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Gonorrhea Introduction Gonorrhea is a curable sexually transmitted disease, or STD. It is the second most commonly reported bacterial STD after chlamydia. Chlamydia is a sexually transmitted disease. It causes symptoms similar to gonorrhea. Millions of people get gonorrhea every year. The highest rates of gonorrhea are among sexually active teenagers and young adults. The bacteria that cause gonorrhea can infect the genital tract, mouth or anus. If left untreated, it can cause many health problems and lead to infertility in both men and women. This reference summary explains the symptoms, causes and treatment of gonorrhea. It also includes information about health complications related to the disease. The Reproductive System This section reviews the male and female reproductive systems. It will help you better understand the way gonorrhea affects the body. The male reproductive organs include: • The testicles. • The duct system, made up of the epididymis and the vas deferens. • The penis. Seminal Vesicles Prostate Gland Male reproductive organs are located both inside and outside the pelvis. Testicles Duct System This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/08/2016 idfu0101 1 The testicles are egg-shaped glands that sit in a soft pouch called the scrotum. The testicles have 2 main functions: • The production of sperm, which are the male reproductive cells. • The production of hormones, including testosterone. Testosterone plays major role in puberty for boys. During puberty, testosterone causes boys to develop deeper voices, bigger muscles and body and facial hair. Testosterone also stimulates the production of sperm. The epididymis and vas deferens make up the duct system. They are located alongside the testicles, inside the scrotum. Semen is created by glands. Semen is a fluid that contains sperm. The seminal vesicles are a pair of glands that help make semen. They are located near the prostate. The prostate is a gland that also secretes semen. The urethra is the channel that carries semen to the outside of the body through the penis. It is also part of the urinary system because it carries urine from the bladder to the outside of the body. The penis is made up of two parts: the shaft and the glans. The main part of the penis is called the shaft. The tip of the penis is called the glans, or the head. At the end of the glans is an opening. Semen and urine exit the body through this opening after traveling through the urethra. The female reproductive organs include: • The ovaries. • The Fallopian tubes. • The uterus. • The cervix. • The vagina. Ovaries Fallopian The female reproductive organs are located in the pelvis, between the urinary bladder and the rectum. Uterus Cervix Vagina This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/08/2016 idfu0101 2 When an ovary releases an egg, the egg goes down the Fallopian tube to the uterus. It may become fertilized by sperm along the way. If a woman gets pregnant, the fetus stays in the uterus until delivery. The inner layer of the uterus is called the endometrium. The endometrial lining grows and thickens each month to prepare for pregnancy. If a woman does not become pregnant, the endometrial lining flows out of the body. This is called a menstrual period. The narrow, lower part of the uterus is the cervix. The cervix is the passageway to the vagina. The vagina opens to the outside of the body between the urethra, which is the urinary bladder opening, and the rectum. Symptoms A small number of people may be infected with the bacteria that cause gonorrhea for several months without showing symptoms. For women, the early symptoms of gonorrhea often are mild. Symptoms usually appear within 2 to 10 days after sexual contact with an infected partner. When women have symptoms, early symptoms may include: • Bleeding associated with vaginal intercourse. • Painful or burning sensations when urinating. • Yellow or bloody vaginal discharge. More advanced symptoms in women include cramps and pain, bleeding between menstrual periods, vomiting or fever. Men have symptoms more often than women. Symptoms in men can include: • White, yellow or green pus from the penis with pain. • Burning sensations that may be severe during urination. • Swollen or painful testicles. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/08/2016 idfu0101 3 Gonorrhea can also cause a rectal infection in both women and men. It can be transmitted through anal sex. Symptoms of rectal infection include: • Anal itching. • Bright red blood in stool. • Abnormal discharge. • Painful bowel movements. Symptoms often appear 2 to 5 days after infection but could appear as late as 30 days later. Causes Gonorrhea is caused by bacteria. The bacteria grow in warm, moist areas. The bacteria that cause gonorrhea can grow in the: • Anus. • Eyes. • Mouth. • Reproductive tract, like the cervix, uterus and Fallopian tubes in women. • Throat. • Urethra, which is the tube through which urine leaves the body. People get gonorrhea by having sexual contact with an infected person. Sexual contact includes oral, anal and vaginal sex. This is because the bacteria that cause gonorrhea are carried in semen and vaginal fluids. Diagnosis If you have the symptoms of gonorrhea, your health care provider will perform a physical exam and review your patient medical history. He or she may ask you about your sexual activities over the last several months. It is important to be honest. If your health care provider suspects that gonorrhea is causing your symptoms, he or she will need to test for it. Tests may include taking a sample of blood or urine. The sample will be tested for the bacteria that cause gonorrhea. Many health care providers prefer to use more than one test to increase the chance of an accurate diagnosis. