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GONORROEIA

Gonorrhoea is an infection caused by a sexually transmitted bacterium called Neisseria gonorrhoea.

gonorroeia

Briefly

It can infect both sexes and it usually affects the rectum or the throat or the urethra, while in females, gonorrhea may infect the cervix. The most common way of gonorrhea transmission is sexual contact. Babies can also be infected during childbirth if their mothers were diagnosed with gonorrhea during pregnancy. In that case, babies may experience problems with their eyes.

Most of the times gonorrhea is considered an ordinary infection and it does not even cause any symptoms. Nevertheless, treatment is necessary so that to avoid serious and irreversible damages. Best ways of prevention are the use of a condom during sexual intercourse, keep a monogamous relationship as well as to abstain from any sexual activity.

Symptoms

Gonorrhea usually infects the genital tract but it may also infect various areas of the body.

Genital tract: Men usually present symptoms including pus-like discharge from the tip of the penis, painful urination, and swelling or pain in one testicle. Women usually present symptoms including painful urination, increased vaginal discharge, vaginal bleeding between periods, pain in the abdominal and pelvic areas, as well as vaginal bleeding after vaginal intercourse.

Rectum: Common symptoms include pus-like discharge from the rectum, anal itching, irritation during bowel movements and/or spots of bright red blood on toilet tissue.

Eyes: When gonorrhea affects the eyes, it may cause sensitivity to light, pus-like discharge from one or both eyes and eye pain.

Throat: In this case, symptoms may include swollen lymph nodes in the neck and a sore throat.

Joints: If one or more joints become infected by bacteria (septic arthritis), the affected joints may be warm, red, swollen and extremely painful, especially when you move an affected joint. 

When to visit the dermatologist

You should arrange an appointment to see your dermatologist-venereologist if you notice symptoms or signs such as burning sensation during urination or pus-like discharge from the vagina, the penis, or the rectum. It is also necessary to visit your doctor if your sexual partner reveals that s/he has chlamydia, as it may be necessary for you to take antibiotic medication even if you have no symptoms. If you do not follow the treatment it is possible to re-infect your partner once his/her treatment is completed.

Causes

Gonorrhea is caused by the Neisseria gonorrhea bacterium. Usually, the bacterium is transmitted during sexual intercourse, including vaginal, anal or oral intercourse.

Risk factors

• Young age
• A new sexual partner
• Large number of sexual partners
• Prior gonorrhea diagnosis

Complications

IIf gonorrhoea remains untreated it may lead to severe complications, including the following:

Infertility in women: Gonorrhoea is possible to spread into the fallopian tubes and the uterus causing pelvic inflammatory disease, which will probably result in greater risk of pregnancy complications, infertility and scarring of the tubes. Pelvic inflammatory disease is a severe infection and immediate treatment is mandatory.

Infertility in men: Men with gonorrhea can experience epididymitis. Inflammation of the epididymis refers to the swelling of the tube which is located behind the testicles and stores the sperm. Epididymitis may result in the swelling and pain of the testicles and if left without treatment it may result in infertility.

Spread of the infection to the joints and other body areas: The bacterium that causes gonorrhea may spread through the circulatory system leading to the infection of other body parts such as the joints. When a patient experiences a spread infection to the joints may present with swelling, stiffness, skin sores, rash and fever.

Increased risk of HIV/AIDS: Being diagnosed with gonorrhoea make the patient more prone to HIV, the virus that causes AIDS. People diagnosed with both infections may pass both gonnorhea and AIDS to their partners.
Complications in babies. Babies who contract gonorrhoea from their mothers during birth can develop blindness, sores on the scalp and infections.

Preparation for your appointment

Α. At your appointment with the dermatologist-venereologist you should be prepared to answer the following questions:

  • When did the first symptoms begin?
  • Are the symptoms continuous or occasional?
  • Are your symptoms intense?
  • Have you had any other sexually transmitted diseases in the past?

Β. Questions you may want to ask your doctor:

  • What kinds of tests should I go through?
  • Should I be tested for other STIs?
  • Should my partner be tested for gonorrhea?
  • How long should I wait before resuming sexual activity?
  • What can I do in the future at the level of prevention?
  • For which complications should I be alert?

Tests and diagnosis

To establish the presence or not of the gonorrhea bacterium in a patient’s organism, it is necessary to test a cell sample by:

Urine test to help identifying the presence of bacteria in the urethra.

• Swab of affected area: A swab of a patient’s urethra, throat, rectum or vagina can collect bacteria which will be identified in the laboratory.

Tests for other STDs. It may be necessary to conduct tests for other sexually transmitted diseases as gonorrhea increases the risk of such infections, chlamydia mainly that are often accompanying gonorrhea. It is also recommended to do an HIV test.

Treatments and medications

Treatment for adults: In adults, gonorrhea treatment usually involves antibiotics. Given the fact that that the bacterium has certain drug-resistant strains, it is recommended to follow treatment with injectable ceftriaxone combined with either azithromycin or doxycycline taken orally.

Treatment for partners: Sexual partners should also follow a treatment regimen following the relevant tests for gonorrhea, even in cases that no symptoms are present. Treatment is the same and it is necessary to be followed to avoid re-infection of the person that had gonorrhea first.

Treatment for babies: Newborns by infected mothers should receive medication for their eyes immediately after birth. In case of an eye infection development, babies should necessarily receive treatment with antibiotics.

Prevention

To reduce the risk of gonorrhea you can follow the instructions below:

Do not avoid using a condom. Abstaining from sex is the surest way to prevent gonorrhea. However, if your sex life is active, use a condom during any type of sexual contact, including anal sex, oral sex or vaginal sex.

Ask your partner to be tested for sexually transmitted diseases. Do not have sexual contacts with partners showing unusual symptoms, such as burning sensation during urination or genital rashes or sores.

Make sure you have regular gonorrhea screening if you belong in an increased risk group. In this group people with previous gonorrhea or other STD diagnosis are included, as well as people with a new sex partner and people with multiple sex partners.

About the author:

Christofer Tzermias

Specialised in the UK (Oxford & London) and in North America (New York & San Diego) in the field of LASER Dermatology, Dr Tzermias, has been providing dermatological state-of-the-art treatments using cutting-edge LASER and Energy based Devices for over 20 years. He has been Director of Interventional and LASER Dermatology Department at the Athens Medical Center for over 18 years and for the last 9 years is the Scientific Director of IQ - Intensive Quality Dermatology & Cosmetic Surgery Clinics, which at the 2017 Healthcare Awards won the ‘Innovation Award for Innovative Services’ for their pioneering contributions. Since 2018, IQ Dermatology & Cosmetic Surgery Clinics has also been operating in London, UK and in Muscat, Oman. Dr Tzermias is a Fellow of the world-renowned American Society for LASER Medicine and Surgery (ASLMS), a Founder Member of the European Society LASER Dermatology (ESLD), the Vice President of the ‘Open Health Alliance’ and he is also on the Board of Directors of Elitour - Greek Medical Tourism Council.

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