Gonorrhoea

Gonorrhoea

Gonorrhoea in Ireland

At present, gonorrhoea is one of the less reported STDs in Ireland — only 98 cases of gonorrhoea were reported here in 1997. However, it is the most common reportable sexually transmitted infection in the USA. In 1995, over 390,000 cases of gonorrhoea were reported to the US Centres for Disease Control and Prevention, at a cost of close to $1.1 billion. It is the second most common sexually transmitted disease in the UK. Approximately 50,000 cases are reported there each year.

What is gonorrhoea?

Gonorrhoea is a sexually transmitted infection caused by a bacterium, Neisseria gonorrhoeae. The bacterium multiplies in moist, warm areas of the body such as the urethra (tube draining the bladder) in men and the genital tract in women. It is commonly known as "the clap".

How is gonorrhoea passed on? 

Gonorrhoea is most commonly spread during sexual intercourse with an infected partner. Gonorrhoea of the rectum can occur following anal intercourse and may also occur in women due to spread of the infection from the vaginal area. The infection can also be passed from mothers to infants during birth, causing eye infections in the infant.

What are the symptoms of gonorrhoea?

Symptoms will usually develop within two to ten days following sexual contact with an infected partner. Some people may not have any symptoms, so you could be infected with gonorrhoea and not be aware of it.

In men:

Men often have more symptoms than women. Symptoms can include:

  • Painful or burning sensation when urinating
  • Pus-like discharge from the penis.
  • Testicular pain

In women:

More than 50% of infected women have no symptoms of the infection.

Initial symptoms can include:

  • Pain or burning sensation during urination
  • Pus-like discharge from the vagina.
  • More advanced symptoms can include:
  • Bleeding between periods
  • Pain during sexual intercourse
  • Abdominal pain
  • Fever.

What are the symptoms of gonorrhoeal infection of the rectum?

The majority of people who have a gonorrhoeal infection of the rectum have no symptoms. Only about one in ten have symptoms. These include:

  • Anal itch.
  • Pus-like discharge
  • Painful bowel movements.

How is gonorrhoea diagnosed?

Many disorders can cause a discharge from the urethra or vagina and laboratory tests will be necessary to confirm a diagnosis of gonorrhoea. Three techniques are usually used in the diagnosis:

Gram stain — a smear of the discharge from the penis or the cervix is placed on a slide and the smear is stained with a dye. The slide is examined under a microscope for the presence of the bacteria.

Detection of bacterial genes — urine or cervical swabs are taken and tested for the genes of the bacteria.

Culture — a sample of the discharge is placed on a culture plate and incubated for up to two days to allow the bacteria to multiply.

How is gonorrhoea treated?

Gonorrhoea can be treated with antibiotics. It is important that the full course of antibiotics are taken as prescribed. You will usually be advised to return for further tests to confirm that the antibiotics have been effective. You should refrain from sexual intercourse during treatment.

You should also take the time to wash your hands frequently and thoroughly, as the bacteria can be transferred to the eyes.

All sexual partners of a person with gonorrhoea should be tested and treated if infected, whether or not they have symptoms of infection.

How can I protect myself from gonorrhoea?

Use condoms during vaginal and anal intercourse to reduce the risk of infection.

Limit your number of sexual partners, as the risk of infection increases as the number of partners increases. Have regular check-ups, especially if you or your partner have other sexual partners.

What is the outlook?

If gonorrhoea is treated at an early stage, there should be no long-term consequences. However, treatment will not protect against re-infection so it is vital that all sexual contacts are notified and have treatment, if necessary.

If untreated, there is a risk that men may develop epididymitis (inflammation of the testicles) or prostatitis (inflammation of the prostate gland) that can cause sterility.

In women, an untreated infection can spread to the womb and the fallopian tubes and cause pelvic inflammatory disease, which can cause infertility and ectopic pregnancy.

The bacteria that cause gonorrhoea can occasionally spread through the bloodstream to cause gonococcal arthritis (inflammation of the joints). Research into an effective vaccine is ongoing.

What about gonorrhoea during pregnancy?

The infection can be passed from an infected mother to her child during delivery, causing an eye infection called ophthalmia neonatorum in the child. This can be prevented if the doctor applies medications to the baby’s eyes immediately after birth. Due to this risk of transmission to the child, pregnant women should have at least one test for gonorrhoea.

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