All About Gonorrhea

Sexually Transmitted Disease or Infection (STD or STI) evokes feelings of anxiety and fear at the very mention of the word. Despite that fear, STIs are still very common and poorly understood by many people, even those engaging in risky sexual activities that predispose them to acquire a form of the disease.all about male and female gonorrhea All About Gonorrhea

Worldwide, more than a million are infected with STIs daily. Although there are over 20 other STIs, the most widely known are Syphilis, Trichomoniasis, Gonorrhea and HIV/AIDS. In this article, information on Gonorrhea will be given focus.

What is Gonorrhea? 

Records on Gonorrhea date back as far as the 1300s. Caused by bacteria, Neisseria Gonorrhea that grow on warm moist areas of the body, the disease is typically passed on via direct contact between infectious mucous membranes of the mouth, eyes, genitals and anus. Even the fingers can transfer the bacteria from an infected mucous membrane to another.

Following transfer of the organism from an infected person, the incubation period is from 2 – 10 days. Males typically experience burning sensation on urination and pus discharges from the urethra, though approximately 10% do not manifest symptoms. For the females, pain in the lower abdomen and on urination and vaginal discharges are the common symptoms. However, more than half of the infected females are actually asymptomatic. If the throat is infected, the symptoms are redness, soreness and difficulty swallowing.

                                Table of Symptoms

                             (and possible complications)

Male

(more likely to be symptomatic)

      • Pain on urination
      • Creamy yellow or bloody discharge

Complications:

  • Chronic infection can affect the prostate, epididymis and periurethral glands
  • Sterility
  • Arthritis
  • Heart and Kidney Disease
Female
      • Genital and urinary discharge
      • Pain during intercourse or dyspareunia
      • Pelvic pain or tenderness
      • Vaginal bleeding
      • Fever
      • Proctitis

Complications:

  • Infection of the fallopian tube or Salpingitis
  • Ectopic Pregnancy
  • Scarring of the uterus
  • Sterility
  • Pelvic inflammatory disease (PID)
  • Arthritis
  • Heart and Kidney Disease
Newborn Transmission of STIs from mother to child could lead to: 

  • Low birth weight
  • Prematurity
  • Sepsis
  • Pneumonia
  • Congenital Deformities
  • Neonatal Conjunctivitis
  • Stillbirth

We do not only fear Gonorrhea for its effect on the sexually active teens and adults. But we also fear it for its possible effect on a baby born to an infected mother. The table above shows the possible complications a newborn can get from his infected mother.

Diagnosis of Gonorrhea

Diagnosis of gonorrhea is done by taking patient sexual history, reading the symptoms manifested (if any) and by identifying the bacteria through gram stain for symptomatic men and culture for asymptomatic men and women. The specimen used for gram stain is taken from the following sites: urethra, anal canal, endocervix and oropharynx. Other diagnostic tests include: Gonozyme or Enzyme Immunoassay for detecting Gonococcal Antigens and Nucleic acid probe-based assay.

Prevention and Treatment of Gonorrhea

Gonorrhea is treated with antibiotics. Currently, the first line of treatment is an injectable cephalosporin in combination with another oral antibiotic such as azithromycin or doxycycline. Before 2007, the recommended antibiotic of choice by the US Center for Disease Control was ciprofloxacin. But resistance to the drug has prompted CDC to change its recommendation since then.

Preventive measures for Gonorrhea and STIs in general begin with counselling on safer sex practices especially to vulnerable populations as sex workers, adolescents and people who use injectable forms of drugs.

Neisseria Gonorrhea today.

Gonorrhea today is a serious global health problem. In fact, the recent scare comes from the possibility that the 2nd most common STI in the world could soon become incurable due to the high incidence of antibiotic resistance seen in modern strains of N. Gonorrhea. In 2008, 128 million cases of STIs have arisen in the Westerm Pacific Region where the Philippines belong.

Take note. If you say YES to all or some of the questions below, you might want to make an appointment with your doctor. However, remember that gonorrhea can be asymptomatic, so one can never be too sure even with the absence of the common symptoms. Put to mind that prevention is always better than cure.

1. Do you have multiple sexual partners?
2. Do you have any of the symptoms stated above?

a. Pain during and after sex?
b. Unusual discharges?
c. Lower abdominal pain?
d. Skin rash?
e. Sore throat from oral contact?
f. Irritation in your anal area?

References: 

  1. Pathophysiology: Concepts of Altered Health States. Porth, C.M. 6th Edition. 2002. Lippincott Williams & Wilkins
  2. Community Health Nursing Services in the Philippines. Department of Health Philippines. 2000.­
  3. The Women’s Complete Wellness Book. The American Medical Women’s Association. First St. Martin’s Griffin Edition. Golden Books Publishing Co., Inc. United States of America. March 2000.
  4. http://www.who.int/mediacentre/factsheets/
  5. http://www.niaid.nih.gov/topics/gonorrhea/ 
  6. http://www.theverge.com/2014/3/12/5500246/gonorrhea
  7. http://www.familyplanningquincy.org/std-clinic/std-symptom-checklist/

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