Gonorrhea (male, female): see what it is and how to treat

Gonorrhea is a very common sexually transmitted disease or infection. The causative bacteria affect the urogenital tract of men and women, but the manifestation is quite different between each sex. In women, for example, the condition is asymptomatic in most cases

What is gonorrhea?

Gonorrhea is one of the most common sexually transmitted diseases or infections (STD / STI) among men and women. It is caused by the bacterium Neisseria gonorrhoeae , which is also known as Gonococo .

One of the easiest ways to contract the infection is through sexual intercourse without using condoms, either through penetration or through oral sex.

The bacterium usually develops in several places on the body, among them, the rectum, the urogenital apparatus, the trachea and the eyes.

Once it is present in the body, it is possible that the patient has some characteristic symptoms of the problem.

Even with a steady partner, it is important to stay informed about the disease and never fail to undergo routine tests.

Gonorrhea can be found in ICD 10 (International Classification of Diseases) by code A54 and in ICD 11 by code 1A7Z.

Causes

Gonorrhea is caused by a bacterium called Neisseria gonorrhoeae, also known by the name Gonococo. This bacterium proliferates mainly in hot and humid environments.

Therefore, its growth is easier especially in the rectum, urogenital trachea, trachea and eyes.

It is when it affects these systems that it begins to cause symptoms.

Transmission: how does contagion occur?

Contrary to what many people imagine, gonorrhea is not only transmitted through ejaculation. In fact, it can be transmitted by oral, vaginal or anal intercourse without using a condom.

Even in contact with the bacteria, there are chances of gonorrhea not developing. But the risks are high, as they range from 50% to 70% of being infected.

When the couple has more than one unprotected relationship, the risk of contracting the infection increases to more than 90% depending on the exposure of the sexual organ to the bacteria.

If the condom tears, it is very important that the tests are done as soon as possible and, if necessary, treatment is carried out.

There is also the possibility of vertical transmission, that is, from the pregnant woman to the baby, and, very rarely, it is possible to contract gonorrhea through contact with contaminated surfaces.

Risk factors

There are some factors that increase the risk of getting gonorrhea. The main one is not to use a condom during sexual intercourse, however, factors such as age, social exclusion and drug abuse are also related to an increased risk of infection.

This is because younger people who suffer from social exclusion (such as LGBT + groups), may have less access to information and contraceptive methods, which makes them more likely to be infected by the bacteria.

Likewise, people who abuse substances, such as alcohol and other drugs, have their judgment changed during the effect of the substance and are more likely to be exposed to risky situations.

What are the symptoms of gonorrhea?

Many people do not experience any symptoms when they contract gonorrhea.

This represents a huge problem, both for the individual, who may not receive adequate treatment and have his condition aggravated, and for public health, since, without showing the symptoms, the person can have unprotected sex and spread the disease .

For this reason, routine examinations are very important, especially when there has been unprotected sex.

With regard to the symptoms themselves, they vary according to the patient’s gender, that is, they are some in women and others in men. Understand the difference:

Female Gonorrhea (in women)

Approximately, only 50% of women affected by the disease usually have symptoms. When gonorrhea reaches the female audience, it is common for it to attack the cervix, which usually happens silently.

Despite this, it is possible that the disease causes blood leaks, which occur a few days after contact with the bacteria.

The appearance of vaginal discharge can help in the clinical diagnosis, since the problem is often confused with cases of cystitis , when bacteria infect the urinary tract. This symptom is a differential when it comes to identifying this STD.

With that, we can say that the main symptoms of gonorrhea in women are:

  • Itching in the private parts;
  • Dysuria (burning or pain when urinating);
  • Pain during sex;
  • Yellow or whitish vaginal discharge, very similar to pus;
  • Escape of vaginal blood.

Male gonorrhea (in men)

Symptoms of gonorrhea usually appear in men 5 or 30 days after infection. In the case of men, it is more common that approximately 90% of patients have symptoms. Are they:

  • Dysuria (burning or pain when urinating);
  • Whitish or yellowish urethral discharge;
  • Painful bowel movements;
  • Itch;
  • Skin rashes;
  • Hemorrhages.

