Sexually transmitted diseases: gonorrhea

By Cristiano Antonino On May 9, 2023

When we hear about STDs, gonorrhea is one of the most mentioned and well known

Caused by a bacterium (Neisseria gonorrhoeae), gonorrhea is an infection that causes various discomforts to those who find themselves suffering from it.

Unprotected sexual intercourse with already infected subjects causes its transmission, which does not always manifest itself with recognizable symptoms.

This makes it difficult to diagnose.

Let’s see specifically what the symptoms of gonorrhea are and when it is appropriate to contact your doctor.

Symptoms of gonorrhea

Starting from the assumption that gonorrhea is a bacterial infection which, if not treated properly, risks causing serious consequences on health, we must highlight a fact: it is often asymptomatic.

In the case of unprotected sex of any kind (anal, oral or vaginal) with a partner whose medical history we do not know, it is good to consider getting tested.

Although it can be asymptomatic, especially in women, here are some symptoms that can make you turn on an alarm bell:

Severe burning sensation while urinating;
Increased and abnormal vaginal secretions;
Anal itching;
anal bleeding;
Severe stomach aches;
testicular swelling;

Abnormal bleeding outside the menstrual cycle.

Other lesser known symptoms

In addition to the most common ones mentioned above, gonorrhea can result in a disseminated gonococcal infection, which has quite specific symptoms such as:

skin rashes;
muscle weakness and pain;
tendon inflammation;
articolar pains;
endocarditis;
meningitis.

Why diagnosis is important

The symptoms described above are not only typical of gonorrhea and, for this reason, noticing the infection can be difficult.

A complete list of symptoms and your suspicions should be reported to your doctor: always be honest about the possibility of having had unprotected sex, as untreated gonorrhea can have serious consequences such as infertility and miscarriages in women and infertility resulting from inflammation in men.

How is gonorrhea diagnosed?

If suspected, the doctor will have to prescribe laboratory tests with specific swabs taken from the infected area.

The areas in which to carry out the swab to be taken to the laboratory for analysis are the cervix, rectum, urethra and pharynx.

Gonorrhea in man

This sexually transmitted disease is much more difficult to detect in women, in light of the symptoms we have described above and which can often be associated with ovulation or other types of vaginal infections.

In humans, the diagnosis is simpler since the symptoms are more evident and characteristic.

In fact, gonorrhea is also known by the term “drain” and is manifested by secretions that come out of the penile urethra.

These can be liquid or mucous, sometimes associated with pus leakage, and involve burning and redness.

It is not uncommon for men with gonorrhea to complain of severe pain when urinating or even difficulty urinating properly.

When the first symptoms appear

Although, as already mentioned, gonorrhea can be asymptomatic, it is good to know that the first symptoms of this infectious disease can occur up to 7 days after infection.

This venereal disease is contracted only by unprotected sexual contact of any kind, by direct transmission.

Women can incubate the bacteria responsible for gonorrhea for up to a month.

Infection by direct transmission

Is penetration necessary to get gonorrhea? No!

In fact, an exchange of fluids is sufficient, which can also take place during oral intercourse or through the exchange of sex toys or infected underwear on which secretions are present.

Infection by indirect transmission

In the latter case we speak of indirect transmission, the disease is contracted by means of infected material such as towels, linens, sheets.

However, it is rare that gonorrhea is transmitted indirectly: gonococcus, in fact, does not resist much to the external environment, since in order to proliferate it needs a warm and humid environment – just like that of the vagina, rectum and urethra.

Complications of the disease

We have illustrated how gonorrhea can lead to serious consequences, both in men and women.

The latter, in addition to infertility and the increase in the frequency of spontaneous abortions, risks experiencing peritonitis or the infection becoming chronic, causing pelvic inflammatory disease.

In men, the greatest risk is to develop epididymitis, which is a painful inflammation that can lead to infertility.

Conjunctivitis and gonorrhea: the link

More rare, but widely documented, is the correlation between conjunctivitis and gonorrhea.

Their association is especially increased in newborns, who can be infected from the infected mother during the passage through the birth canal.

Gonorrhea in newborns

If a pregnant woman with gonorrhea gives birth naturally, she is likely to pass the disease on to her baby.

The manifestation of the pathology is frequently ocular: the passage of the newborn in the birth canal and the contact with the infected walls can lead the newborn to develop a very serious conjunctivitis, which can lead to blindness.

Gonorrhea and throat

Gonorrhea does not only affect the sexual organs and rectum.

Following oral intercourse, gonorrhea can also affect the throat.

Here are some symptoms:

severe pain in the throat;
redness;
inflammation (stomatitis);
sore and enlarged tonsils.

In this case we speak of oral gonorrhea which can also cause an annoying pharyngitis.

Those at risk

The immunosuppressed, all the more reason, should pay particular attention to their own protection during any sexual intercourse with non-continuous partners.

In general, in fact, the subjects most at risk are precisely the people who have sex with many different partners.

What to do if you test positive

Following the diagnostic tests, if the result is positive, it is advisable to warn all the partners with whom you have had unprotected sex.

This will allow them to undergo tests and laboratory analyses, remembering that in 50% of cases gonorrhea remains asymptomatic.

The absence of symptoms does not preclude the possibility of developing long-term consequences (sterility, infertility, spontaneous abortions, internal inflammation).

How to cure gonorrhea

Once the diagnosis is confirmed, gonorrhea is treated with a course of antibiotics.

Due to its bacterial nature, in fact, it is only through one or more cycles of antibiotics that it is possible to eradicate the infection.

Gonorrhea is often resistant to treatment, as it develops new strains that can have an unpredictable response.

To choose the most effective drug, the attending physician will base himself on the antibiogram, which must also be studied according to the patient’s medical history.

In pregnant women, for example, some drugs are unusable.

The most common drugs to combat gonorrhea

The best antibiotic therapies to fight and contrast the gonorrhea infection can be chosen, as mentioned, only following the susceptibility test.

The classic scheme of therapy is represented by a single dose of cephalosporin (ceftriaxone) intramuscularly, associated with azithromycin by mouth (combined therapy).

Alternatively, the following drugs may also be considered:

Macrolides
Cefixime
Tetracyclines
Doxycycline
Spectinomycin

Beyond the meds

At the same time as antibiotic therapy, the patient must absolutely abstain from sexual intercourse until the infection has resolved.

Furthermore, those who have had unprotected sex should necessarily inform their partners so that they too can undergo the tests and, possibly, the necessary therapies.

Can it heal spontaneously?

This bacterial infection cannot heal on its own.

Although you may be asymptomatic or show an apparent regression of symptoms, gonorrhea has strains that, remaining latent, can infect your future partners and lead to the development of long-term consequences.