Gonorrhea is an infection caused by a sexually transmitted bacterium called Neisseria gonorrhoeae. The bacterium can be transmitted through sexual contact and oral sex. It can also be passed from mother to child during birth.

The CDC reports that more than 2 million cases of gonorrhea were reported in the US in 2015.

“We expect gonorrhea will continue to increase,” said Dr. Gail Bolan, director of the CDC’s Division of STD Prevention.

Gonorrhea has increased nearly fivefold since 1995. It is now the second most common bacterial sexually transmitted infection in the US, according to the CDC.

CDC officials said they do not know why gonorrhea is on the rise and what factors may be driving it. Possible factors include increased testing and better detection of the disease, said Bolan.

“We don’t have any more tools than we had 20 years ago to correct the problem,” she said.

But “more and more of the cases are showing up in labs that are testing for STD, so more cases are being found,” she said.

Yet a person can be infected with gonorrhea and not know it, she added.

Overview

There are several risky behaviors that put people at risk for infection, including not using condoms or other birth control methods, using anonymous and unchaste sex, and having multiple sexual partners, among other things.

“No matter how safe you are, you are still putting yourself at risk for gonorrhea,” said Bolan.

In many cases, gonorrhea infection causes no symptoms, so the disease is highly contagious.

As gonorrhea is often asymptomatic, people may unknowingly transmit it to partners who do not show any signs of infection.

Gonorrhea Symptoms

Symptoms typically develop between two weeks and six weeks after exposure. Symptoms include:

  • inflammation of the epididymis, which is the organ in males that houses the testicles
  • burning sensation when urinating
  • swollen glands
  • burning, itching, or swelling in the testicles
  • swollen, red or painful breasts
  • yellow or white, cottage cheese-shaped vaginal discharge
  • yellow, stringy discharge from the vagina
  • burning when urinating
  • redness of the eyes
  • yellowing of the skin and/or lips
  • stomach ache
  • fever
  • chills
  • rapid heartbeat
  • slurred speech

While the CDC notes that gonorrhea is curable with antibiotics, most infections go untreated.

Early detection and treatment is the best way to prevent future infections and complications.

Key complications

Complications may include:

  • erectile dysfunction
  • a reduced libido
  • chronic pelvic pain
  • less frequent or no periods
  • pelvic inflammatory disease, which may include bacterial vaginosis
  • kidney inflammation
  • chronic pelvic pain due to infection
  • not getting pregnant
  • any pregnancy complications

Other Complications

Treating any STD as soon as possible can help prevent complications.

The CDC state that any STD, regardless of the stage, can affect fertility in men or women. Treating gonorrhea and other STDs as soon as possible can help prevent the potential side effects of untreated STDs.

All STDs can lead to some or all of the following complications:

  • an abnormal Pap smear
  • pelvic inflammatory disease, including bacterial vaginosis
  • a shortened duration of regular periods, or an increased chance of getting pregnant
  • male infertility
  • diabetes
  • stage 4 endometriosis
  • endometrial and ovarian cancers
  • Pregnancy complications

Vaginal discharge from the infection can cause cervical infections and cause an elevated risk of preterm delivery. Vaginal discharge may also cause a person to develop a yeast infection.

Complications may also occur during pregnancy if a woman has the infection. More information is available on the United States Department of Health and Human Services (HHS) website.

Heart problems

People can experience heart complications from untreated STDs, particularly if an infection is left untreated for a long time.

The impact of untreated STDs varies from person to person. For instance, the CDC note that untreated gonorrhea can lead to penile or rectal pain or itching, which may lead to difficulty or pain during sex.

Early detection

The CDC recommend that anyone who suspects that they have a sexually transmitted infection consult their doctor for treatment. Anyone with questions about STDs should talk to a health care professional.

Anyone who has concerns about STDs can also contact their local sexual health clinic or the CDC Sexual Health Information Line.

Outlook

Untreated gonorrhea can cause damage to the body and can put a person at risk of complications. Therefore, it is crucial to be treated as soon as possible.

Several years ago, doctors found that treatment with the recommended single-drug, single-dose oral antibiotic reduced the risk of developing complications and decreased the duration of antibiotic use.

With proper treatment, the risk of side effects and of developing complications decreases. For some individuals, the risk is already low.

Gonorrhea can also affect these parts of the body, so it’s important to consult with your doctor for specific suggestions on what to do if that happens:

  • The genitals (genitals or perineum)
  • The abdomen
  • The shoulders
  • The back

Risks

To reduce your gonorrhea risk, experts recommend using a condom for sex without a condom or barrier method for oral sex with new or casual partners, as well as staying well below the 175 threshold for infection that’s considered a moderate risk.

Symptoms of gonorrhea often don’t appear, meaning you could unknowingly carry the infection and spread it to another person. In fact, according to the CDC, many people do not realize they’re infected with gonorrhea because the symptoms are similar to those of the common cold. Symptoms include a white or yellow discharge from the genitals that lasts longer than seven days. Your mouth or throat may also become sore, red, or swollen. Sometimes, a swollen, painful lump or swelling may occur in your testicles or in your abdomen.

Unlike the common cold or flu, symptoms of gonorrhea don’t tend to get better on their own. According to Mayo Clinic, symptoms can include a burning sensation when urinating, a feeling of fullness in your belly, and an increased urge to urinate. Other symptoms may include yellow or white patches on the throat or back of the throat, a sore or pain when urinating, and back pain. Gonorrhea can also cause a chronic, burning pain in your pelvis. The infection can also cause ulcers, if left untreated.

The “gold standard” of treatment

According to the CDC, the best way to prevent gonorrhea is by using condoms and abstaining from sex with new or casual partners. “There’s no vaccine, so your only protection is using condoms or abstaining from sex,” says the CDC. “Be smart and practice safer sex.”

condoms

Signs and symptoms of an STD usually appear when it’s passed from a pregnant woman to her baby. However, women can also contract gonorrhea when they’re having sex with men or when they have sex with someone who already has the infection.

How to avoid it

Most people are not aware of how many different STD infections are out there, as some are not immediately noticeable like chlamydia, which is most commonly reported, and may not have symptoms. It’s important for women to know they can contract an STD during pregnancy, as it may pass to the fetus. Pregnant women may also contract STD through breastfeeding and during sex with an infected partner.

If you don’t have symptoms, though, it can be difficult to determine if you have an STD, says MedlinePlus.

Conclusion

In the past, doctors recommended testing for gonorrhea and chlamydia if a woman who is pregnant or already has children has sexual contact with a new partner. The CDC no longer recommends these tests for pregnant women, but doctors still recommend testing any time there has been sexual contact with a new partner or someone you’ve had sex with in the past. It’s important to take these tests as soon as possible, as most infections can only be treated if treated within two weeks of the time you are infected.

References

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Sexual Health,

Last Update: October 1, 2020