Gonorrhoea

Posted by Dr Elaine Loh on May 16, 2014 in STD | 16 comments

Gonorrhoea is a common sexually transmitted disease (STD) caused by the bacteria Neisseria gonorrhoea, also known as ‘the clap’.

It is frequently transmitted via vaginal, oral or anal sex and can infect the cervix, urethra, rectum and, less commonly, the throat or eyes.

In women, up to 90% of gonorrhoea infection affects the cervix.

It can also be transmitted from a pregnant woman to her baby during childbirth.

Risk factors:

Multiple sexual partners

New partner

Unprotected sex

Homosexuality

Sexual partner who has a STD

Having another current STD

Symptoms:

In both men and women, gonorrhoea infection can remain asymptomatic.

If you do get symptoms, they can show up from a few days to many months after exposure.

In women:

Abnormal vaginal discharge – thin, purulent, yellow or green

Mild odour

Pain passing urine

Pain during sex

Lower abdominal pain

Abnormal vaginal bleeding (in between period or after sex) – rare

In men:

Penile discharge – white, yellow, green and occasionally blood tinged

Pain passing urine

Pain in the testicles – rare

In both men and women:

In the rectum – usually no symptoms, but may cause discharge, itch or pain.

In the throat – usually no symptoms

In the eyes – can present with pain, swelling, irritation or discharge (conjunctivitis)

Treatment:

Gonorrhoea can be treated with antibiotics and the 1^st line antiobitic use is rocephine (ceftriaxone). However, gonorrhoea is becoming more difficult to treat due to drug resistant strains. Commonly, individuals with gonorrhoea can also have other STD such as chlamydia; hence antibiotics are usually given to treat both gonorrhoea and chlamydia.

As for most STD, treatment of an individual infected with gonorrhoea also involves treating their sexual partner. After treatment of gonorrhoea, it is recommended to get tested again to ensure clearance of gonorrhoea (increasing incidence of drug resistance), relapse or re-infection.

It is recommended to refrain from having sex until both you and your sex partner have completed treatment or as advised by your doctor.

Complications:

1% of individuals with untreated gonorrhoea can go on to develop widespread gonorrhoea infection resulting in skin pustules, infection of the joints (fingers, wrists, toes, ankles, knees) , brain or heart valves.

In men, untreated gonorrhoea can give rise to inflammation of the epididymis (the tube that carries the sperm), prostate and urethra. Rarely this can cause subfertility.

In women, pelvic inflammatory disease (PID) is generally the most feared complication of gonorrhoea, with up to 20% of women with gonorrhoea having retrograde spread of infection from the cervix towards the uterus, fallopian tubes, ovaries etc leading to PID. Chronic complications of PID, such as fallopian tubal factor subfertility, ectopic pregnancy (pregnancy outside the uterus), and chronic pain, may occur in up to 25% of affected patients.

Other rare complications include septic abortion, chorioamnionitis (infection of amniotic fluid) during pregnancy, infant or adult blindness from eye infection.

Individuals with gonorrhoea are more susceptible to HIV and also increase risk of co-infection with other STDs, especially chlamydia.

Correct used of latex condoms can reduce the risk of contracting or spreading gonorrhoea.

If you think you are at risk of contracting gonorrhoea, it would be advisable to get tested as it is a simple test (in men – urine test, in women – vaginal swab test) and to get treated early.

To find out more about gonorrhoea or other STDs, please visit your doctor or visit Our Clinics.

All Our Doctors are Fully Certified and Trained to conduct specialised STD and HIV Testing.

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