Medical experts have defined gonorrhea as a bacterial infection transmitted during sexual activity. This disease, they noted, is caused by the bacteria called Neisseria gonorrhoeae.
According to health reports, any type of sex can spread gonorrhoea. It can be contracted through the mouth, vagina, penis, or anus. It is, however, not transmitted from toilet seats.
The bacteria grow in warm, moist areas of the body. This can include the tube that carries urine out of the body (urethra). In women, the bacteria may be found in the reproductive tract which includes the fallopian tubes, uterus, and cervix.
Gonorrhoea can be passed even if the penis or tongue does not go all the way into the vagina or anus. If the vagina, cervix, anus, penis or mouth come in contact with infected secretions or fluids; then transmission is possible.
Some medical experts say that a woman who has not had anal sex can get gonorrhea in the anus or rectum if bacteria are spread from the vaginal area, such as when wiping with toilet paper. Also, eye infections in adults may result when discharge carries the disease into the eye during sex or hand-to-eye contact.
Medical reports on gonorrhea say the disease does not always show any symptoms. But in men, gonorrhea can cause pain when urinating including discharge from the penis. If untreated, it can cause problems with the prostate and testicles.
In women, the early symptoms of gonorrhoea often are mild. Though it can cause bleeding between periods, pain when urinating, and increased discharge from the vagina. If untreated, it can lead to pelvic inflammatory disease which causes problems with pregnancy and infertility.
A consultant urologist, Dr. Gabriel Ogah, opined that gonorrhea infections in the mouth and throat are usually without symptoms.
Ogah noted that in such a situation, symptoms may include soreness and redness in the mouth or throat. A culture test is used to determine if gonorrhea is causing these symptoms.
He said, “If gonorrhea infects the eye, men and women might experience conjunctivitis (inflammation of the eyelid lining). Symptoms of conjunctivitis include redness, itching, and discharge from the eye. The bacterium that causes gonorrhea requires very specific conditions for growth and reproduction.”
The doctor added that the bacteria cannot live outside the body for more than a few seconds or minutes, nor can it live on the skin of the hands, arms, or legs.
Ogah added, “It survives only on moist surfaces within the body and it is found most commonly in the vagina, and, more commonly, the cervix. The disease can even exist in the back of the throat (from oral-genital contact) and in the rectum.”
On its severity, he said the infection can also be passed from a pregnant woman to her baby.
“If you’re pregnant and likely to have gonorrhoea, it is important to get tested and treated before your baby is born. Without treatment, gonorrhoea can cause permanent blindness in a newborn baby,” he stated.
Commenting further on the symptoms of the disease, Ogah said typical symptoms of gonorrhoea include a thick green or yellow discharge from the vagina or penis, pain when urinating and (in women) bleeding between periods.
Another consultant urologist, Dr. Ademola Popoola, listed redness and swelling of the genitals, burning or itching of the vaginal area as other symptoms of the disease.
He said, “If untreated, gonorrhoea can lead to a severe pelvic infection with inflammation of the fallopian tubes and ovaries. Symptoms usually appear two to five days after infection. However, it may take up to a month for symptoms to appear in men.”
Some people do not have any of the symptoms and may not know that they have contracted the disease.
Popoola said, “This increases the risk of complications and the chances of passing the infection on to another person. If the infection spreads to the bloodstream, symptoms include, fever, rash and arthritis-like symptoms.”
On how gonorrhea can be diagnosed, an Obstetrician, Dr. Kingsley Ekwuazi, said it can be easily diagnosed by testing a sample of discharge picked up using a swab.
He added that testing a sample of urine can also be used to diagnose the condition in men.
“If you have gonorrhea, you should ask to be tested for other sexually transmitted infections, including chlamydia, syphilis, and Human Immunodeficiency Virus. If you are a woman aged 21 or older, you should be sure you have had a recent Pap smear,” Ekwuazi stated.
Meanwhile, Popoola said yearly gonorrhoea testing is often recommended for all sexually active women younger than 25 years, as well as older women with risk factors such as new or multiple sex partners, or a sex partner who has a sexually transmitted infection.
On his part, Ogah said sometimes the tests do not show bacteria because of sampling errors especially if the sampled area does not contain bacteria even when the woman has an infection.
But Popoola noted that newer tests to diagnose gonorrhoea involve the use of DNA probes or amplification techniques to identify the genetic material of the bacteria. However, these tests are more expensive than cultures but typically yield more rapid results.
Ogah, commenting on the treatment procedure, said gonorrhoea is usually treated with a single antibiotic injection and tablet.
He stated, “Some strains of gonorrhea have been found to be resistant to certain drugs (known as antimicrobial resistance), so the recommended treatment for most cases involves two antibiotics. One delivered as an injection and the other as an oral medication.”
He further said it’s usually recommended that one attends a follow-up appointment a week or two after treatment in order to conduct another test to see if one is free from the infection.
According to him, untreated gonorrhea infections in men may lead to prostatitis (inflammation of the prostate gland), scarring of the urethra (which can cause a narrowing or closing of the urethra), infertility and epididymitis (inflammation of the epididymis, the elongated, sperm-carrying, cord-like structure along the posterior border of the testes).
“In women, untreated gonorrhea infections may lead to pelvic inflammatory disease. PID can develop from several days to several months after infection with gonorrhea. Left untreated, PID can cause infertility. Untreated gonorrhoea may also lead to chronic menstrual difficulties, postpartum endometritis (inflammation of the lining of the uterus after childbirth), miscarriage, cystitis (inflammation of the urinary bladder) and mucopurulent cervicitis (characterised by a yellow discharge from the cervix.),” Ogah said.
A general practitioner, Dr. Rotimi Akande, advised that sexual partners must be tested and treated to prevent passing the infection back and forth.
“You and your partner must finish all of the antibiotics. Use condoms until you both have finished taking your antibiotics. Gonorrhea is one of the easier STDs to prevent because the bacterium that causes the infection can survive only under certain conditions. The use of condoms protects against gonorrhea infection. Since the organism can live in the throat, condoms should be used during oral-genital contact as well.”
Popoola noted that all sexual contacts with persons with gonorrhoea should be tested. This helps prevent further spread of the infection.
In his explanation on the disease, Akande said gonorrhoea and other STDs can be successfully prevented by using appropriate contraception and taking other precautions.
“It is advisable for sexual partners to use condoms every time they want to have sex. Also, use a condom to cover the penis, or a latex or plastic square (dam) to cover the female genitals if you desire oral sex. Do not share sex toys, washing them and covering them with a new condom before anyone else uses them,” he advised.
Furthermore, Akande noted that avoiding sexual contact is the only sure way to prevent gonorrhea, adding “If you and your partner do not have sex with any other persons, this can greatly reduce your chance also. It’s better to prevent gonorrhea than to treat it, and the only way to completely prevent the infection is to abstain from all types of sexual intercourse.”
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