Gonorrhoea: Symptoms, Treatment and Prevention

What is gonorrhoea and how is it transmitted? Read on to find out more about one of the most common sexually transmitted infections.

One of the most common sexually transmitted infections (STIs), gonorrhoea is an infectious disease caused by a bacterium that thrives in warm and moist areas like the genital tract, mouth and anus. Although curable with antibiotics, the infection can cause lifelong problems if left untreated.

Here are some important facts that you should know about gonorrhoea, from its causes and symptoms to treatment and prevention tips.

Gonorrhoea Causes and Risk Factors

Gonorrhoea is a sexually transmitted infection caused by Neisseria gonorrhoeae, a bacterium that tends to grow and multiply in warm and moist areas of a woman’s reproductive tract, mainly in the cervix, womb and fallopian tubes, and in the urethra of both men and women. The bacterium can also infect a person’s mouth, throat, eyes and anus.
Gonorrhoea spreads from person to person through unprotected sexual contact, whether through vaginal, oral or anal sex with an infected partner. Individuals with multiple sexual partners and those who do not use a condom during sexual intercourse are at higher risk of the infection.
An infected mother can also transmit the infection to her newborn baby during delivery.

Gonorrhoea Symptoms and Signs

Symptoms associated with gonorrhoea usually occur within two to 14 days after a person has been infected.
In men, symptoms of gonorrhoea typically begin to show a week after the person has been infected. Some common ones include:
  • A burning sensation while urinating
  • Greater frequency or urgency of urination
  • A pus-like discharge from the genitals
  • Swelling of or redness in the penis and testicles 
Some men may not develop noticeable symptoms. However, the infection is still contagious and may spread from the infected person to a partner who may not be aware of the infection due to a lack of obvious signs and symptoms. 
Often, women with gonorrhoea do not develop any obvious symptoms of gonorrhoea. However, when symptoms do occur, they can cause a lot of distress. Some symptoms that women may experience include:
  • A burning sensation while urinating
  • Greater frequency or urgency of urination
  • Pain during sexual intercourse
  • Sharp pains in the lower abdomen
  • General irritation in the outer area of the vagina
  • Increased vaginal discharge and vaginal bleeding between periods
  • A fever
Rectal and throat infection may occur in both men and women infected with gonorrhoea. With rectal infection, the person may experience anal itching, discharge, bleeding or painful bowel movements.

Gonorrhoea Complications

If left untreated, gonorrhoea can cause serious complications.
Women infected with gonorrhoea may develop pelvic inflammatory disease, which can damage the fallopian tubes. When this happens, the woman may become infertile or face a higher risk of an ectopic pregnancy, in which a fertilised egg grows outside the womb.
Men infected with gonorrhoea may experience epididymitis, an inflammation of the tube located at the back of the testicles that stores sperm, which can lead to infertility.
The infection can also spread through the bloodstream and infect other parts of the body including the joints, brain and heart. Having gonorrhoea also makes you more susceptible to the human immunodeficiency virus (HIV) that can lead to Acquired Immunodeficiency Syndrome (AIDS). A person infected with both HIV and gonorrhoea can readily transmit these infections to their partners.

Gonorrhoea Screening and Diagnosis

There are several testing options for gonorrhoea. First, fluid samples are collected from infected areas of a person, such as the urethra, cervix, throat or rectum. These samples are then sent to the laboratory for testing. The doctor may conduct a gram stain, which is a quick and inexpensive laboratory test that enables him or her to identify the bacterium under a microscope. 
Culture studies may also be employed if the diagnosis from the gram staining is not clear. In such instances, doctors may grow bacteria samples collected from the infected area to better detect the presence of gonorrhoea.

Gonorrhoea Treatment Methods

Gonorrhoea can be treated with antibiotics. However, in many parts of the world, including Singapore, treating gonorrhoea is becoming more difficult because of drug-resistant strains. Some individuals with gonorrhoea may also have other sexually transmitted infections like chlamydia. When this occurs, doctors will likely prescribe antibiotics that can treat both infections.
It is important to follow your doctor’s advice and complete the course of antibiotics prescribed. If symptoms persist after you have completed the course of treatment, you should return to your doctor for a re-evaluation.
Do note that people who have had and been treated for gonorrhoea can contract the disease again if they come into sexual contact with an infected person. 

Gonorrhoea Prevention

Here are some steps you can take to reduce your risk of infection:

  • Abstain from casual sex and avoid having multiple sex partners 
  • Keep a healthy and long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected
  • Practise safer sex by using condoms correctly and regularly 
  • Inform your partner if you have been diagnosed with or treated for gonorrhoea. Avoid sexual intercourse until you and your partner have completed your treatment for gonorrhoea
  • Avoid sexual intercourse until you and your partner have completed your treatment for gonorrhoea
If you think that you may have an STI, you can go for a sexual health screening or HIV screening at polyclinics, private clinics, and hospitals.
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