Gonorrhea

Overview: What Is Gonorrhea?

The term “Tripper” comes from the Low German word “drippen,” which means “to drip.” The origin of the word already indicates how this sexually transmitted disease often manifests itself: Gonorrhea is characterized, among other things, by discharge, which, however, can be quite inconspicuous or may not occur at all.

This sexually transmitted disease is harmless at first, but it can have far-reaching consequences if left untreated. In the worst-case scenario, it can lead to infertility. This is particularly worth considering because most of those affected are between the ages of 15 and 25, and they often have not yet finished planning their families.

Gonorrhea can usually be treated effectively with antibiotics. So, seek medical advice if you suspect you have been infected with a sexually transmitted disease.

Gonorrhea: Causes and Risk Factors

The so-called gonococci, also known as Neisseria gonorrhoeae, are the causative agents of the disease. They are found only in humans. Outside the body, they are exposed to cold and oxygen—and thus to an environment in which they cannot survive.

The germs attach themselves to the mucous membranes, especially in the urinary and reproductive organs. During unprotected vaginal, anal, or oral sex, the pathogens can spread and infect the partner. People who frequently change partners are at particularly high risk of contracting gonorrhea. It is not possible to become infected in the restroom or through other means of transmission.

If a pregnant woman contracts gonorrhea, the bacteria are transmitted to the baby during childbirth. However, the child does not develop a sexually transmitted disease; instead, the gonococci colonize the conjunctiva of the eyes, which can lead to a purulent inflammation. However, gonorrhea is rare in pregnant women and is often detected during prenatal checkups.

Symptoms: Discharge and pain when urinating

Since the bacteria colonize the genital organs, the typical symptoms appear there. However, the severity of the symptoms differs between men and women. Symptoms usually appear two to five days after infection. In rare cases, it may take as little as one day or as long as two weeks for gonorrhea to become apparent.

Types of Symptoms

Symptoms in Women

In women, gonorrhea often affects the cervix and the canal connecting the vagina to the uterine cavity. Sometimes, gonorrhea causes no symptoms at all in women, or only very mild symptoms that those affected hardly notice. In fact, about half of women do not experience any noticeable symptoms. What sounds positive at first often has negative consequences: If the patient has no symptoms, she generally does not begin treatment. The bacteria continue to multiply, and the gonorrhea becomes chronic. In addition, the woman may infect her sexual partners as the infection progresses.

Early signs include, for example:

• Watery vaginal discharge. Usually in combination with a urinary tract infection.
• Pain when urinating.
• Menstrual irregularities may occur if the uterine lining is infected with gonococci.
• Intermenstrual bleeding or a period that is significantly longer than usual

In rare cases, the bacteria can travel further through the body from there. If it does, additional symptoms may occur, such as pelvic inflammatory disease and inflammation of the fallopian tubes. The latter can increase the risk of ectopic pregnancies. Another symptom may be chronic abdominal pain.

Symptoms in Men

About 75 percent of affected men develop typical symptoms. Symptoms therefore occur more frequently than in women. In men, the symptoms are often more pronounced than in women with the condition. Early signs include, for example:

• Burning sensation when urinating
• Redness and swelling of the urethral opening
• First watery, then mucous discharge

Symptoms that appear after two to three weeks, once gonorrhea has spread throughout a man’s body:

• Pain in the perineum and bladder
• Redness, swelling, and tenderness of the epididymis
• general feeling of illness
• Fever

Early diagnosis is therefore definitely advisable, and it is important to treat gonorrhea as soon as possible. If left untreated, a gonorrhea infection can lead to infertility in both men and women, which should be avoided.

Diagnosis of Gonorrhea

If you suspect you have gonorrhea, see a doctor for an examination. Diagnosis is simple: We take swabs from the affected areas—such as the cervix or the urethra—and analyze them. In some cases, we also examine the smear specimen under a microscope, for example, in men with typical symptoms of gonorrhea.

To be sure that the condition is actually gonorrhea, it is often necessary to stimulate the growth of the bacteria and perform a culture. Bacterial cultures are also useful for testing the bacteria for possible antibiotic resistance. Men can also provide a urine sample to test for gonorrhea. We would be happy to explain which diagnostic procedure will be used in your case during a personal consultation.

Gonorrhea: Prevention, Early Detection, Prognosis

Since gonorrhea is primarily transmitted through sexual intercourse, it is advisable to use condoms. This is especially true for people who frequently change partners, as their risk of infection is particularly high. People in long-term relationships are less likely to contract gonorrhea.

Condoms not only protect against gonorrhea, but also against unintended pregnancies, HIV, hepatitis B, syphilis, and HPV infection. HPV is a risk factor for cervical cancer. Because of all these advantages, the condom is the most commonly used form of birth control.

However, condoms provide adequate protection only if they are used correctly. When opening the package, make sure they do not come into contact with scissors or sharp fingernails. In addition, they should not be reused. Also, be sure to check the expiration date.

There is currently no vaccine for gonorrhea. Condoms are the only preventive measure. It should be noted, however, that gonococci can also be transmitted through oral sex.

Course and Prognosis (Gonorrhea)

People who recognize the symptoms early and seek proper treatment for gonorrhea generally have a good prognosis. In most cases, gonorrhea clears up without any complications. However, it is possible that those affected may become infected again at a later date. A single infection does not guarantee lifelong immunity, as is the case with other infectious diseases. Preventive measures are therefore important even in cases of previous infections.

If left untreated, serious complications such as infertility may occur. Both men and women may find that they are no longer able to have children later in life.

If gonorrhea spreads throughout the body, further complications may arise. However, that is rarely the case.

The following are possible:

• Skin inflammation with pustules
• Conjunctivitis: Typical symptoms include red, burning eyes, itching, sensitivity to light, increased tearing, swelling, stickiness, and a feeling of pressure in the eye.
• Endocarditis: Possible symptoms include fever, chills, loss of appetite, and sweating.
• Joint Inflammation (Arthritis)

Conjunctivitis can also occur in babies whose mothers have gonorrhea. It can lead to corneal ulcers, which, in the worst-case scenario, can cause the child to go blind. The infection can be prevented in children through Credé prophylaxis. If necessary, the baby will be given antibiotic eye drops to kill the pathogens.

Gonorrhea: Treatment with Antibiotics

The only treatment option is antibiotics. The standard treatment is an injection of ceftriaxone, along with azithromycin, which patients must take orally. As a rule, a single treatment is sufficient to eliminate the bacteria. During treatment, patients should refrain from sexual intercourse.

Some people also have a chlamydia infection, which is another common sexually transmitted disease. In this case, other bacteria have colonized the urinary tract or the genital organs, where they cause symptoms similar to those caused by the gonorrhea pathogen. They are also treated with antibiotics.

If you have been diagnosed with gonorrhea, your partner should also get tested. On the one hand, there is a high probability that he or she is also infected. On the other hand, treatment ensures that you won’t become infected again.

Gonorrhea Treatment in the Future

There are now gonococci that are resistant to antibiotics. This poses a challenge for the experts. Once bacteria develop resistance, they pass it on, so it is likely that more cases that are difficult to treat will occur in the future. There are already drugs that used to be effective against gonorrhea but have since lost their effectiveness. In isolated cases, there were even instances in which not a single available antibiotic was effective. As antibiotic resistance continues to spread, the need for new drugs will likely increase.

At present, however, many patients can be treated effectively with the antibiotics currently available. Before starting treatment, we can test for resistance to a specific active ingredient and take appropriate action if necessary. We recommend that you consult with us regarding this matter.