Gonorrhea is a sexually-transmitted disease caused by the bacteria Neisseria gonorrhoeae.  Symptoms are painful urination, discharge from the urethra, and pain in the mid-lower abdomen.  Complications of untreated gonorrhea are especially serious in females, including: serious infection or infertility.

What causes gonorrhea?

Gonorrhea is caused by the bacteria Neisseria gonorrhoeae.  The bacteria is spread from person-to-person through intimate contact.  Rarely gonorrhea may be spread by contact with contaminated surfaces or casual contact with an infected person.  Infected mothers may spread the bacteria to a newborn infant at birth.

What is gonorrhea infection and how common is it?

Infection with Neisseria gonorrhea occurs primarily in the genital tract of males and females.  On occassion, infection may occur in the throat and rectum.  Gonorrhea is considered a sexually-transmitted disease (STD) because it is primarily spread from person-to-person via sexual contact.  Infants born to infected mothers may develop a severe eye infection that can lead to blindness.  This risk is reduced by giving all infants antibiotic eye medicines routinely.

358,366 cases of gonorrhea were reported to the Centers for Disease Control in 2006.  It is the second most common STD in the United States, second only to chlamydia.

Gonorrhea infection typically occurs 2 to 10 days after contact with an infected person.  However, symptoms may not be noticeable for several weeks.

What are the symptoms of gonorrhea?

In males:

• Painful urination
• A white discharge from the end of the penis
• And sometimes (in more serious infections)... abdominal pain, testicle pain, swelling of the penis, urgency to urinate, or urine leakage.

In females:

• Painful urination
• A white discharge from the urethra and/or vagina
• Swelling, redness, and pain of the vulva (the outside parts of the genitalia)
• And sometimes (in more serious infections)... abdominal pain, vaginal bleeding between menstrual cycles, fever, a general ill feeling.

In newborn infants:

• Redness, swelling and discharge from the eye

Should I see a doctor?

Yes.  If you have any of the above symptoms or are concerned about the possibility of an STD, you should see your doctor.  Doctors are required to protect your privacy, therefore in most cases they are not allowed to tell your parents without your permission.  If doctors suspect abuse, they may be required to notify authorities.

What are the possible complications of untreated gonorrhea?

Females are especially susceptible to complications.  Infection may spread to the uterus, fallopian tubes and ovaries (i.e., pelvic inflammatory disease).  Scarring of the fallopian tubes may cause permanent damage and infertility.  Severe infection may also spread to the inside of the abdomen (i.e., peri-hepatitis or Fitz-Hugh-Curtis).

Both males and females may develop a systemic infection (about 1-3% of cases).  This occurs when the bacteria is spread throughout the body by the bloodstream.  This type of infection can cause joint pain, skin rashes, and more serious infections of the bones or nervous system.

How is gonorrhea diagnosed?

In males, a small cotton swab is inserted into the urethra about 2-3 centimeters.  The swab is sent to a laboratory for evaluation. 

In females, a pelvic exam is necessary.  A cotton swab can be used to sample fluid from the cervix. 

In infants, a cotton swab is used to sample discharge from the eye.

Bacteria culture tests may take a few days, but are likely to provide the most accurate results.  Rapid tests are available in some laboratories, with results in a few minutes or hours.

Occassionaly, if symptoms suggest infection in the throat or rectum, a cotton swab may be used to sample these areas also.

All people with suspected gonorrhea infection should be tested for chlamydia also, since symptoms are often the same.

How is gonorrhea treated?

Uncomplicated infections typically respond well to an antibiotic given as a single shot (i.e., Rocephin or ceftriaxone).  Oral antibiotics may be used in some cases.

How can gonorrhea be prevented?

• Sexual partners of infected individuals should be checked for infection, even if they have no symptoms.
• Barrier contraceptives, such as condoms, are helpful in preventing spread of gonorrhea (but not perfect).
• Appropriate education should be given to all children as they enter the teenage years.
• All newborn infants (whether or not infection is suspected) should be given antibiotic eye medicine shortly after birth.