Gonorrhea: Causes, Symptoms & Treatment

One of the most common venereal diseases is gonorrhea or clap. In this case, there are various complaints in the area of the sexual organs. Due to oral sex, which is becoming increasingly popular today, the pathogens can also quickly spread to the mouth and throat area. Also in the anal area it comes very often to the typical symptom pictures of a tripper disease.

What is gonorrhea?

What used to be a protracted and sometimes even fatal disease is nowadays considered quite curable: the so-called gonorrhea or gonorrhea. Triggered by a tiny bacterium that belongs to the so-called “gram-negative cocci,” this disease can run very different courses – from asymptomatic to exceedingly complicated. Neisseria gonorrhoeae, as the pathogen is called in full, takes its name from Albert Neisser, who first discovered this germ in a urethral swab in 1879. Gonorrhea occurs worldwide and exclusively affects humans. A cure for the infection was first possible in 1944 with the invention of penicillin. In the meantime, however, the germ rarely responds to treatment with the former all-purpose weapon penicillin. Experts refer to this as “resistance.” Fortunately, there are some alternative drugs and combinations that can effectively combat gonorrhea.

Causes

Gonorrhea is mainly transmitted sexually. It makes little difference whether intercourse is vaginal, anal, or oral. Transmissions from the throat with gonorrhea are less common, however. The aggressive pathogen can sometimes also cause severe eye infections by touching the eyes with the hands. Infection with gonorrhea triggers urethritis with itching and discharge in men. Without antibiotic treatment, symptoms often do not resolve for 2 months. In women, a complication feared by the pathogen is adhesion of the fallopian tubes, which leads to infertility if left untreated. However, there is a particularly great danger for the expectant life. In the first three months of pregnancy, the bacterium can ascend to the uterus and cause the loss of the fetus. Later, the embryo is protected because a mucus plug closes the cervix. Eye infection of the newborn with gonorrhea is a feared complication, as the pathogen can enter the eyes through vaginal secretions, leading to blindness. Gonorrhea can be particularly dangerous if it enters the bloodstream. Sepsis with gonorrhea bacteria is often severe and fatal. Mortality increases the longer gonorrhea remains undetected and thus untreated.

Symptoms, complaints, and signs

An infection with the venereal disease gonorrhea does not always entail complaints. Especially in women, an infection is often mild. A good half do not notice anything. They pass on the bacteria unknowingly. Symptoms vary according to gender. The first symptoms appear after three to ten days. Men usually complain of severe pain when urinating. They state that they excrete glass fragments. If no treatment takes place, the problems can develop into chronic prostatitis. The penis, along with its foreskin, is severely reddened. A purulent, yellow-greenish discharge develops. In advanced stages, swelling and lower abdominal pain are also possible. Male carriers of the disease can pass on the pathogens during sexual contact. Anal intercourse leads to a terminal inflammation in the rectum, and oral intercourse leads to sore throat in the sexual partner. Female patients usually suffer from cervicitis. This is accompanied by a purulent discharge. Like men, women sometimes also suffer from pain during urination. In extreme cases, the bacteria spread further and attack the fallopian tubes and ovaries. Fever and discomfort in the lower abdomen then accompany the disease. In a few cases, symptoms can also affect the entire body. Men and women then suffer from fever, joint inflammation and skin changes. Likewise, the heart and brain can be attacked.

Complications

If gonorrhea is caught early enough, chances are good that it will heal completely, but if it is not treated or is inadequately treated, various complications can occur. One common complication is infertility in either men or women.It can also happen that the gonococci, the pathogens of gonorrhea, spread through the bloodstream in the body and cause secondary diseases such as inflammation of the joints, tendon sheath inflammation, conjunctivitis and iris inflammation of the eye, heart muscle inflammation or skin inflammation. If a pregnant woman is infected with gonorrhea, the child can be infected with the pathogen during birth. Ulcers can then form in the infant, infecting the cornea of the eye and, in the worst case, leading to blindness. In rare cases, the pathogens can spread increasingly through the bloodstream and cause blood poisoning, which is referred to in technical jargon as gonococcal sepsis. It primarily affects people with a general immune deficiency, for example with AIDS or other infectious diseases. Other serious complications from gonococcal infection can include meningitis or inflammation of the inner lining of the heart.

When should you see a doctor?

