What Is Gonorrhea?

What Is Gonorrhea?

Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. It can be transmitted during vaginal, anal or oral sexual contact. Depending on the site of contact, the bacterium can affect the genital area, urethra, rectum or throat. The infection can pass from mother to baby during childbirth, particularly causing eye infections in newborns. 

Gonorrhea can occur at any age. The infection may cause no symptoms, particularly in women and in throat or rectal infections. Having no symptoms does not mean that the infection is absent or cannot be transmitted. 

What are the symptoms of gonorrhea?

Symptoms vary depending on the site of infection, and some people have no symptoms at all. If symptoms develop, they may begin in the days following sexual contact; they do not necessarily appear within the same timeframe for everyone.

Possible symptoms in women include:

1. Increased or changed vaginal discharge
2. Burning when urinating
3. Bleeding between periods or after sexual intercourse
4. Lower abdominal or pelvic pain
5. Pain, discharge or bleeding with a rectal infection

Possible symptoms in men include:

1. Discharge from the penis
2. Burning or pain when urinating
3. Testicular pain or tenderness
4. Pain, discharge or bleeding with a rectal infection

Throat infections often cause no symptoms; a sore throat may sometimes occur. Eye infections may cause pain, sensitivity to light and heavy discharge. Rarely, the infection can spread to the bloodstream, causing fever, joint pain or skin rashes. 

What can happen if it is left untreated?

Untreated gonorrhea can lead to pelvic inflammatory disease (PID), damage to the fallopian tubes, an increased risk of ectopic pregnancy or infertility in women. Men may develop inflammation of the epididymis. Rarely, the infection can spread to the bloodstream and affect the joints or other organs. During pregnancy, there is a risk of transmission to the baby at childbirth. 

How is gonorrhea testing performed?

The most commonly used diagnostic method is the NAAT/PCR test, which detects the bacterium's genetic material. Samples should be collected from the site of contact where the infection may be present, rather than testing only urine or genital samples:

• A first-catch urine sample or genital swab for genital infection
• A rectal swab if there has been anal contact or there are rectal symptoms
• A throat swab if there has been oral contact or a throat infection is suspected

A urine test does not rule out a throat or rectal infection. The sample type for testing should therefore be determined with a physician based on sexual contact history and symptoms. PCR does not determine antibiotic susceptibility; culture and antibiotic susceptibility testing may be needed if treatment fails or resistance is suspected. 

At Wellcare Laboratories, gonorrhea testing is available as part of the STI PCR panel. You can find information about the panel contents and suitable sample types on our STI PCR panel page.

People diagnosed with gonorrhea are advised to discuss with a physician whether testing is needed for possible coexisting infections such as chlamydia, syphilis and HIV. The likelihood of coinfection varies from person to person and should not be expressed as a fixed rate.

Who should be tested for gonorrhea?

People who have symptoms or have had contact with a partner diagnosed with gonorrhea should consult a healthcare professional for testing. The CDC recommends annual screening for sexually active women under 25, and screening for those aged 25 and over when risk factors are present, such as a new partner, multiple partners or a partner diagnosed with an STI. For men who have sex with men, testing may be planned at least annually according to the anatomical sites of contact, and more frequently if risk continues. Screening decisions should be made with a physician based on local recommendations and individual risks. 

How is gonorrhea treated?

Gonorrhea is treated with antibiotics; the medication and dose should be determined by a physician, taking current treatment recommendations and local antibiotic resistance into account. Antibiotic resistance in gonorrhea is a significant public health concern. Self-medicating with antibiotics or repeating a previous treatment is therefore not appropriate. Treatment used for gonorrhea may not always cover coexisting infections such as chlamydia; the doctor will assess whether additional treatment is needed. 

The person receiving treatment should avoid sexual contact for 7 days after single-dose treatment and until their partners have been treated. Assessing recent partners and treating them when necessary also helps prevent reinfection. Having had gonorrhea does not provide immunity; the infection can be acquired again. Repeat testing within approximately 3 months after treatment is recommended. For throat gonorrhea, a test of cure 7–14 days after treatment is also required. 

How can gonorrhea be prevented?

1. Use condoms correctly and consistently during vaginal, anal and oral sexual contact; condoms reduce the risk but may not eliminate it completely.
2. If your partner has symptoms or has been diagnosed with gonorrhea, avoid sexual contact until both partners have been assessed and treatment has been completed.
3. Discuss the need for testing with a healthcare professional if you have a new partner or have had high-risk contact.
4. If you are diagnosed with gonorrhea, ensure that your partners are also informed and assessed.

For gonorrhea testing in Northern Cyprus, you can visit one of our branches in Nicosia or Kyrenia. The sample type is determined according to the site being tested and the clinical situation.