Sexually transmitted diseases – Gonorrhea

Gonorrhoea is considered to be one of the most common curable sexually transmitted diseases in the world oftenly caused by the Gram-negative bacterium called Neisseria gonorrhoeae, a bacterium that grows and multiplies easily in the warm and moist areas of the reproductive tract, including the cervix (opening to the womb), uterus (womb), and fallopian tubes (egg canals) in women, and in the urethra (urine canal) in women and men. It is also known to grow in the eyes, throat, mouth, and/or anus.

The Centers for Disease Control and Prevention (CDC) estimates that not less than 700,000 persons in the U.S. get new gonorrheal infections every year. Although, only about half of these infections are reported to CDC there were 330,132 cases of gonorrhea were reported to CDC in 2004. The national gonorrhea rate declined from 1975 to 1997, following the implementation of the national gonorrhea control agenda in the mid-1970s. The rate of reported gonorrheal infections in 2004 was nailed only to 113.5 per 100,000 persons.

Gonorrhea can be spread through contact with the penis, vagina, mouth, or anus and ejaculation is not necessarily instrumental for gonorrhea to be transmitted or acquired. However it can be spread from a mother to the baby during delivery. The risk of people who have had gonorrhea and received treatment to get infected again is relatively high should they engage in any sexual contact with a person infected with gonorrhea.

The incubation period can vary from 2 to 14 days with most symptoms appearing within days 2 and 5 after acquiring it from an infected partner. Sometimes a small number of people may not manifest any symptoms yet for several months.

Most of the time men with gonorrhea may have no symptoms at all, however some may have some signs or symptoms that surface two to five days after infection and it can take as long as 30 days to surface. Symptoms as well as signs may include a burning sensation when urinating, or dysuria accompanied by thick, copious, purulent (condensed milk-like) urethral discharge. Every so often men with gonorrhea obtain painful or swollen testicles. This urethral inflammation often accompanied by discharge, and sometimes the discharge itself, is called "leet." If it’s not treated accordingly, ascending infection could extend to the epididymis, testes or prostate manifesting symptoms such as scrotal pain or swelling.

In most cases with women, the symptoms are often mild, but majority of the women who are infected are asymptomatic or having no symptoms.  The symptoms can still be so non-specific as to be mistaken for a bladder or vaginal infection even if there’re slight manifestations of the symptoms. The initial symptoms and signs include a painful or burning sensation when urinating, dysuria, intermenstrual bleeding or postcoital bleeding, increased vaginal discharge, or vaginal bleeding between periods. The cervix may sometimes appear somewhere from normal to the extreme of marked cervicitis with a mucopurulent exudates; the involvement of the urethra causes little purulent secretion, dysuria and frequency. Women with this type of infection are at risk of developing serious complications from the infection, despite the presence or severity of symptoms.

Other symptoms of rectal infection in both men and women include discharge, soreness, anal itching, bleeding, or painful bowel movements. Rectal and throat infection may cause a sore but usually have no symptoms.

Gonorrhea infection increases the risk of becoming infected with HIV (human immunodeficiency virus, the virus that causes AIDS). This is mainly due to the weakening of the mucosal surface secondary to the gonorrhea infection. PID is the most common result of untreated gonorrhoea. It is a serious infection of the female reproductive tract. It causes scarring of the fallopian tubes which normally leads to increased risks of causing ectopic pregnancy since the fertilized egg may not be able to pass through the narrowed as well as scarred fallopian tube. These are critical conditions which are potentially life-threatening to the mother.

There are several antibiotics that can successfully cure gonorrhea in adolescents and adults. However, there are already drug-resistant strains of gonorrhea that are increasing in many areas of the world, including the United States, so the successful treatment of gonorrhea has become more and more difficult. Since many people with gonorrhea may also have chlamydia, another sexually transmitted disease, the antibiotics for both infections are usually given together. Persons infected with gonorrhea should also be tested for other STDs.

Though medication will stop the infection of gonorrhea, it will not repair any permanent damages done by the disease.

Doctors usually prescribe a single dose of one of the following antibiotics to treat gonorrhoea: Cefixime 400 mg orally in a single dose, or Ceftriaxone 125 mg intramuscular injection in a single dose, or Ciprofloxacin 500 mg orally in a single dose, or Ofloxacin 400 mg orally in a single dose, or Levofloxacin 250 mg orally in a single dose as co-infection with chlamydia is common, doctors repeatedly prescribe a mixture of antibiotics, such as ceftriaxone and doxycycline or azithromycin, which will then treat both diseases.