If typical gonorrhea symptoms are noticed, such as a burning sensation when urinating, swelling or redness in the genital area, or discharge from the urethra, a visit to the doctor is recommended. Symptoms in the throat indicate a spread of gonorrhea as a result of oral sex. Medical advice is required at the latest when fever or bleeding occurs. If left untreated, gonorrhea can develop into a chronic disease. As a result, there is a risk of infertility. If the signs occur immediately or some time after unprotected sexual intercourse, gonorrhea may be the underlying cause. Pregnant women and men who already suffer from a chronic disease of the prostate or epididymis should consult a doctor quickly. The same applies to people who have a weakened immune system or cardiovascular disease due to another condition. Gonorrhea is diagnosed and treated by a urologist or gynecologist. The medical professional can diagnose the condition by taking a swab and a urine sample and take appropriate action. If this is done at an early stage, possible consequences such as inflammation of internal organs, infertility and so on can be avoided. Therefore, a doctor should be consulted quickly if the aforementioned complaints occur and do not subside on their own within a few days.

Treatment and therapy

Treatment of gonorrhea is now carried out by highly effective antibiotics. Since the well-tried penicillin is now obsolete, the Robert Koch Institute recommends treatment with 3rd generation cephalosporins in high doses (e.g., ceftriaxone). With the so-called Flourchinolonen, which were gladly used for the therapy, many resistances developed in the course of the time. Here, testing of the appropriate antibiotics would be indicated, among others ofloxacin. It is performed as a so-called “resistance testing” in the medical laboratory. Complicated gonorrhea should be treated over a longer period of time. Since there is often an infection with clamydia and gonorrhea, the treating physician must use antibiotic combinations in this case. In this case, either doxycycline or azithromycin are suitable in addition to cephalosporins. In 2012, it became known that in some countries the gonorrhea pathogen Neisseria gonorrhoeae is already resistant to common broad-spectrum antibiotics. If no other antidote is developed in the near future, this would mean that infected individuals would retain irreversible physical damage for life; for example, infertility in men and infertility in women.

Prevention

Infection with gonorrhea can be effectively prevented by using condoms during sexual intercourse. If the condom is perceived as a foreign body, sexual partners should not be changed constantly. If one partner is infected with gonorrhea, both partners must always be treated, otherwise the so-called “ping-pong” effect occurs, i.e. repeated re-infection with gonorrhea. The disease of the newborn with gonorrhea is now very well covered by pregnancy prophylaxis and therefore occurs in the rich industrialized nations as good as no longer.

Follow-up

The disease of gonorrhea requires early treatment. For effective aftercare, it is important to include the partner in the therapy to prevent reinfection. Until the final test has taken place, those affected should refrain from sexual contact.Otherwise, there is a risk that the pathogen will be transmitted to another person. Typically, sufferers experience pain when urinating and notice a discharge. To reduce these complaints, daily hygiene is very important. This helps to alleviate the discomfort. Whether the therapy and follow-up treatment have been successful is determined by the doctor during a PCR test. This is generally done two weeks after the end of therapy. If this check is positive for gonococci, it is necessary to have a further test for culture and resistance. Depending on the evaluation, a course of antibiotics may be required. Depending on how the antibiotic therapy goes, further testing may be due. During the post-treatment period, it is advisable not only to suspend sexual activities. The entire organism needs some rest, because the immune system is put under a lot of strain during recovery.

This is what you can do yourself

Self-treatment is not advisable for gonorrhea. Scientists agree that exclusively a treatment with antibiotics provides relief. However, even here more and more limits can be identified. This is because the pathogens have developed resistances. As a result, some therapies are prolonged until an effective combination of drugs is found. Patients can only support a medical therapy. This means that there are limits to self-help. Patients refrain from any sexual contact until a test confirms a cure. This prevents the transmission of the pathogens to other people. Because one aspect must not be neglected: Sexuality always has an impact on the life of the partner. Often, both persons even suffer from an infection at the same time. They must then take treatment together to prevent a constantly recurring mutual infection. Significant complaints of gonorrhea sufferers are pain during urination and a discharge. Adequate daily hygiene can at least partially alleviate these symptoms. To prevent infection in everyday life, the use of condoms is advisable. It is precisely chance acquaintances and one-night stands that carry the greatest risk of gonorrhea. Prevention is the best means against infection.