Gonorrhea

What Is It?

Gonorrhea is a sexually transmitted disease (STD) that is caused by bacteria called Neisseria gonorrhoeae. These bacteria can be passed from person to person during sexual activity (vaginal, oral, and anal intercourse) leading to infections of the cervix, vagina, and urethra. If untreated, these "lower" gonorrhea infections can spread to higher portions of the reproductive tract, causing prostatitis (prostate inflammation) and epididymo-orchitis (inflammation of the epididymis and testes) in men, and pelvic inflammatory disease (PID) in women.

Gonorrhea also can cause gonococcal proctitis (inflammation of the anus and rectum), especially in those who practice anal intercourse. In those who practice oral sex, it may infect the throat, causing gonococcal pharyngitis.

Less commonly, gonorrhea can spread to other parts of the body through the bloodstream, causing fever, a characteristic rash and arthritis. In pregnant women with untreated gonorrhea, bacteria may spread to the eyes of their babies during childbirth, causing gonococcal ophthalmia, a severe eye infection in newborns.

Approximately 600,000 Americans are diagnosed with gonorrhea annually, but because many people with gonorrhea do not seek treatment, the total number of cases may be much higher.

Symptoms

Many people who are infected with gonorrhea (women more commonly than men) will develop no symptoms at all. When it does cause symptoms, they usually develop within 10 days after sexual intercourse with an infected person. Men may develop a discharge from the urethra (the opening at the end of the penis where urine comes out), redness around the urethra, frequent urination, and pain or a "burning" discomfort during urination. Women may develop pain or discomfort on urination, frequent urination, a vaginal discharge, and discomfort in the anal or rectal area. In at least 15 percent of women, the bacteria will spread to the uterus and fallopian tubes, causing pain with intercourse, abdominal pain, abnormal menstrual bleeding and fever. In cases of gonococcal pharyngitis, there may be either no symptoms or a simple sore throat.

Many patients with gonococcal proctitis have no symptoms. When symptoms are present they commonly include rectal pain or itching, a rectal discharge that contains blood, mucus, pus or tenesmus (a persistent urge to move the bowels). If gonorrhea spreads through the bloodstream, it may cause fever, pain and swelling in several joints, and a characteristic rash.

In newborns infected with gonococcal ophthalmia, symptoms appear one to four days after birth and can affect one or both eyes. Symptoms include redness of the eyes, swelling of the eyelids, and an eye discharge that is thick and contains pus. If untreated, gonococcal ophthalmia can cause blindness.