What Is Gonorrhea?

Gonorrhea is caused by the Neisseria gonorrhoeae bacteria, which infects the mucous membranes of the reproductive tract, including the cervix, uterus, and fallopian tubes in women, and the urethra in both men and women. The bacteria can also infect the mouth, throat, eyes, and rectum.

The CDC estimates 1.6 million new gonococcal infections occurred in the U.S. in 2018. It's the second most commonly reported bacterial STD. However, many infections have no symptoms, so the true number is likely much higher.

Symptoms

Many people with gonorrhea have no symptoms at all. When symptoms do appear, they can include:

• In men: Painful urination, discharge from the penis
• In women: Increased vaginal discharge, bleeding between periods, pelvic pain
• In both: Rectal pain, discharge, or bleeding; sore throat

How is Gonorrhea Spread?

Gonorrhea spreads through sexual contact with the penis, vagina, mouth, or anus of an infected partner. It can also be passed from an infected mother to her child during childbirth.

Risks and Complications

If left untreated, gonorrhea can lead to serious complications, including:

• Pelvic inflammatory disease (PID) in women, which can cause infertility
• Epididymitis (testicular inflammation) in men, potentially leading to infertility
• Disseminated gonococcal infection, a life-threatening blood infection

Gonorrhea also increases the risk of acquiring or transmitting HIV.

Testing and Treatment

Gonorrhea can be diagnosed through laboratory testing of urine, urethral (for men), or vaginal/cervical (for women) samples. The most common test is a nucleic acid amplification test (NAAT), which can detect the presence of Neisseria gonorrhoeae bacteria. For people with rectal or oral sex exposure, there are also FDA-cleared tests for diagnosing gonorrhea in the rectum and throat. These tests involve taking a swab sample from the affected area.

Getting tested is important because many people with gonorrhea don't have any symptoms, so they may not realize they are infected. Prompt diagnosis and treatment is crucial to prevent the serious complications of untreated gonorrhea.

Gonorrhea can be cured with the right antibiotics. The CDC currently recommends a single intramuscular injection of the antibiotic ceftriaxone as the preferred treatment. In some cases, an alternative oral antibiotic regimen may be used, such as a combination of azithromycin and cefixime. This may be necessary if the gonorrhea strain is resistant to ceftriaxone.

After receiving treatment, it's important for patients to abstain from sex until the infection is cleared, usually about a week. Partners should also be tested and treated to avoid re-infection. Even after successful treatment, re-infection is common, so patients should be retested about 3 months later.

Testing and Treatment

1. CDC. "Gonorrhea - CDC Fact Sheet (Detailed Version)." https://www.cdc.gov/gonorrhea/about/index.html.