Gonorrhea

Sexually transmitted infections (STIs) continue to be a significant public health concern worldwide. Among the most prevalent of these is gonorrhoea, a bacterial infection that affects both men and women. Often asymptomatic in its early stages, gonorrhoea can lead to severe reproductive and systemic health complications if left untreated.

This comprehensive page offers valuable insights into gonorrhoea, including its causes, symptoms, prevention, and treatment strategies. Whether you're seeking general awareness or guidance for living with gonorrhoea, this guide provides practical and medically accurate information.

Gonorrhoea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. It primarily infects the mucous membranes of the reproductive tract, but it can also affect the rectum, throat, and eyes. The infection is commonly transmitted through vaginal, oral, or anal sex with an infected person. In some cases, it can also be passed from mother to child during childbirth.

If not diagnosed and treated early, gonorrhoea can result in severe health complications, including pelvic inflammatory disease (PID), infertility, and increased susceptibility to HIV.

According to the World Health Organization (WHO), there are an estimated 82 million new cases of gonorrhoea globally each year. The condition is most prevalent among young people aged 15–24 years.

In India, data on gonorrhoea is often underreported due to social stigma, lack of routine screening, and underdiagnosis. Nevertheless, the National AIDS Control Organisation (NACO) reports a significant prevalence of STIs, with gonorrhoea being one of the leading causes.

While gonorrhoea is generally categorised as one infection, it can manifest in different parts of the body:

1. Genital Gonorrhoea – Affects the penis, vagina, cervix, or urethra.
2. Rectal Gonorrhoea – Affects the rectum and is common among people who engage in receptive anal sex.
3. Pharyngeal Gonorrhoea – Affects the throat and may result from oral sex.
4. Ocular Gonorrhoea – Rare; affects the eyes, usually due to hand-to-eye transmission.
5. Disseminated Gonococcal Infection (DGI) – When the infection spreads through the bloodstream, causing fever, joint pain, and skin lesions.

Causes of Gonorrhoea

Gonorrhoea is caused by the bacterium Neisseria gonorrhoeae, which thrives in warm, moist areas of the reproductive tract. It spreads primarily through unprotected sexual contact:

• Vaginal, anal, or oral sex with an infected partner
• Sharing sex toys without proper cleaning or condom use
• Mother to child during childbirth

Risk of transmission increases with multiple sexual partners, lack of condom use, or history of previous STIs.

Symptoms of Gonorrhoea

Many individuals with gonorrhoea show no symptoms, particularly women. When symptoms do occur, they may vary depending on the site of infection.

In Men:

• Painful urination
• White, yellow, or green discharge from the penis
• Swollen or painful testicles
• Sore throat (if oral infection is present)

In Women:

• Increased vaginal discharge
• Painful urination
• Vaginal bleeding between periods
• Lower abdominal pain
• Pain during intercourse

Other Sites:

• Rectum: Itching, discharge, bleeding
• Throat: Sore throat, swollen lymph nodes
• Eyes: Redness, discharge, pain

Diagnosis involves laboratory testing, often including:

1. Nucleic Acid Amplification Test (NAAT) – Highly accurate, typically using urine samples or swabs from affected areas.
2. Gram Stain – Detects bacteria in samples from the urethra or cervix.
3. Culture Test – Confirms antibiotic sensitivity.
4. Rapid Tests – Available in some settings for immediate results.

Routine screening is recommended for sexually active individuals, especially those with multiple partners or a history of STIs.

Gonorrhoea is treatable with antibiotics. However, due to increasing resistance, treatment must be guided by current clinical guidelines.

Standard Treatment:

• Ceftriaxone (injectable) is currently the first-line treatment. (Aceft 250mg injection)
• In some cases, Azithromycin or Doxycycline may be added. (Aktion 500mg Tablet)

Treatment should be completed fully, even if symptoms improve. Sexual partners must also be treated to prevent reinfection.

There are no alternative therapies that can cure gonorrhoea. However, supportive therapies may help relieve symptoms:

• Probiotics: To restore healthy bacterial balance, especially if antibiotics disturb gut flora.
• Hydration and rest: For general well-being.

Alternative remedies should never replace antibiotic therapy.

Several factors increase the risk of acquiring gonorrhoea:

• Unprotected sex
• Multiple sexual partners
• History of other STIs
• Young age (15–24 years)
• Men who have sex with men (MSM)
• Inconsistent or incorrect use of condoms

Untreated gonorrhoea can cause serious health problems:

In Women:

• Pelvic Inflammatory Disease (PID)
• Infertility
• Ectopic pregnancy

In Men:

• Epididymitis
• Infertility

Other Complications:

• Disseminated gonococcal infection (DGI)
• Increased risk of HIV transmission
• Neonatal conjunctivitis in infants (can cause blindness)
   

While gonorrhoea is curable, being diagnosed with it can be stressful. Here are tips to manage and recover effectively:

• Complete the full course of antibiotics
• Abstain from sex until cleared by your doctor
• Inform sexual partners for testing and treatment
• Attend follow-up appointments
• Practice safe sex going forward
• Look after your mental health – seek counselling if needed

Myth 1: Gonorrhoea only affects people who have many sexual partners
 Fact: Even a single encounter can lead to infection if protection isn’t used.

Myth 2: You can’t get gonorrhoea from oral sex
 Fact: Oral sex can transmit the bacteria to the throat.

Myth 3: Antibiotics are not needed if symptoms go away
 Fact: Symptoms may subside, but the infection can persist and cause complications.

Myth 4: Once treated, you’re immune
 Fact: You can get gonorrhoea again if exposed.

Consult a doctor if you:

• Notice symptoms such as unusual discharge or painful urination
• Had unprotected sex with a new or multiple partners
• Are informed by a partner that they have gonorrhoea or another STI
• Are pregnant and suspect exposure to an STI

Early diagnosis and treatment prevent complications and transmission
 

ions to Ask Your Doctor

• What test will confirm I have gonorrhoea?
• What treatment options are available?
• How long will it take to recover?
• Should my partner also get tested?
• When can I resume sexual activity?
• Will this affect my fertility?

• Be understanding and non-judgemental
• Encourage them to seek medical care
• Offer to accompany them to appointments
• Promote open conversations about safe sex
• Support them emotionally – STIs can carry a stigma
   

Gonorrhoea remains a prevalent and serious public health concern but is highly manageable with early detection and proper treatment. With rising antibiotic resistance, timely intervention and safe sexual practices are more important than ever.

Whether you’re trying to prevent infection, seek treatment, or support someone else, awareness is your strongest tool. Regular testing, education, and destigmatisation of STIs are essential steps towards a healthier society.