Signs and Symptoms of Gonorrhea: When to Contact a Doctor
In a 2015 report, the Centers for Disease Control and Prevention estimated that the United States sees 20 million new cases of STDs every year. About half of those are from sexually active youths between the ages of 15 to 24. By the age of 25, it’s estimated that half of all sexually active people will have had a sexually transmitted infection (STI) at some point. These STDs or STIs often can be transmitted through oral, anal, or vaginal sex and often do not show any symptoms. While many STDs are curable, many people who are infected might not even know until it is too late. One such STD that can have serious health repercussions is Gonorrhea.
What is Gonorrhea?
Gonorrhea is a sexually transmitted disease (STD) that affects both women and men. Gonorrhea is also sometimes called the “clap” or the “drip.” Why is Gonorrhea called the clap? The term dates back to as early as the 16th century and may be based on old English or French. It is a bacterial infection caused by the bacteria neisseria gonorrhoeae. The bacteria aims for the mucous membranes, which are moist, soft tissues not covered by our outer layer of skin. Thus, when someone has the infection, the bacteria can be found in the vagina, cervix, uterus, fallopian tubes, urethra, and rectum as well as the eyes (the lining of the eyelid), mouth or throat.
Gonorrhea is the second most common sexually transmitted bacterial infection in the US after Chlamydia. More than 800,000 individuals in the US are infected with the STD Gonorrhea every year, with it being most common for those aged 14 to 24.
How Do You Get Gonorrhea?
Gonorrhea is a STD, meaning it is transmitted by having oral, anal, or vaginal sex with a person who already has Gonorrhea. The infection is spread through semen and vaginal fluids, but the transmission of the disease is not dependent on ejaculation. While the infection comes from these fluids, it can infect the eyes, mouth, and throat in addition to the genitals, urethra, and anus. Anyone can get Gonorrhea, even if they have been diagnosed and treated for Gonorrhea before. Additionally, women who are pregnant can pass Gonorrhea onto their child during birth. This can result in the baby having joint, eye, or blood infections.
Since semen and vaginal fluids are required to transmit the bacteria that causes Gonorrhea, you cannot get gonorrhea through casual contact. For example, it is not possible to get Gonorrhea from kissing, holding hands, hugging, sneezing, sitting on a toilet, or sharing food.
Certain traits do increase your likelihood of contracting gonorrhea:
- Engaging with multiple sexual partners in one year – The more partners you engage with, the more likely you will be exposed to an infected person and contract a STD.
- Having unprotected sex – Condoms can reduce the likelihood of you contracting a STD; however, condoms are never 100% effective. If you are concerned you may have a STD, you should get tested regardless of whether you used a condom in your last sexual encounter.
- Younger than 24 – Individuals younger than 24 are more likely to practice unprotected sex than other age groups and are also less likely to be tested.
- Previous diagnosis of a STD – Having already contracted a STD increases your body’s susceptibility to contracting another STD. Contracting Gonorrhea increases your body’s susceptibility to contracting HIV/AIDS.
What are the Symptoms of Gonorrhea?
How do you know if you have Gonorrhea? Sometimes someone with Gonorrhea does not show any symptoms. It is unclear how common it is, with some estimates being the majority of men and women to only 10% of men and 40% of women show no symptoms. Gonorrhea early symptoms can appear within one or two weeks after having sex with a partner with Gonorrhea. Even with no Gonorrhea symptoms, it is still possible to transmit the disease and damage the reproductive system.
There are some differences in how Gonorrhea presents in men vs women, but in general the most common reported signs of Gonorrhea in both men and women are:
- Gonorrhea discharge – For women and men, this includes abnormal discharge from the vagina or penis that may be green, yellow, or white.
- Burning sensation while urinating – Also called dysuria, this symptom is common with other STDs and is an important sign to get tested.
- Painful, burning and swollen glands in throat – This is a very common sign of a Gonorrhea infection from oral sex.
Women can also have painful periods, bleeding between periods, pain during sex, abdominal pain, or a fever. Men can have a less common symptom of swelling or pain in either or both testicles. Gonorrhea can infect one or both eyes causing discharge, conjunctivitis (itchy, red eyes), or sensitivity to light. Gonorrhea can also spread or infect the anus causing:
- Rectal pain
Gonorrhea and Chlamydia: Understanding the Differences
Chlamydia is the most common STD in the US. Chlamydia is caused by the bacteria Chlamydia trachomatis, which produces an infection in the mucus membranes. Like Gonorrhea, Chlamydia bacteria can grow and infect women in the cervix, uterus, or fallopian tubes and in men, in the urethra. It can also infect the anus, mouth, eyes, and throat. Additionally, just like Gonorrhea, Chlamydia can pass onto newborns during childbirth if the mother is infected and remains untreated. The same risk factors, like having unprotected sex, having multiple sexual partners in a given time frame, and being between the ages of 14 and 24, apply to Chlamydia as well.
