Gonorrhoea: causes, symptoms and treatments
Gonorrhoea is a sexually transmitted infection that mainly affects men under the age of thirty. Gonorrhoea is the most common sexually transmitted infection after chlamydia. If left undiagnosed and untreated, this infection can lead to infertility.
What is Gonorrhoea?
Also known as gonorrhoea, gonorrhoea or clap, gonorrhoea is a sexually transmitted infection that mainly affects men under the age of 30. It is caused by a bacterium, the gonococcus, which is transmitted during unprotected sex. All types of sexual intercourse can be contaminating, including fellatio and cunnilingus, which are thought to cause half of all cases of gonorrhoea.
What are the symptoms of gonorrhoea?
In some men, gonorrhoea causes no symptoms, but these people are still contagious. When symptoms do appear, infected men complain of tingling or burning when urinating, or of a whitish discharge from the penis or rectum. Gonorrhoea is less likely to cause symptoms in women. When it does, infected women experience pain when urinating or during sexual intercourse, yellowish or bloody vaginal discharge and stomach pains.
What are the possible complications of gonorrhoea?
If left undiagnosed and untreated, gonococcal infection can develop into complicated forms.
In men, untreated gonorrhoea can cause inflammation of the prostate or epididymis (the cord above each testicle). These complications can lead to infertility problems.
In women, complications are more common because gonorrhoea often has no symptoms. After a few months to a few years, untreated gonorrhoea can cause chronic stomach pains and inflammation of the uterus and fallopian tubes, leading to infertility or ectopic pregnancies (outside the uterus). During pregnancy, gonorrhoea can be transmitted from the mother to the newborn during childbirth, causing an eye infection in the newborn that can lead to blindness.
Gonorrhoea also increases the risk of HIV/AIDS infection (estimated to be 3 to 6 times higher).
How is gonorrhoea transmitted?
Gonorrhoea is caused by a bacterium, Neisseria gonorrheae or gonococcus. This bacterium is transmitted by unprotected sexual intercourse with an infected person, whether or not they have symptoms. All types of sexual intercourse can be contaminating, including oral sex.
Re-infections can be frequent, as gonococcus does not confer immunity.
Who is at risk?
The data provided by the surveillance networks have made it possible to identify people at greater risk of gonococcal infection:
- men aged between 21 and 30 and women aged between 16 and 25;
- men who have sex with men (MSM);
- people infected with HIV/AIDS;
- people with high-risk practices (multiple sexual partners, inconsistent condom use, unprotected fellatio).
How can gonorrhoea be prevented?
Like all sexually transmitted infections, the prevention of gonorrhoea is based on the systematic use of condoms (even for fellatio).
Along with condoms, screening is another way of combating sexually transmitted infections such as gonorrhoea. If the results are positive, the doctor can prescribe a suitable course of antibiotics to reduce the risk of contamination and complications.
There is no vaccine against gonorrhoea.
Unlike other agents responsible for sexually transmitted infections, the gonococcus has the particularity of rapidly acquiring various antibiotic resistance mechanisms. Cases of resistance are multiplying, linked to inappropriate or abusive use of these drugs. The choice of antibiotic must be guided by local information about possible resistance, hence the importance of monitoring the susceptibility of strains in each country.
How is gonorrhoea diagnosed?
Gonorrhoea is diagnosed by taking a swab from the affected organs (urethra, vagina, rectum, throat). This sample is sent to a laboratory for analysis to identify the bacteria and check for any resistance to antibiotic treatment.
If gonorrhoea is diagnosed, screening for other sexually transmitted infections (STIs) is recommended. Patients are also advised to contact their recent sexual partners so that they can be screened and, if necessary, treated with antibiotics. Unprotected sexual intercourse should be avoided for one week following a single dose of treatment, or for the duration of the treatment if it is longer.
How is gonorrhoea treated?
Gonorrhoea is treated with antibiotics. Because many strains of gonococcus have become resistant to the most common antibiotics, the doctor may take a sample to find the most effective antibiotic. People with gonorrhoea are routinely treated for chlamydia, as these two sexually transmitted infections are often associated. A follow-up visit is recommended one week after treatment.
What antibiotics are recommended for gonorrhoea?
The antibiotics prescribed for gonococcal infection are usually a single-dose cephalosporin: either ceftriaxone for injection or cefixime for oral administration. In certain specific cases, a longer course of treatment may be indicated.
If symptoms persist on the 3rd day after administration of the antibiotic, you should consult your doctor again to adjust your treatment if necessary.