea but do not display any signs. If signs are present, how they present depends on the site of the infection. For men the most common sign is discharge coming out of the penis. Most of the time, the discharge is thick, yellow-green and quite voluminous. Some patients even have to put tissues in their pants just to soak up the discharge. This may be accompanied with pain passing urine. For women, vaginal discharge is the most common sign of a Gonorrhea infection. Of note is that because of how close the rectum is to the vagina, rectal gonorrhea can be present in women even without her having had anal intercourse.
Throat Gonorrhea usually presents with a sore throat. Sometimes this is indistinguishable from sore throats caused by any other virus or bacteria. The only way to know for sure is to do a throat swab test.
Rectal Gonorrhea usually causes discomfort in the anus, the sensation of having to go to the toilet and a discharge from the anus (usually described as a feeling of always feeling wet).
Symptoms can come on as quickly as 2 days after exposure. Or can take up to 1 month.
Other infections such as Chlamydia and NSU (including Mycoplasma Genitalium) can have similar symptoms.
What’s the worst that could happen?
An untreated Gonorrhea infection can have serious implications because like Chlamydia, the Gonorrhea progressively moves from the initial site of infection and damages the area as it moves. Over time, Gonorrhea can cause Pelvic Inflammatory Disease in women and Acute Bacterial Prostatitis in men. A prolonged infection may also result in a urethral or vaginal infection progressing to the testicles and ovaries respectively leading to long term infertility.
What is Disseminated Gonorrhea Infection?
A further complication that is unique to Gonorrhea is that it can spread beyond the genital area by entering your bloodstream and infecting your joints and the overlying skin. Known as disseminated Gonorrhea, most patients come to a clinic reporting a pain in their joints – most commonly the wrist which is worse on movement. There may be skin irritation or pustules (pimple-like swelling) over the affected joint. In women, menstruation is a particular “triggering” event that leads to disseminated Gonorrhea infection because the untreated bacteria enters the blood during the menses and spreads to the joints.
How do I get tested for Gonorrhea?
Testing for Gonorrhea is site-specific. In other words, you will need one test per area that needs to be tested.
A urine test will look for infections in the urethra.
A throat swab will look for infections in the throat.
A rectal swab will look for infections in the rectum.
A vaginal swab will look for infections in the vagina (this can also be done with a urine test)
So it is important to share with your Doctor which areas have been exposed and where your symptoms are. Also if your partner has symptoms, where his/her symptoms are too.
The current gold standard test for Gonorrhea is the PCR test.
How do I get treated for Gonorrhea?
Gonorrhea involves treatment with antibiotics. Most of the time an injectable antibiotic is needed to treat Gonorrhea. The course and duration of the antibiotics depends on the site of the infection and how long the infection has been present.
If the symptoms of Gonorrhea are obvious and unmistakable, Doctors usually provide treatment for you and your partner/s even before test results become available.
Resistance to treatment
In recent years, there is growing concern of some Gonorrhea strains developing resistance to antibiotics. The first highly antibiotic resistant Gonorrhea strain was reported in Japan in 2011 with other similarly resistant strains being found each year leading to health authorities declaring that Gonorrhea is becoming a “superbug” that is resistant to many antibiotics. This is why seeing a Doctor and getting proper treatment is so important. Taking over the counter treatments, especially antibiotics, will only contribute to making this issue worse.
What can I do if I think I have Gonorrhea?
Early detection is always important in treating a disease. See a Doctor and get tested.
In the case of Gonorrhea, treatment can be immediately given upon diagnosis or if there is a high clinical suspicion of you being infected. It is important that you follow up with your doctor 2 – 3 weeks after receiving treatment to confirm clearance of the bacteria. If there is still Gonorrhea in your system despite treatment, more tests need to be done to determine if the bacteria you have is resistant to antibiotics and a more specific antibiotic plan needs to be created for you.
It is also important to get your sexual partner/s tested and treated even if they do not have any symptoms. This breaks the chain of transmission and also reduces the risk of complications from Gonorrhea.
Using a condom correctly and consistently during every sexual encounter reduces the risk of getting infected with Gonorrhea.
Is the injection a vaccination against Gonorrhea?
With the current drive to vaccinate people against COVID, some patients mistakenly assume that the injection they receive for the treatment of Gonorrhea gives them immunity against the bacteria.
This is not true.
The injection given for Gonorrhea is an Antibiotic and NOT a vaccine against the illness, this injection also only works for the single episode of Gonorrhea. Should you get infected again, it is important to get another dose of Antibiotics.
In summary
Gonorrhea is a common STD in society and can have widespread complications. Early detection and treatment can help prevent these complications and improve your overall health.
Have a question? Feel free to put it in the comments section below.
Or visit us at our Men’s Health Clinic.
Have a question but need more privacy? Contact us on our Telegram channel. You can also follow us to get the latest news on STDs/HIV and Men’s Health.
Men’s Health – https://t.me/joinchat/uj8HDPzLtpk3NTA1
STD/ HIV Channel – https://t.me/joinchat/83vmPfDJa205ZTc1