Gonorrhea

Overview: What is gonorrhea?

The term “gonorrhea” comes from the Low German “drippen”, which means “to drip”. The origin of the word already shows how the venereal disease often manifests itself: gonorrhea is noticeable, among other things, through discharge, which can also be quite inconspicuous or even absent.

The sexually transmitted disease is initially harmless, but can have far-reaching consequences if left untreated. In the worst case, it can lead to infertility. This is particularly worth considering because most of those affected are between 15 and 25 years old and family planning is often not yet complete.

Gonorrhea can usually be treated well with antibiotics. So seek medical advice if you suspect you are infected with the sexually transmitted disease.

Gonorrhea: causes and risk factors

The so-called gonococci, also known as Neisseria gonorrhoeae, are the cause of the disease. They only occur in humans. Outside the body, they are exposed to cold and oxygen and thus to an environment in which they are unable to survive.

The germs settle on the mucous membranes, especially in the urinary and genital organs. During unprotected vaginal, anal or oral sex, the pathogens can spread and infect the partner. People who frequently change their partner are particularly at increased risk of gonorrhea. Infection is not possible via the toilet or other infection routes.

If a pregnant woman contracts gonorrhea, the bacteria are transmitted to the baby during birth. However, the child does not then develop a sexually transmitted disease, but the gonococci settle in the conjunctiva of the eyes, which can lead to a purulent inflammation. However, gonorrhea is rare in pregnant women and is often detected during prenatal examinations.

Symptoms: Discharge and pain when urinating

As the bacteria colonize the reproductive organs, this is where the typical symptoms occur. However, the severity of the symptoms differs between men and women. Symptoms usually appear two to five days after infection. In rare cases, it can take just one day or up to two weeks before gonorrhea becomes noticeable.

Types of symptoms

Symptoms in women

In women, the cervix and the connecting canal between the vagina and the uterine cavity are often affected by gonorrhea. Sometimes gonorrhea in women causes no symptoms at all or only very mild symptoms that those affected hardly notice. In fact, around half of women do not experience any clear symptoms. What initially sounds positive often has negative consequences: If the patient has no symptoms, they usually do not start treatment. The bacteria therefore continue to multiply and the gonorrhea becomes chronic. In addition, the woman can later infect her sexual partners.

The first signs are, for example

• Watery discharge from the vagina. Usually in combination with urethritis.
• Pain when urinating.
• Cycle disorders are possible if the uterine lining is infected with gonococci.
• Intermenstrual bleeding or significantly longer periods than usual

In rare cases, the bacteria can migrate further through the body from there. If they do, additional symptoms may occur, such as pelvic inflammatory disease and inflammation of the fallopian tubes. The latter can promote ectopic pregnancies. Another symptom can be chronic abdominal pain.

Symptoms in men

Around 75 percent of affected men develop typical symptoms. Complaints therefore occur more frequently than in women. The symptoms are often more pronounced in men than in women. The first signs are, for example

• Burning sensation when urinating
• Redness and swelling of the urethral orifice
• first watery, then mucous discharge

Symptoms after two to three weeks, when the gonorrhea has spread in the man’s body:

• Pain in the perineum and bladder
• Redness, swelling and tenderness of the epididymis
• General feeling of illness
• Fever

Early diagnosis is therefore advisable in any case and it is important to treat gonorrhea at an early stage. A progressive gonorrhea infection can lead to infertility in both men and women, which should be avoided.

Diagnosis gonorrhea

If you suspect that you have gonorrhea, have a medical examination. The diagnosis is simple: we take swabs of the affected areas, for example the cervix or urethra, and analyze them. In some cases, we also look at the smear preparation under the microscope, for example in men with typical gonorrhea symptoms.

To be sure that gonorrhea is really present, it is often necessary to stimulate the bacteria to grow and to grow a culture. Bacterial cultures are also useful for testing germs for possible antibiotic resistance. Men can also give a urine sample to detect gonorrhea. We will be happy to explain to you in a personal consultation which diagnostic procedure will be used in your case.

Gonorrhea: prevention, early detection, prognosis

As gonorrhea is mainly transmitted during sexual intercourse, the use of condoms is advisable. This is especially true for people with frequently changing partners, as the risk of infection is particularly high for them. People in long-term partnerships are less likely to contract gonorrhea.

The condom not only protects against gonorrhea, but also against unwanted pregnancies, HIV, hepatitis B, syphilis and HPV infection. HPV is a risk factor for cervical cancer. Because of all these advantages, the condom is the most commonly used contraceptive.

However, condoms only offer sufficient protection if they are used correctly. When opening the packaging, they should not come into contact with scissors or sharp fingernails. In addition, they should not be used more than once. Also pay attention to the best-before date.

There is currently no vaccine against gonorrhea. Condoms are the only preventive measure. However, it should be mentioned that gonococci can also be transmitted during oral sex.

Course and prognosis (gonorrhea)

Those who recognize symptoms early and have gonorrhea treated professionally usually have a good prognosis. Gonorrhea usually heals without consequences. However, those affected may become infected again at a later date. A single infection does not guarantee lifelong immunity as with other infectious diseases. Preventive measures are therefore also important for earlier infections.

If treatment is not received, serious complications such as infertility can occur. Both men and women may not be able to have children later on.

If gonorrhea spreads in the body, further complications may occur. However, this is rarely the case.

The following are possible:

• Skin inflammation with pustules
• Conjunctivitis: Typical symptoms are red, burning eyes, itching, photophobia, increased lacrimation, swelling, adhesions and a feeling of pressure in the eye.
• Endocarditis: Possible symptoms include fever, chills, loss of appetite and sweating.
• Joint inflammation

Conjunctivitis can also occur in babies whose mother has gonorrhea. It can lead to corneal ulcers, which in the worst case can cause the child to go blind. Infection of the child can be prevented by Credé prophylaxis. If necessary, the baby is given eye drops with antibiotics to kill the pathogens.

Gonorrhea: treatment with antibiotics

The only treatment option is the administration of antibiotics. The standard therapy is an injection with ceftriaxone and azithromycin, which the patient must swallow. As a rule, a single treatment is sufficient to eliminate the bacteria. Those affected should refrain from sexual intercourse during treatment.

Some also suffer from a chlamydia infection, another common sexually transmitted disease. In this case, other bacteria have taken up residence in the urinary tract or genital organs, where they cause symptoms similar to those of gonorrhea. They are also treated with antibiotics.

If you have been diagnosed with gonorrhea, your partner should also be examined. On the one hand, there is a high probability that he or she is also infected. On the other hand, treatment ensures that you do not become infected again.

Gonorrhea treatment in the future

There are now gonococci that are resistant to antibiotics. This poses a challenge for the experts. Once bacteria have developed resistance, they pass it on, so it is to be expected that more difficult-to-treat cases will occur in the future. There are already active substances that used to help against gonorrhea but have now lost their effectiveness. Occasionally, there have even been cases in which not a single available antibiotic helped. As antibiotic resistance continues to increase, the need for new drugs is likely to rise.

At present, however, many patients can be treated well with the antibiotics available. We can test for resistance to a particular active substance before treatment and react accordingly if necessary. It is best to contact us for advice on this topic.