Gonorrhea is one of sexually transmitted diseases (STD). The incidence of gonorrhoea has been increasing lately, especially among young people. Gonorrhea was first mentioned already five thousand years ago. It is a contagious disease caused by a bacterium called Neisseria gonorrhoeae (gonococcus). This bacterium is very demanding and dies quickly in the environment; its transmission occurs therefore only through sexual contact. The disease affects mostly genitourinary tract or rectum in homosexual men; it manifests by redness and itching. Gonorrhea can occur also as conjunctival or pharyngeal infection. Secondarily, joints, bones or cardiovascular system can be infected.
Risk Factors for Gonorrhea
One of the main risk factors is promiscuity, sexual intercourse with an unknown person, not using a condom, and prostitution.
Symptoms of Gonorrhea
Gonorrhea is caused by a bacterium called Neisseria gonorrhoeae. The bacterium during sexual intercourse infects human reproductive system and multiplies quickly in the wet environment. Gonorrhea can infect both men and women – in women cervix is usually affected, urethra in men.
Symptoms of Gonorrhea in Women
Gonorrhea in women is often symptomless. The women may not know about their infection and therefore infect their sexual partners. In case the disease has clinical symptoms, it usually begins 2-8 days after infection. Smelly vaginal discharge appears; sometimes painful urination or bleeding from the genitals may occur. Untreated gonorrhea can have serious consequences. The infection spreads quickly from the vagina to the fallopian tubes and ovaries, resulting in adhesions and obstruction of the fallopian tubes that can cause infertility. During the propagation of the inflammation, women may feel sick, abdominal pain or vomit. If a pregnant woman is infected by gonorrhea, there is a risk of premature birth or miscarriage. At delivery, the fetus is at risk of infection during passage through the birth canal of the infected mother. In newborns, the disease manifests by a purulent discharge from the eyes or swelling of the eyelids, sometimes the infection of the eyes can result in blindness. To prevent this, all children of infected women are administered disinfecting drops to prevent further spread of infection.
Symptoms of Gonorrhea in Men
In men symptoms usually occur 2-6 days after infection. Typical are symptoms of inflammation of the urethra with painful urination, burning and cutting when urinating, redness and swelling around the mouth of the urethra and also purulent discharge from the urethra. If untreated, the disease later causes also prostatitis (inflammation of the prostate) or epididymitis (inflammation of the epididymis), leading in the worst case to male infertility. Prostatitis manifests with pain during urination and also defecation, painful erections and pollutions or spontaneous ejaculation at night. Epididymitis is accompanied by painful swelling and redness of the scrotum. Up to 10% of infected men have no symptoms of gonorrhea.
Diagnosis of Gonorrhea
Gonorrhea is diagnosed – apart from clinical examination and careful patient's history – by laboratory tests. Three diagnostic methods are used – microscopic examination of vaginal smear in women and urethral smear in men (sample of the discharge is stained and observed under a microscope); PCR or ELISA test to detect DNA of the bacteria in urine of both sex; culture test (sample of the discharge is cultured for several days – if the person is infected, the bacteria grows in visible colonies).
Treatment of Gonorrhea
If you suspect you have gonorrhea, it is necessary to consult a doctor as soon as possible, preferably a gynecologist, an urologist, or a dermatovenerologist. Treatment of gonorrhea is relatively easy in early stages. Patients are administered appropriate antibiotics according to the culture test for usually 7-10 days; sexual abstinence is necessary until the disease is successfully treated. Having unprotected sexual intercourse with the knowledge of gonorrhea infection is a criminal offence in most countries. In confirmed gonorrhea infections it is also necessary to examine and treat all the patient's sexual partners. If the treatment of gonorrhea is started early, the risk for future consequences is small. As for all other sexually transmitted diseases, the best treatment is gonorrhea prevention – thus partner faithfulness and following principles of safe sex.
Complications of Gonorrhea
Untreated gonorrhea or gonorrhea that has been poorly treated, both can have significant consequences. A serious complication in both men and women is infertility. In women, the bacteria can spread into the uterus and fallopian tubes, causing so-called pelvic inflammatory disease (inflammation of the abdominal organs). As a result, adhesions and scar tissue develops, increasing the risk of pregnancy complications, premature birth, miscarriage, or infertility. In men, prostate inflammation or complicated inflammation of epididymis can cause infertility. Another possible complication is the spread of the infection throughout the body, attacking joints, bones, cardiovascular system, and other. In children infected from their mothers during childbirth, there are complications such as blindness, skin ulcers and other organ infections. Gonorrhea infection also increases susceptibility of the organism to infection with HIV.