An expert guide to playing safe

Gonorrhea, or “The Clap,” is an ancient and common bacterial sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae.

The origin of the term “the clap” is shrouded in mystery, but most likely comes from a French term for brothels “les clapiers. ”

Gonorrhea thrives in warm, moist areas of the body such as the cervix, uterus, fallopian tubes, and penis. Gonorrhea also grows in the urethra, mouth, throat, eyes, and anus. Although easy to treat with antibiotics, it often goes undiagnosed. Untreated infections can lead to serious medical consequences.

Gonorrhea is a major cause of male and female infertility, ectopic pregnancy, and pelvic pain. Gonorrhea can spread through the bloodstream to infect the joints. It can progress to the fallopian tubes causing pelvic inflammatory disease (PID). Gonorrhea infections facilitate the transmission of HIV infection.

How common is gonorrhea?

Cases of gonorrhea are on the rise worldwide, with over 75 million cases estimated worldwide each year. The incidence is highest in young, sexually active men and women ages 15–24. Recent data shows an increase in cases among MSM (men who have sex with men), but this may be the result of improvements in awareness and screening.

What are the symptoms of gonorrhea?

Gonorrhea often causes no symptoms and is only discovered during routine STD testing. The asymptomatic nature of this bacteria allows it to remain undetected and spread from person to person. Symptoms may appear as early as 2–5 days after exposure.

Male symptoms include burning during urination, irritation around the opening of the penis, or penile discharge. If the infection spreads, it can cause epididymitis as the bacteria infects the tubes surrounding the testicles or prostatitis if it reaches the prostate.

Female symptoms include vaginal discharge, vaginal odor, burning with urination, and irregular vaginal bleeding. Gonorrhea may spread from the cervix up to the surrounding organs causing PID (pelvic inflammatory disease). Symptoms include lower abdominal pain, low back pain, nausea, fever, pain during intercourse, or irregular vaginal bleeding.

Rectal infections may cause anal discharge, anal itching, rectal soreness, anal bleeding, or painful bowel movements. Throat infections typically have no symptoms. The bacteria can spread through the bloodstream to the joints, causing a potentially life-threatening condition called gonococcal arthritis.

How is gonorrhea transmitted?

Some STDs are transmitted from skin to skin contact. Others are passed via fluid transmission. Gonorrhea is transmitted when bodily fluids from the penis, vagina, anus, or mouth are shared from one to another. This includes vaginal, anal, or oral sex. Gonorrhea can be passed during any sexual act where bodily fluids are passed from one person to another. It is not spread through kissing, toilet seats, swimming pools, bathtubs, shared clothing, or any other casual contact.

How is gonorrhea diagnosed?

To diagnose gonorrhea, a lab specimen is obtained from the cervix, anus, throat, penis, or urine. Results are usually available within 1–2 days. A physical exam is not reliable to diagnose this infection.

How is gonorrhea treated?

Gonorrhea is a curable STD. An antibiotic injection called Ceftriaxone plus oral Azithromycin is the current CDC recommended treatment. All sex partners should be notified, evaluated, tested, and treated. If not, then one may be reinfected by an untreated partner or the infection spread to future partners. Multi-drug resistant strains of gonorrhea are on the rise. Treatment compliance is imperative to prevent the spread of antibiotic-resistant strains.

One should abstain from unprotected sexual contact until they and their sex partners have completed their treatment. I recommend asking for a follow-up test to confirm treatment success (a test of cure).

Gonorrhea can cause complications during pregnancy

During pregnancy, untreated gonorrhea can lead to preterm labor, preterm rupture of membranes (water breaking), and premature delivery. Pregnant women may pass gonorrhea infections to their babies during birth leading to eye and lung infections. Antibiotics are given to babies in the US to protect their eyes.

Play it safe — Prevention is key

Prevention is best achieved by abstinence from sexual activity or to be in a long-term, mutually monogamous relationship. The use of latex condoms consistently and correctly can reduce the risk of transmission.

Condoms are highly effective in preventing fluid transmitted STDs. Water-based lubricants should be used with latex condoms to provide the most protection.

The CDC recommends annual screening for all sexually active individuals younger than 26. Men and women with risk factors, including a new sex partner or multiple sex partners, should undergo testing. All pregnant women should undergo testing for gonorrhea. Women and men with new partners should be tested for all sexually transmitted diseases.

If you are going to play, then play safe.

 

Blog Author: Dr. Jeff Livingston