Sex and Relationships: Sexually at risk for gonorrhoea

Heather Little-White, PhD, Contributor

FACT: anyone who is sexually active can get gonorrhoea. This causes concern for sexually active persons who may have unusual symptoms as is the case with Outlook reader Dorethwho has a discharge and is very worried that she may have gonorrhoea.

As a sexually transmitted infection (STI), gonorrhoea is caused by a bacterium, Neisseria gonorrhoea, which thrives in warm, moist areas of the reproductive tract, in places like the opening to the womb (the cervix), the womb (uterus), and the Fallopian tubes in women and in the urethra in women and men. Other moist areas in which the bacterium can grow include the eyes, mouth, throat and anus.

Highly infectious

Gonorrhoea is highly infectious and you could contract the disease through sexual intimacy with the penis, vagina, mouth and anus. Contrary to what is commonly believed, ejaculation does not have to take place for gonorrhoea to be transmitted or acquired. Gonorrhoea can also be spread from mother to baby during delivery.

The rates of infection are higher among sexually active teenagers and young adults in the 15-29 age group. Unprotected sex with multiple partners is also risky. You could be infected and not know it because you do not have any symptoms in the early stages. However, symptoms will eventually appear and will vary in men and women depending on the parts of the body infected.

Symptoms in men

Some men may experience symptoms two to five days on being infected while others may not experience any symptoms of gonorrhoea up to 30 days. Common symptoms and signs include:

A burning sensation during when urinating.

A white, yellow, or green discharge from the penis.

Swollen and painful testicles at times.

Symptoms in women

According to the Centers for Disease Control and Prevention (CDC), women may experience mild or no symptoms. Women may mistake symptoms of gonorrhoea for infections of the bladder or vagina. Initial symptoms in women include:

A painful or burning sensation when urinating.

Increased vaginal discharge.

Vaginal bleeding between periods.

Serious complications from the infection, regardless of the presence or severity of symptoms.

Infections in the throat may cause a sore throat, but usually there are no symptoms.

Anal infection

When the anus is infected, there may be no symptoms. Symptoms in men and women, if infected, may include:

Discharge

Anal itching

Soreness

Bleeding

Painful bowel movements.

Ectopic pregnancy

Early treatment of gonorrhoea can prevent serious and permanent health problems in both women and men. Women may experience pelvic inflammatory disease (PID) as a result of gonorrhoea. PID may cause mild or severe symptoms, including abdominal pain and fever. Gonorrhoea may also cause abscesses to develop in the Fallopian tubes causing long-lasting, chronic pelvic pain. Subsequently, the tubes are damaged to the extent that they cause infertility or may increase the risk of ectopic pregnancy - a condition which may be fatal when the fertilised egg grows in the Fallopian tube outside the uterus. This disease can limit a woman's ability to have children if left untreated.

Painful testicles

Men may experience painful condition of the ducts attached to the testicles in a condition called epididymitis. If untreated, it leads to infertility in men.

Another life-threatening condition is gonorrhoea spreading to the blood or joints. In addition, people with gonorrhoea can more easily contract HIV, the virus that causes AIDS. HIV-infected people with gonorrhoea can transmit HIV more easily to someone else than if they did not have gonorrhoea (CDC).

Mother and child

If a pregnant woman has gonorrhoea, she may pass the infection to her baby when the baby passes through the birth canal during delivery. The baby may become blind; develop joint infection or a life-threatening blood infection. If the gonorrhoea infection is treated soon after the disease is contracted, women will reduce the risk of these complications. It is important for the pregnant women to visit a clinic or a doctor for regular examination, testing and treatment.

Testing

How do you know that you have contracted gonorrhoea disease? Through several laboratory tests, gonorrhoea can be detected. In a simple laboratory test, a sample from an infected part of the body is tested. A Gram stain test can be done quickly in the clinic or a doctor's office. A sample from a urethra or a cervix is examined under a microscope to see the gonorrhoea bacterium. This test works better for men than for women.

Treatment

Gonorrhoea can be cured by several antibiotics, although the treatment of gonorrhoea is becoming more difficult due to increasing drug-resistant strains of gonorrhoea around the world. It is possible that gonorrhoea may be accompanied by chlamydia and other STIs which can also be treated with antibiotics. Testing for gonorrhoea should also include tests for other STIs.

A dose of medication to cure gonorrhoea should be taken in its entirety. Medications stop the infection but will not repair any permanent damage done by the disease. After treating one round of gonorrhoea does not mean that persons cannot be infected again if they engage in sexual intercourse without a condom. If there is no improvement in the symptoms after treatment, the infected person should return to the doctor for additional tests.

Prevention better than cure

The safest way to avoid contracting gonorrhoea and other STIs is to abstain from sexual intercourse. It is best to use a condom if you have to be sexually active and you are not in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. Latex condoms when used correctly and every time you engage in sexual intercourse should reduce your risk of contracting gonorrhoea and other STIs.

Gonorrhoea is transmitted very efficiently as a woman runs a 60 to 90 per cent chance of contacting the infection from just one sexual encounter with an infected male (Norris 2006). It is also easily spread just by contact with the fluids of an infected person, not just sexual contact.

Reinfection

If you experience any of the early symptoms like a genital discharge or burning during urination, it is advisable to stop having sex and go to the doctor or clinic immediately. If you have been diagnosed and treated for gonorrhoea, you should notify all recent sex partners so they can get tested reducing the risk of re-infection and your partners developing complications from gonorrhoea. Once infected, you should not engage in sexual intercourse until treatment is completed.

Historically, gonorrhoea was, commonly referred to as the clap derived from les clapiers meaning rabbit hutches, the slang name for brothels in Paris during the Middle Ages. Whatever slang name gonorrhea gets today, it is still a dangerous sexually transmitted infection one would not want to get.

name changed for privacy

Send feedback/questions to:heatherl@cwjamaica.com.