It is not uncommon to have an infection of the epididymis (a small duct above the testicles that stores sperm), which causes a strong sensation of pain and swelling in the scrotum.

On the other hand, patients rarely complain of swelling or discomfort in the testicles, anal discharge or swelling in the urethra.

Gonorrhea in newborns

When it affects newborns, gonorrhea causes symptoms similar to conjunctivitis , that is, red eyes accompanied by swollen eyelids.

Symptoms usually appear 4 days after delivery and, if left untreated, can lead to blindness or cause a more severe manifestation of symptoms, which is characterized by bloodstream infection ( sepsis ) and meningitis .

Other symptoms of gonorrhea

Gonorrhea does not affect only the genitals. In fact, it can affect the anus, eyes, throat and joints. Understand the symptoms for each of these cases:

Eyes

If gonorrhea affects the eyes, the patient may have:

  • Sensitivity to light;
  • Pus secretion;
  • Pain in the eyes.

Anus

When it reaches the anus, gonorrhea can cause symptoms, such as:

  • Itch;
  • Pus secretion;
  • Bleeding.

Throat

Gonorrhea may also affect the throat. When this happens, the symptoms are:

  • Pain at the site;
  • Difficulty swallowing;
  • Emergence of yellow plaques in the throat.

Joints

Finally, it may be that gonorrhea causes an infection in the joints, leading to the following symptoms:

  • Swelling;
  • Redness;
  • Strong pain;
  • Inflammation.

How diagnosis is made in asymptomatic cases

For most diseases, tests are requested when there is evidence or suspicion. This usually occurs when there are symptoms. However, many cases of gonorrhea, predominantly in women, are asymptomatic.

In this case, there is usually a delay in diagnosis and underreporting of the infection. Therefore, there is an intense work with health professionals, especially gynecologists, to maintain a routine of early detection tests.

Physical assessment (in men and women), provision of information, awareness of the disease and knowledge of the specificities of gonorrhea and other STDs / STIs is essential for effective action.

Diagnosis: which test to detect gonorrhea?

First, the doctor will do a physical examination, as the routine ones, to raise the suspicion. In it, he will observe the symptoms and analyze his history to see whether or not there is a need to order tests.

This is because the diagnosis of gonorrhea is only confirmed when gonococci are detected in the body via microscopic examination, which uses the Gram stain technique, culture or NAAT of genital fluids, blood or joint fluids.

The doctor who usually orders these tests is the urologist or gynecologist. Understand a little more about each of them:

Gram stain

This examination is done through the analysis of urethral secretion samples. To collect the sample, the technician will use the swab , a small “cotton swab” used to collect materials, inserting it into the urethra (in the case of men) or in the endocervical canal (in the case of women).

It is a slightly invasive and painless examination, although it is common for it to cause some discomfort to patients.

After collecting the samples, with the help of a microscope, the laboratories will check for the presence or absence of gonococci, thus attesting or ruling out a diagnosis of gonorrhea.

Culture

The culture seeks to make gonococci multiply in a controlled environment, attesting to the diagnosis of gonorrhea through the analysis of urethral secretions.

NAAT

NAAT, or Nucleic Acid Amplification Tests, aim to simultaneously detect gonorrhea and chlamydia infections, differentiating them in subsequent specific tests.

The collection process is the same as the Gram stain, in which the swab is introduced into the urethra or endocervical canal.

There are some preparations that must be taken by men and women before taking the exam. Check out:

Men

It is important that men do not have sex for at least 3 days before the exam. It is also indicated that they do not urinate for at least 1 hour before the exam.

Women

Women, on the other hand, must not be menstruating, must not have used any type of shower or vaginal cream for at least 1 week before the exam and, like men, neither can they have sex for at least , 3 days.

Is there a cure?

YEAH ! Gonorrhea is curable and it usually occurs through specific antibiotics , which are used orally or injectable and which are indicated according to individual assessment.

