What is gonorrhoea?

Gonorrhoea is one of the very common sexually transmitted infections affecting both sexes. Statistically, it is more common in men - there is only one infected woman for every three infected. However, statistics can be somewhat misleading, as the disease can be asymptomatic in women, making diagnosis difficult.

Infection is most common among young people(25-34 years - more than 37% of reported cases) and among teenagers 15-24 years (36% of reported cases).

What are the symptoms of gonorrhoea?

Gonorrhoea does not produce symptoms immediately after infection. In men, the first signs may occur between the third and sixth days after infection, or even later; in women, however, it is not until between seven and 14 days after infection.

Symptoms of gonorrhoea, photo: panthermedia

Early signs of infection, which are usually acute, include pain or burning during urination and discharge of various colours (white, green or yellow); the disease may also produce no symptoms.

Other symptoms may also include:

in men:
- swelling of the testicles,
- inflammation or swelling of the foreskin.
in women
- bleeding between periods.

Symptoms may also affect the rectum if a person has anal sex. These may include:

itching around the anus,
pain,
bleeding,
pain during bowel movements.

The infection can also be located in the throat if it follows oral sex, but it can also cause no symptoms.

Symptoms of gonorrhoea in men and women, photo: panthermedia

Interestingly, gonorrhoea can cause conjunctivitis, known as 'pink eye', if semen or vaginal fluid enters the eye. This is because it is a bacterial infection.

How to diagnose yourself?

To diagnose a gonorrhoea infection, the patient must undergo an examination, in which a urine sample or swab may be taken:

penis,
cervix,
urethra,
rectum,
eyelid or
throat.

There are also tests available in pharmacies with which you can check for the presence of bacteria yourself.

If the result is positive, it should be consulted with your doctor so that you receive guidance on the treatment process as soon as possible. The doctor may also refer the patient for another test before taking further steps.

If gonorrhoea is indeed diagnosed, all sexual partners of the affected person should also be tested.

How to treat gonorrhoea?

Once diagnosed, treatment should be started as soon as possible to avoid possible complications. Treatment usually involves the administration of antibiotics.

A visit to the doctor, photo: panthermedia

A single dose of 500 milligrams of intramuscular ceftriaxone is recommended. Until 2020, doctors used to give ceftriaxone in combination with a dose of azithromycin, but the guidelines have been changed because Neisseria gonorrhoeae, the bacterium that causes gonorrhoea, is increasingly resistant to azithromycin.

Your doctor may recommend a different treatment - for example, involving taking an oral antibiotic.

The current recommendation is to give two antibiotics at a time - ceftriaxone intramuscularly with azithromycin orally.

It is extremely important to complete the entire course of treatment, as directed by the doctor. If the patient does not notice an improvement after a few days, they should return to their doctor for further advice. Further investigations can determine whether the treatment is working.

During treatment, intercourse should be avoided until the doctor deems it safe.

What is associated with the occurrence of gonorrhoea during pregnancy?

If gonorrhoea occurs during pregnancy, inform your healthcare provider as soon as possible. Untreated gonorrhoea increases the risk of stillbirth.

Gonorrhoea in pregnancy, photo: panthermedia

The infection can spread to the baby during birth and the newborn may need antibiotics immediately.

Infection transmitted to the newborn can cause:

infection of the joints,
loss of sight,
bacteraemia, a life-threatening blood infection.

If gonorrhoea was not diagnosed during pregnancy and the newborn develops conjunctivitis, one possible cause could be gonorrhoea. Symptoms such as red eyes, thick pus in the eyes or swollen eyelids usually appear 2-4 days after birth.

What complications can gonorrhoea cause?

Gonorrhoea can cause serious complications. These include infection of the blood (bacteraemia), or septicaemia - characterised by fever, pain and swelling of the joints and specific, sparse lesions on the skin.

The disease can also lead to myocarditis or meningitis and infertility.

Complications after gonorrhoea, photo: panthermedia

In men, gonorrhoea can cause inflammation of the epididymis, or inflammation of the tubules that carry sperm, which can lead to fertility problems.

In addition, untreated gonorrhoea can lead to:

infection of the joints, requiring intravenous treatment,
disseminated gonococcal infection, which can be life-threatening,
an increased risk of HIV infection or transmission, as any infection can cause open wounds that make it easier for viruses and bacteria to enter the body.

How to prevent infection?

Ways to prevent gonorrhoea infection include:

avoiding sexual activity if there is a risk of infection,
using protection methods such as condoms or oral cofferdams,
having sex only with a mutually monogamous partner who is not infected.

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Gonorrhoea - what is the risk and how to treat it?

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