Once infected, Chlamydia can begin to show symptoms in one week or up to three weeks. Chlamydia, like Gonorrhea, produces very similar symptoms:
- Discharge – For women, this may have a strong odor and be yellowish from the vagina. For men, this can vary greatly, but may be cloudy or clear discharge around the tip of the penis.
- Burning sensation while urinating – This occurs in both men and women.
- Pain or swollen sexual organs – For men, this originates in the testicles and for women this is in the pelvis and vulva.
Similar to Gonorrhea, Chlamydia can exhibit no symptoms though this is much more common with the majority of people showing no symptoms. This often leads women to believe they have a yeast infection and self-treat with over the counter medication. Thus, it is important to consult a doctor to ensure you receive a proper diagnosis and treatment. Gonorrhea and Chlamydia are both diagnosed with a swab of the infected area and treated with antibiotics. These bacterial infections, Chlamydia and Gonorrhea, can also occur at the same time, so it is important to be tested for both.
Complications from Gonorrhea & Their Symptoms
Because Gonorrhea can have no symptoms, some people go untreated. Even with those who have symptoms, stigma, access, or other reasons get in the way of getting medical attention. Not receiving prompt and proper treatment can create serious health problems.
For women, Gonorrhea that goes untreated can spread through your uterus to your fallopian tubes. Fallopian tubes connect the ovaries to the uterus and transport fertilized eggs during pregnancy. If untreated gonorrhea spreads to this area the result is pelvic inflammatory disease (PID), affecting around 5% of women in the US.
Pelvic inflammatory disease, similar to Gonorrhea, can have no symptoms or just some pelvic or abdominal pain initially. Unfortunately, PID can do permanent damage to a women’s reproductive system, including:
- Long-term pelvic pain – PID can damage the fallopian tubes or other areas of the reproductive system inflaming them and causing chronic pelvic pain.
- Infertility – As the infection spreads through the fallopian tubes, the damage can cause scars that prevent any sperm from reaching an egg.
- Ectopic pregnancy – Sometimes, the sperm is able to get through and fertilize an egg, but the same damage and scarring can prevent the fertilized egg from reaching the uterus. This fertilized egg can implant in the fallopian tubes or elsewhere. Since these other areas are not designed to expand as the egg goes, they can rupture causing massive internal bleeding and even death. It is extremely important to call a doctor immediately, if you experience any symptoms, such as heavy vaginal bleeding, dizziness or shoulder pain.
- Premature birth – Even with the damage caused by the disease, it is still possible to conceive a child. Sometimes, PID can result in the birth occurring before the due date, which can risk the health and development of the child.
For men, Gonorrhea can also lead to serious health problems. Gonorrhea can cause infertility in men, and sometimes the infection can spread past the penis causing fever or pain. In addition, it is possible for Gonorrhea to cause:
- Epididymitis – This occurs when the epididymis is infected, the tube beside the testicle that carries sperm, which causes inflammation, scrotal pain, and fever.
- Proctitis – This results in inflammation of the rectum.
- Prostate gland infection – This is an infection of the prostate gland, which can cause fever, pain during sex or while urinating, and pain in the lower back.
- Blood or joint infection – Untreated Gonorrhea can spread to the joints or blood, causing a life-threatening illness.
When to Contact a Doctor
If you have any of the symptoms described you should go see a doctor. In general, if you are sexually active and have any usual discharge, burning sensations, or pain while having sex, you may have a STD and should get tested.
Additionally, if you are a woman, you should contact a doctor immediately if you have any of the following symptoms, as they can be a sign of a serious complication of gonorrhea called pelvic inflammatory disease:
- Fainting or signs of shock
- Serious lower abdominal pain
- Temperature that is higher than 101 F
Should any of these symptoms arise or if you suspect you may have a STD, it is very important to get tested. Even if you have no symptoms, as is sometimes the case of those with Gonorrhea but are sexually active, you should be getting tested regularly, so you do not unknowingly spread the disease. You can make an appointment with your primary care physician or see an urgent care in order to be tested and receive treatment.