With proper treatment and followed to the letter by the patient, the bacteria is usually eliminated within a few days or weeks.

However, if the patient is not treated correctly, that is, not taking antibiotics for the time stipulated by the doctor and not taking the treatment seriously, using alcoholic beverages, for example, he is at risk of developing supergonorrhea (version antibiotic-resistant disease).

What is the treatment?

The treatment of gonorrhea is performed through the prescription of specific antibiotics, indicated according to each patient’s condition.

They can be ingested through the oral route or by injection. Within a few days or weeks the bacterium is usually eliminated, as long as the patient strictly adheres to medical recommendations.

In the event that gonorrhea is diagnosed in newborns, doctors are usually aware of this situation before delivery and apply a remedy to the baby’s eyes shortly after birth.

Gonorrhea may affect the baby’s eyes, which can damage your retina during the construction phase in the form of conjunctivitis. If not treated properly, this infection can even lead to blindness.

When the disease persists, the use of antibiotics may be necessary.

If you have been diagnosed with gonorrhea, be sure to get tested for other sexually transmitted infections, such as chlamydia, syphilis , hepatitis B and HIV . Each of them has its own symptoms and complications, and it is necessary to treat each one individually.

As there are high rates of chlamydia-associated gonorrhea infection, both the CDC (Center for Disease Control and Prevention in the USA) and countries in Europe and Canada recommend that treatment be done with two different drugs, each with its mechanism of action, always aiming to treat both infections.

Also in 1999, the treatment protocol guided the use of a range of antibiotics, for example, Ofloxacin , cefixime, Ciprofloxacin hydrochloride , ceftriaxone, Tianfenicol . In 2006, there was a reformulation of the protocol, which changed the orientation and, in 2015, a new reformulation.

Medicines: what is the best remedy for gonorrhea?

The drugs commonly used to treat gonorrhea are:

The treatment for gonorrhea has already undergone several changes of indication. Today, the therapeutic protocol adopted by the Ministry of Health, in conjunction with studies worldwide, guides the use of a single dose of Ceftriaxone 250mg and Azithromycin 1g.

Dual treatment is indicated due to the high possibility of co-infection with chlamydia. Thus, the scope of therapy is greater.

According to the guidelines of the updated Clinical Protocol and Therapeutic Guidelines, in 2016, treatment consists of:

  • NOT complicated gonococcal infection (urethra, cervix, rectum and pharynx): Ceftriaxone 500mg, IM, single dose + Azithromycin 500mg, 2 tablets, VO, single dose;
  • Disseminated gonococcal infection : Ceftriaxone 1g IM or IV daily, completing at least 7 days of treatment + Azithromycin 500mg, 2 tablets, VO, single dose;
  • Gonococcal conjunctivitis in adults : Ceftriaxone 1g, IM, single dose;

Chlamydia infection : Azithromycin 500mg, 2 tablets, VO, single dose OR Doxycycline 100mg, VO, 2x / day, for 7 days (except pregnant women).

Attention!

NEVER  self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

What is supergonorrhea?

Supergonorrhea is the name given to a variety of the bacteria that causes antibiotic-resistant gonorrhea. It is suspected that its origin has to do with the appearance of other superbugs.

Superbacteria, which are characterized by being more resistant to drugs, appear when patients do not get the treatment indicated by the doctor correctly.

If the body suffers a bacterial infection, these microorganisms spread throughout the body and reproduce at a very fast rate. By taking antibiotics, we seek to kill these bacteria.

The problem occurs when antibiotics are not taken correctly, that is, when the patient does not follow the medical recommendation and stops taking the medication as soon as the most uncomfortable symptoms disappear, for example. Then thousands of bacteria that would die if the treatment was continued until the end stay alive and reproduce.

This makes the disease more difficult to treat and the effect is cumulative.

If the patient, once again, does not take the medications in the right way, he will leave alive only the bacteria that are more resistant to the medication administered, which this time is stronger.

This can be described as a kind of accidental “artificial selection”. Paralleling Darwin’s theory, the environment (our body and the action of antibiotics) ends up selecting (leaving alive) only those that are more adapted (antibiotic-resistant bacteria, called superbugs).

