By Dr Ananya Mandal, MD
Gonorrhoea is a sexually transmitted infection (STI) that is caused by bacteria Neisseria gonorrhoeae, also known as gonococcus. Gonorrhoea has been referred to as the “clap” in history.
Who gets gonorrhea?
All sexually active persons are susceptible to gonorrhoea. Those who have multiple sexual partners and do not use barrier contraceptives like condoms are particularly at risk.
Incidence of gonorrhea
Gonorrhoea is the second most common bacterial STI. It ranks after chlamydia in incidence. The incidence of gonorrhoea in the UK has fallen over the period of a decade.
However, over 17,000 new cases of gonorrhoea were reported in 2009. It most commonly affects men aged between 20 to 24 and women aged between 16 and 19. Nearly 50% of the new gonorrhoea cases occur in under 25 year-olds. Higher rates are found in men who have sex with men and certain ethnic groups.
Risk factors for gonorrhea
Some of the risk factors for gonorrhea include:
young age (less than 25 years)
previous history of STI
presence of other STIs and HIV infection
those with new or multiple sexual partners
recent unprotected sexual intercourse with new or unknown partners
unprotected anal intercourse
frequent insertive oral sex
history of commercial sexual activity and drug use
Transmission of gonococcus
Gonococcus is present in the discharge from the penis and vaginal fluid of the infected men and women. It can be passed from person to person by having unprotected vaginal, oral or anal sex.
It can also be transmitted by sharing sex toys and vibrators with an infected individual without washing or covering them with a condom at each use. Gonococcus can be transmitted from a pregnant woman to her baby.
Symptoms of gonorrhea
Around 50% of women and 10% of men may show no symptoms of the infection. The incubation period is usually taken as being between 2 and 5 days but may be up to 10 days. Incubation period is the time taken from exposure to the infection and appearance of the symptoms. There is usually a discharge from the vagina or penis accompanied by pain during urination, bleeding between periods in women etc.
Detection and diagnosis of gonorrhea
If a person has any of the symptoms of an STI or has a history of unprotected sexual intercourse or other risky behaviors with an infected partner, they need to get tested for gonorrhoea. Detection may be made on regular visits at the local sexual health or genitourinary medicine (GUM) clinic for a sexual health test. Gonorrhoea can be easily diagnosed through a simple swab test or men may be asked to provide a urine sample.
Treatment and complications of gonorrhea
Gonorrhoea is treatable with antibiotics. Treatment should begin as early as possible. If left untreated, gonorrhoea can lead to more serious long-term health problems. Some of the long term problems associated with untreated gonorrhoea include infertility and pelvic inflammatory disease. In men, if left untreated complications like inflammation of the epididymis (epididymitis); prostate gland (prostatitis) and urethral structure (urethritis) may occur.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)