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/08/2016 idfu0101 4 Another test is a culture test. It involves placing a sample of discharge from the penis, vagina or throat onto a culture plate. Cultures allow bacteria time to grow in the samples collected to see if the bacteria are present. Some health care providers use urine or cervical swabs for a test that detects the genes of the bacteria. These tests are more accurate than culturing the bacteria. Treatment Antibiotics are medicine to treat bacterial infections. However, treating gonorrhea with antibiotics is becoming more difficult because drug-resistant strains of gonorrhea are increasing around the world. If you are pregnant or you are younger than 18 years old, you shouldn't be treated with certain types of antibiotics. Your health care provider can prescribe the best and safest antibiotic for you. Gonorrhea and chlamydia often infect people at the same time. Therefore, health care providers usually prescribe a combination of antibiotics that will treat both diseases. If you have gonorrhea, all of your sexual partners should get tested and then treated if infected, whether or not they have symptoms. Health experts also recommend that you not have sex until your infected partners have been treated. Complications Many complications can happen if gonorrhea is left untreated. This section discusses possible complications. In untreated gonorrhea infections, the bacteria can spread to the reproductive tract. More rarely, it can spread into the blood stream and infect the joints, heart valves or brain. This can lead to arthritis, endocarditis and meningitis. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/08/2016 idfu0101 5 The most common result of untreated gonorrhea in women is pelvic inflammatory disease, or PID. PID caused by gonorrhea often appears immediately after the menstrual period. PID causes scar tissue to form in the Fallopian tubes. If the Fallopian tube is partially scarred, the fertilized egg may not be able to pass into the uterus. If this happens, the embryo may implant in the tube, causing an ectopic pregnancy. This serious complication results in a miscarriage and can cause death of the mother if not treated promptly. In men, gonorrhea causes epididymitis, a painful condition of the testicles that can lead to infertility if left untreated. Also, gonorrhea affects the prostate gland and may cause scarring in the urine canal. Ectopic Pregnancy If you are infected with gonorrhea, your risk of getting HIV infection increases. Therefore, it is extremely important for you to either prevent yourself from getting gonorrhea or get treated early if you already are infected with it. If you are pregnant and have gonorrhea, you may give the infection to your baby as it passes through the birth canal during delivery. A health care provider can prevent infection of your baby's eyes by applying silver nitrate or other medicine to the eyes immediately after birth. Because of the risks from gonorrhea to both you and your baby, health experts recommend that pregnant women have at least one test for gonorrhea during prenatal care. Prevention The best way to avoid getting sexually transmitted diseases is to abstain from sexual contact. This means that you do not have sex or sexual contact, such as oral or anal sex, at all. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/08/2016 idfu0101 6 Another way to avoid it is to be in a long-term, mutually monogamous relationship with a partner who has been tested and is not infected. Mutually monogamous means that both partners abstain from having sex with other people. They only have sex with each other. You can also reduce your chances of getting gonorrhea or another STD by using latex condoms. This only works if the condoms are used correctly every time during vaginal or rectal sexual activity. Summary Gonorrhea is a curable sexually transmitted disease caused by bacteria. The bacteria that cause gonorrhea are carried in semen and vaginal fluids. Millions of cases are reported worldwide every year. Sexually active teenagers and young adults have the highest rates of gonorrhea. Some people display no symptoms for several months after becoming infected with gonorrhea. This makes it easy to spread gonorrhea. If left untreated, gonorrhea can cause health complications such as infertility in men and women. Antibiotic medicines are often used to treat gonorrhea. However, treating gonorrhea is becoming more difficult because drug-resistant strains of gonorrhea are increasing around the world. If you have gonorrhea, all of your sexual partners should get tested and then treated, if infected, to prevent the disease from spreading. The best way to avoid gonorrhea is to abstain from sex entirely or have only one sexual partner that has tested negative for gonorrhea. Condoms are effective in reducing the risk of getting gonorrhea, but they are not 100% effective. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/08/2016 idfu0101 7