As the superbugs reproduce very quickly, the infection progresses at an accelerated rate, making conventional treatment no longer possible, which can lead the patient to serious complications of the disease more easily.

Metronidazole is for gonorrhea?

No. Metronidazole is a medication used to treat infections such as trichomoniasis , vaginitis, giardiasis , amoebiasis . In addition, infections caused by agents such as Bacteroides fragilis and others, are also effectively combated. However, the medication is not part of those used to treat gonorrhea.

Is Gonorrhea Like Chlamydia? What’s the difference?

Both chlamydia and gonorrhea are sexually transmitted diseases or infections caused by bacteria. Both can manifest quite similar symptoms, however, each is caused by different agents.

It is part of the treatment protocol to use drugs to treat both conditions, as soon as the chances of double infection (by gonorrhea and chlamydia) are high.

Living together

Living with gonorrhea does not usually cause major changes in everyday life, nor does it cause pain, except in cases where it has spread and brought more serious complications.

In addition to the use of medications and medical follow-up, it is essential that the infected person talk to his partner, reporting on the infection. If there is a fixed relationship, it is necessary that the other person is also medicated.

As for sex, it is recommended that the infected person does not have sex during the treatment stipulated by the doctor, as there is a risk of contamination of the condom itself.

After the treatment is carried out, it is still necessary that sexual intercourse always be done with the use of condoms for at least 6 months, as the inflammations and bruises caused by the disease may take time to achieve complete healing, which increases the risk of contracting other diseases. infections, such as candidiasis .

Read more: Medicine to treat penile candidiasis

Prognosis

The prognosis of gonorrhea is usually good. With the exception of cases of supergonorrhea, adequate medical treatment is able to eliminate the bacteria from the human body with some tranquility.

However, if the patient does not get the treatment right, complications as serious as a supergonorrhea infection can happen.

Complications

If left untreated, in addition to causing a condition of supergonorrhea, the infection can bring serious complications, such as:

Meningitis

Meningitis is an inflammation of the meninges, which are the membranes that surround our central nervous system, in the brain. It causes symptoms such as high fever , headache , stiff neck, nausea, vomiting, mental confusion and seizures .

Osteomyelitis

The osteomyelitis is a bone infection that usually affects long bones such as the legs and arms. It can cause symptoms such as pain, redness, swelling and abscesses.

Endocarditis

It is an inflammation in the internal structures of the heart. It causes symptoms such as tiredness , pallor, persistent cough , heart murmur , pain in the muscles and joints, blood in the urine, loss of appetite and others.

If not treated properly, you can have complications such as heart attack , heart failure, infection in other parts of the body, such as the brain, kidneys and liver, as well as pulmonary embolism , stroke and glomerulonephritis (inflammation in the kidney region).

Hepatitis

Hepatitis is an inflammation in the liver that can be caused by bacterial or viral infections. It can manifest symptoms such as fever, headache, nausea, vomiting, lack of appetite, weakness, constant cough and pain in the muscles and joints.

Epididymitis

Epididymitis is the inflammation of the epididymis, a channel between the testis and the vas deferens (the channel that conducts sperm). It causes symptoms like swelling of the scrotum and pain. If not treated properly, the disease can progress and cause infertility.

Infectious arthritis

It is an infection in the fluid and tissues of a joint. It causes symptoms such as pain in the joint area, swelling, redness, in addition to high fever and signs of tiredness and malaise.

Problems in pregnancy

Gonorrhea can cause problems in pregnancy such as premature birth and infection of the newborn. In addition, it can cause ectopic pregnancy , which is when it happens outside the uterus.

Normally, the egg is lodged in the fallopian tubes, so that the pregnancy cannot be continued, as it poses very great risks to the woman.

Pelvic Inflammatory Disease (PID)

PID is an infection that occurs in the vagina and progresses to affect the uterus, also spreading to the tubes and ovaries, taking care of the pelvic area and possibly the abdomen.

