- Fertility & Reproductive Systems
Gonorrhoea Causes and Treatment
Gonorrhoea is a common sexually tranmitted disease, which has faded somewhat in the public's aware nice the AIDS epidemic and the fear of genital herpes have hit the newspaper headlines. Even so, gonorrhoea is still extremely common. It is caused by a bacterium called Neisseria gonorrhoeae and can only be caught by having sex with a person who already has the disease. It has an incubation period of three to seven days after contact.
The symptoms vary significantly between men and women. In women, there may be minimal symptoms with a mild attack, and this allows prostitutes and others to transmit the disease from one man to another without being aware that they are themselves a carrier. When symptoms do occur, they include a foul discharge from the vagina, pain on passing urine, pain in the lower abdomen, passing urine frequently, tender glands in the groin, and fever.
Whether symptoms are present or not, the infection can move further into the body, and involve the womb (uterus) and Fallopian tubes. In these situations gonorrhoea may cause salpingitis and pelvic inflammatory disease which can have infertility and persistent pelvic pain as complications.
In men, the symptoms are usually obvious, with a yellow milky discharge from the penis, pain on passing urine and, in advanced cases, inflamed glands in the groin. If left untreated, the prostate can become infected, which can cause scarring of the urine tube (urethra), permanent difficulty in passing urine and reduced fertility.
Through anal intercourse, a rectal infection with gonorrhoea can develop. An anal discharge, mild diarrhoea, rectal discomfort and pain on passing faeces are the common symptoms. Oral sex can lead to the development of a gonococcal throat infection.
The disease can be confirmed by examining a swab from the urethra, vagina or anus under a microscope and culturing the bacteria on a nutrient substance. There are no blood tests available to detect gonorrhoea. Other sexually transmitted diseases should also be tested for when gonorrhoea is diagnosed, as they may be contracted at the same time. For this reason, blood tests are often ordered by doctors when treating anyone with any form of venereal disease.
A couple of decades ago, gonorrhoea was readily treated with a course of penicillin. Unfortunately, many strains of gonorrhoea are now resistant to penicillin, and more potent antibiotics are required to effect a cure. The antibiotics can be given by mouth or injection, and in some cases a single dose is all that is required. All contacts of the infected person need to be notified, as they may be carriers of the disease and unaware of the presence of the infection.
Some degree of protection from catching gonorrhoea can be obtained by using a condom, but this is not a total protection and has a failure rate of 5% to 10%.
There are a number of other less common complications of gonorrhoea. Babies born to mothers with the infection can develop a gonococcal conjunctivitis (eye infection), which can be treated by eye drops and/or antibiotic injections. The gonorrhoea may also enter the bloodstream and cause a form of septicaemia, which causes fevers and skin sores. The most unusual complication is gonococcal arthritis, which causes pain in the knees, ankles and wrists. This must be treated with both antibiotics and the normal anti-arthritis medications, but if joint damage has occurred, the arthritis may be long-lasting.
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