Gonorrhea
AKA: "The Clap"
Gonorrhea, sometimes called "the clap", is an STD (sexually transmitted disease). It is a bacterial infection caused by the bacterium Neisseria gonorrhoeae, which is also called gonococcus. Gonorrhea is a very common disease: In the United States, it is estimated that 600,000 to over a million people contract gonorrhea each year. Teenagers and young adults have the highest rates of gonorrhea infection, and instances are also higher in ethnic minority communities with lower socioeconomic status.
Like most bacteria, gonococcus likes warm, moist environments. It thrives in the mucous membrane tissues of the genitals, throat, and anus. It is transmitted through penile-vaginal, oral-genital, oral-anal, and genital-anal contact, so penetration does not have to occur to transmit this disease.
Usually, symptoms will appear in one to five days after exposure to the bacteria. Sometimes symptoms take up to two weeks to appear, and in some cases, symptoms don't appear at all.
The two most common signs of gonorrhea are burning during urination and a cloudy, bad smelling discharge from the penis. Some men also notice tenderness or swelling in the lymph nodes of the groin.
These symptoms sometimes clear up on their own; however, that does not mean that the disease is gone. The bacteria may still be present, and the man could be able to infect his partner.
Women are usually asymptomatic, meaning that anywhere from 50% to 80% of women who are infected do not have any symptoms. Usually the woman's cervix becomes infected and produces a yellow-green discharge, but it is not very heavy and often goes unnoticed. Sometimes the discharge is irritating, but sometimes doctors do not recognize gonorrhea symptoms because there are many other disorders that can irritate the vulval tissues.
Also, women with gonorrhea may also have trichomoniasis, which can hide the presence of gonorrhea. Any woman who thinks she might have gonorrhea needs to get tested-and a Pap smear does not test for gonorrhea.
In about 2% of adult men and women with gonorrhea, the bacteria enter the bloodstream and spread to the rest of the body. This systemic infection produces numerous symptoms such as fever, chills, loss of appetite, arthritic pain in the joints, and skin lesions. If arthritic pain develops, it can cause permanent joint damage if not treated quickly. Very rarely, the gonococcus bacteria invade the heart, liver, spinal cord, and brain.
An infant with a gonoccal eye infection.
Also, infants can develop a gonococcal eye infection if the baby passes through the birth canal of a woman infected with gonorrhea. They eye infection can cause blindness if not treated immediately. Adults can also introduce the bacteria to their eyes by handling their genitals then touching or rubbing their eyes, which is one reason it is important to wash with soap and water immediately after genital contact.
Gonorrhea can also infect the throat and rectal area. The throat may become infected through oral contact with infected genitals. Gonorrhea can also cause a sore throat, but most people do not have such symptoms. The rectal area can be infected through anal intercourse or anal contact. Also, women who have genital gonorrhea may transfer it to their anal opening through menstrual bleeding or vaginal discharge. Usually rectal gonorrhea is asymptomatic, but occasionally it can produce itching, rectal discharge, or bowel disorders.
If gonococcal infection goes untreated for two to three weeks, it can affect the prostate, bladder, kidneys, and testicles. Most men who do not receive successful treatment experience only occasional flare-ups which include a discharge and burning during urination. However, abscesses can form in the prostate in a small number of men, resulting in fever, painful bowel movement, and difficulty urinating. In about one out of five men who remain untreated for more than a month, the bacteria can move into the epididymis causing epididymitis, which is when one or both of the epididymal structures are infected. Generally the left side is infected first. Even if the infection is treated, epididymitis can leave scar tissue that blocks the flow of sperm. Usually this does not lead to sterility because only one testicle is affected; however, if both sides are infected, permanent sterility can result.
Serious problems can occur if the bacteria move into the upper reproductive tract and cause Pelvic Inflammatory Disease, or PID. PID can cause sterility and ectopic pregnancy; it can also cause bands of scar tissue to connect structures like the fallopian tubes, ovaries, and uterus to each other or to the abdominal walls. This can cause extreme pain for the woman when standing, walking, or engaging in coitus.
Treatment
Chlamydia infections often accompany gonorrhea infections, so health practitioners often use a treatment that cures both. Before 1976, penicillin or tetracycline was effective against gonorrhea; however, new strains of the bacteria have developed, so those antibiotics no longer work against resistant strains. Thankfully there are newer drugs that are effective against both resistant and nonresistant strains.
Usually the sexual partners of an infected person are also infected, so it is extremely important that all people who were exposed to the bacteria should be examined and treated.
Warning: Graphic Content See Picture
Paraphrased from Crooks and Baur (2002), Our Sexuality, pages 480-483;
and from McAnulty and Burnette (2001), Exploring Human Sexuality, pages 524-526.