It can cause symptoms such as high fever, pain in the belly, vaginal bleeding after intercourse, yellow or greenish discharge with a bad smell and pain during sex.

By spreading through the reproductive system, it can cause serious damage to that area, increasing the risks of ectopic pregnancy, problems during pregnancy and even evolving to conditions that cause infertility.

Read more: Yellow discharge: what can it be?

Increased risk of contracting HIV and other STDs

Gonorrhea, like any other STD, increases the risk of contamination by other diseases, such as HIV, syphilis and all others. This is because, as a rule, STDs cause inflammation and sores on Organs genitals, which leaves the patient much more exposed and susceptible to other infections.

Infertility

If not treated properly, gonorrhea can develop into severe inflammation, which increases the possibility of irreversible damage that often leads to infertility.

How to prevent gonorrhea?

The main way to prevent gonorrhea is through the use of condoms during sex (vaginal, oral and anal).

Even in a fixed relationship, it is important to keep the routine exams up to date so that the eventual identification of the bacteria occurs, as the infection can be asymptomatic. Maintaining a routine of exams helps to take care of your health as a whole.

It is also necessary that actions are taken in order to inform the population about the dangers of STIs, since it is estimated that, in Brazil alone, there are more than 1.5 million people infected with this STI.

If your partner has been diagnosed with gonorrhea it is very important that you get tested and, when it is found that you are not infected, that you avoid sexual contact until the other person is cured.

In general, it is recommended that people do detection tests routinely. Some groups are at risk and, therefore, should pay more attention to screening. For example, people who are sexually active, have multiple partners or have had a history of STD / STI.

Pregnant women are evaluated at the beginning and end of pregnancy, as part of prenatal care.

Common questions

Can gonorrhea be transmitted even when using a condom?

It depends . It is very difficult for a person to be infected with gonorrhea if they have sex with condoms. However, although it is very rare, it can happen that the partner is infected and contaminates the condom at the time of placement.

Is it possible to contract gonorrhea without having sex?

YEAH ! Gonorrhea is transmitted mainly through sexual contact, however, it can be transmitted through contact with contaminated surfaces as well.

What can’t you eat when you have gonorrhea?

Although food plays an important role in maintaining the body, it does not directly interfere in the cure of gonorrhea. Thus, there are no foods, exercises, herbs or other therapies that can accelerate healing or replace antibiotics.

However, an option that may be viable is to combine good nutrition, rich in nutrients and natural products, so that well-being is favored. This is because the diet also has an important bearing on mental health .

Which antibiotic for Gonorrhea?

The correct use of the antibiotic is essential so that there are no risks arising from the treatment, such as the resistance of the bacteria to the drugs. In general, there is a preference for single-dose antibiotics. Among the most used, is azithromycin. However, the choice and time of use should be guided by health professionals.

Is it possible to get gonorrhea through contact with sharp objects?

No . Gonorrhea is transmitted mainly (but not exclusively) through sexual contact, but it does not happen, as in the case of HIV, through contaminated blood.

How long does it take to cure gonorrhea?

The time depends a lot on the severity of the symptoms, but it can take 7 to 14 days. However, the recommendation is not to have sex during treatment even with the use of condoms.

Still, it is also necessary for the condom to be used in all relationships for at least 6 months after healing, as the inflammations may not have healed completely, leaving the patient more susceptible to other STIs.

After taking the medication, is gonorrhea still transmitted?

It depends . On average, after 2 or 3 days of treatment there is no more infection, but the best thing to do is to wait for the treatment to finish.

After the finished treatment, which lasts 7 to 14 days, the bacteria is completely eliminated from the body, so the transmission no longer occurs. However, as stated earlier, it is necessary to continue using condoms, as other infections, such as candidiasis, can occur.

Can I get gonorrhea more than once?

YEAH ! Once cured, if you have sex without a condom with an infected person, contamination can occur again.


Gonorrhea may be taboo, but it need not be. If you have been infected, seek treatment and talk to your partners, suggesting that they get tested. That way, you will not only be treating your infection, but you will be preventing it from spreading to other people.

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