Family doctor

Overview:

• Gonorrhoea is a bacteria which grows in the vagina throat and rectum
• It is spread through sexual intercourse, anal sex and oral sex.
• It is mainly found in people under 30
• Gonorrhoea cannot live outside the body for more than a few minutes
• Men experience a burning sensation while urinating and discharge from the penis
• The majority of women do not have symptoms.
• Some women will experience discharge and burning while urinating
• The condition can cause infertility in women, and less commonly in men
• Treatment involves antibiotics, but drug resistance is emerging
• Sexual partners should be tested
• Condoms are the best prevention

What is gonorrhoea?

Gonorrhoea is one of the oldest known sexually transmitted diseases. It is a bacteria which has been around for centuries. The germs grow in moist, warm areas in the body such as the vagina, penis, throat and rectum.

The disease is more common in urban areas. It is spread through sexual contact including intercourse, anal sex and oral sex. It can also be transferred from a mother to child during child birth, causing eye infections in the infant.

Any sexually active person can be infected with gonorrhoea but is mainly found in people under 30 who have had several sex partners.

Gonorrhoea cannot live outside the body for more than a few minutes

Women infected with gonorrhoea have a 25 to 40 percent chance of also having another STD called chlamydia, and treatment is recommended for both conditions.

What are the symptoms?

Symptoms in men include a burning sensation while urinating and a yellowish white discharge from the penis.

Fifty percent of women will have no symptoms but those who do will experience vaginal discharge, itching, and burning while urinating.

Symptoms usually appear between two to seven days after contact with an infected person, but it can take up to one month for symptoms to start.

Gonorrhoea of the rectum can occur in people who practice anal intercourse, and in women from the infection spreading from the vagina. Symptoms of rectal infection including discharge, anal itching, and sometimes painful bowel movements.

Testing for gonorrhoea involves swabbing the infected site and culturing the swab in a laboratory. The culture is positive when the gonorrhoea bacteria grows on the culture plate.

Sometimes the test is negative, even when the patient has the condition, because of problems with the test.

What can be done to help?

Treatment of gonorrhoea has become difficult in recent years due to the emergence of penicillin resistance to the condition. In the past a penicillin injection could cure almost everyone but now new drugs are being used to cure the disease.

One of the most effective medicines is ceftriaxone which is injected. Oral antibiotics include a singe dose of either cefixime, ciprofloxacin, ofloxacin. However, pregnant women and patients under 18 should avoid ciprofloxacin or ofloxacin.

Treatment should include a drug that will cure chlamydia as well.

All sexual partners of a person with gonorrhoea should be treated, whether or not they show signs of infection.

Once treatment is complete another culture test is necessary to ensure the infection has gone. Antibiotics usually cures gonorrhoea within 24 hours but it may take a week to cure chlamydia. Avoid sexual intercourse for one week after treatment has begun.

Women without symptoms are at risk of developing complications from the STD such as pelvic inflammatory disease which can cause infertility. Symptoms of pelvic inflammatory disease include fever, pelvic cramping, abdominal pain or pain during intercourse.

Men who are not treated may suffer from swelling of the testicles and penis. Both sexes may suffer from arthritis, skin problems and organ infections caused by gonorrhoea spreading throughout the body.

How can it be prevented?

Infection with gonorrhoea does not make a person immune once they recover. Past infections may lead to a higher risk of complications if re-infection occurs.

Condom use and limiting the number of sex partners can help to prevent the disease. Gonorrhoea is one of the easiest STDs to prevent because that bacteria that causes the condition can only survive under certain conditions.

Because the organism can live in the throat, oral sex should also be practised with the use of condoms.

Sexual contact should be avoided if you suspect you may be infected. Sex partners also need treatment.

Future trends

Scientists are continuing to study the organism that causes gonorrhoea and are working on better methods to prevent and treat the disease.

Doctors are concerned about the antibiotic resistance strains of gonorrhoea and researchers are searching for a vaccine to prevent the disease.

Getting help

Do not delay seeking help, partners should be seen as well.

Local sexual health services and family planning clinics can provide help and information. Look for Sexual Health Clinics in the front of the telephone book.

Your doctor, gynaecologist, urologist or Family Planning Clinic can also help.

Auckland Sexual Health Service ph 307 2885, fax 307 2884.