Gonorrhoea, often called the 'clap', is a sexually transmitted infection (STI) caused by a bacteria and spread directly by person to person contact. It is one of the commonest STIs and usually affects sexually active people between the ages of 16 and 25. It can occur in the vagina, penis, throat and rectum.
What Causes Gonorrhoea?
The infecting organism concerned is given the medical name Neisseria gonorrhoeae , and usually has an incubation period (the time between having sex and experiencing the first symptoms of gonorrhoea) of 2 days but may be as long as 10 days in some cases. Unfortunately, up to half of all people infected with gonorrhoea have no symptoms and so are not aware they are infected. Men are more likely to be aware of symptoms than women.
What Are The Signs And Symptoms Of Gonorrhoea?
In men, urination becomes painful and more frequent. There may be a creamy or greenish pus-like discharge from the penis, with irritation around the penis opening (the urethra) or a dull pain in the testicles which may also swell in size. People who engage in anal sex may notice anal irritation, soreness, rectal bleeding or an anal discharge.
Many women are symptom-free. In those who do have symptoms, there is usually painful urination, a creamy or coloured vaginal discharge, low abdominal pain and pain on intercourse.
It is very important to test for infection with gonorrhoea because of the risk of the disease spreading in an infected person with no symptoms. An accurate test is essential to allow for the accurate treatment to be given, as gonorrhoea is readily treatable. STD clinics are open to anyone at most NHS hospitals, and are usually now called GUM clinics, or genito-urinary medicine clinics.
Your doctor will have details of these in your area, or you can obtain their telephone number from the phone book. Most test results are available within 48 hours, and other tests can be carried out at the same time such as for syphilis or HIV. Simple swab tests are painless and easily taken at these clinics and it is important to remember they have strict codes of confidentiality.
What Treatment Might I Need?
Treatment is surprisingly simple, with a single large dose of penicillin being all that is needed in most cases. This can be as an injection, or tablet and other antibiotics can be used if there is a penicillin allergy. Since syphilis is sometimes caught at the same time as gonorrhoea, an follow-up check is recommended to make sure that all the symptoms have gone, and no new ones have appeared. Sex should be abstained from until it is confirmed there is no infection present, usually about three weeks. The sexual contacts of infected people should be treated and tested as a matter of routine. This prevents silent carriers' of the disease continuing to spread it through the community.
What Course Will The Illness Follow?
Following treatment, symptoms will begin to settle within 24 hours and when treated early there are no long-term complications of gonorrhoea. It is only when it remains untreated that complications can occur.
In men, the main complication is of inflammation of the testicles, leading to infertility problems. This is known as epididymitis. In women the main risk is of developing pelvic inflammatory disease (PID), an ascending infection which spreads from the vagina to the uterus and fallopian tubes, and is the major cause of infertility in the UK. There is also the higher risk of ectopic pregnancies - pregnancies outside the womb, as well as abscesses. Pregnant mothers who unknowingly are infected with gonorrhoea cannot pass it on to their baby in the womb, but may infect it during childbirth. This causes an eye infection in the baby, but is easily cured with simple penicillin treatment.
Can I Do Anything To Help Myself?
The only certain way to prevent gonococcal infection is not to have sex, or only have sex with someone who is known to be free of infection. If you are sexually active, the following tips are always sensible;
• Use condoms for vaginal, oral and anal intercourse.
• Limit your number of sexual partners, since the risk of acquiring an STD increases with the number of sexual contacts you have.
• Remember that alcohol and other 'recreational' drugs may cloud your judgment and increase your risk of exposure to STDs including gonorrhoea.
• Always wash your hands thoroughly during any treatment for gonorrhoea.
• If you are infected, use your own towels and flannel while you are being treated.
Tell Your Doctor
1. When did your symptoms start?
2. Have you recently formed a new sexual relationship?
3. Have you had similar symptoms before?
4. Have you had any unsafe sex recently, either heterosexual or homosexual?
5. Are you allergic to penicillin?
Ask Your Doctor
1. When was I likely to have caught gonorrhoea?
2. Who will tell all my sexual contacts, (or my partner)?
3. How frequently will I need follow-up checks?
4. How will I tell I am cured?
5. Will I always need to use barrier methods of contraception?
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