S-e-x may be super fun – and, you know, essential to maintaining the human population – but it can also come with some uncomfortable consequences… like the more than 20 different types of STIs.
Gonorrhoea’s just one of those super-scary infections – but it’s one that definitely needs to be on your radar. With an estimated 820 000 new cases each year, gonorrhoea is the second most commonly reported notifiable disease (i.e., you’re legally obligated to tell someone if you have it) in the US, according to the Centers for Disease Control (CDC). It’s just as big of a problem around the globe too.
Scary, huh? But before you go swearing off s-e-x forever, it’s important to know exactly what you’re dealing with when it comes to gonorrhoea. Because knowledge is your best form of protection – well, after abstinence and condoms.
What is gonorrhoea?
Gonorrhoea, a.k.a. “the clap” is an STI caused by the Neisseria gonorrhoeae bacterium, and is spread though the sexual contact with the penis, vagina, mouth or anus of an infected partner.
The bacteria infects the mucous membranes (basically, any opening to the body), and is commonly found in the cervix, uterus and fallopian tubes in women, and the urethra in both women and men. But the STI can also affect the mouth, throat, eyes and rectum.
It’s seen most often in men and women ages 15 to 24 – of the estimated 820 000 new cases each year, 570 000 are among young people – but anyone who’s having unprotected vaginal, oral or anal sexual contact can get or spread the infection. Also, fun fact: Ejaculation doesn’t have to occur for transmission.
What are the symptoms of gonorrhoea?
Much like chlamydia, gonorrhoea is hard to recognise. In fact, most women and men are asymptomatic, according to the CDC. That means they don’t experience any changes once they’re infected, says Dr Suzanne Fenske, assistant professor of obstetrics, gynaecology and reproductive sciences at Icahn School of Medicine at Mount Sinai in New York City.
If symptoms do show up, they usually occur within 10 days of exposure to the bacteria. They can be mild and mistaken for a UTI or yeast infection – like vaginal itching and discharge – but if you’re having any of the following symptoms, it’s a good idea to get them checked by a doctor.
Gonorrhoea can cause uncomfortable itching in and around the vagina, says Dr Fenske. If this feeling persists, tell your doctor and ask for an STI exam.
Abnormal v@ginal discharge
Depending on where you are in your menstrual cycle, discharge is pretty common, but gonorrhoea can cause women to produce more discharge than normal, says Dr Fenske.
If you notice any differences in discharge – like an unusual colour, consistency or smell – either on your toilet paper or in your underwear, make sure to tell your doctor. It should be noted that a change in discharge doesn’t always mean you have gonorrhoea, but it’s still a safe bet to get checked out.
V@ginal bleeding between periods
There are tons of reasons why you could experience spotting between periods, like stress or having a condition like PCOS. But gonorrhoea could also be the cause, says Dr Fenske. If this isn’t typical for you, make an appointment with your gynae.
Painful and frequent urination
When gonorrhoea infects the urethra, it can cause symptoms similar to a urinary tract infection (you know, that familiar burning sensation when you pee and the feeling that you need to go constantly). If you’ve recently had unprotected sex and are experiencing these symptoms, check in with your doctor.
Pelvic or lower abdominal pain
Left untreated, cervical gonorrhoea can spread to the uterus and fallopian tubes, causing pelvic inflammatory disease. PID can lead to fertility issues in one in eight women, reports the CDC.
As it progresses, PID can cause fevers, pain, and sepsis, as well as chronic pelvic pain, says Dr Fenske. PID pelvic pain can be similar to what you might feel during your period, but it will occur outside of your typical cycle.
Again, this is only if gonorrhoea is left untreated, so make sure to get tested regularly to help protect against STIs spreading and causing PID.
@nal itching, soreness or bleeding; or a sore throat
In some cases, rectal gonorrhoea infections may show up as anal itching, soreness, bleeding or painful bowel movements, according to the CDC. An infection of the throat may cause a sore throat – but in many rectal and pharyngeal infections, gonorrhoea is asymptomatic.
How is gonorrhoea diagnosed?
“If symptoms are present, then most people will be diagnosed with gonorrhoea within two weeks of exposure,” says Dr Fenske. Women who suspect they have gonorrhoea can be diagnosed with a vaginal swab test or a urine test, which you can get at a walk-in clinic or from your primary-care doctor or gynae.
Only about 90% of cervical gonorrhoea cases are found via urine tests, says Dr Fenske, so a vaginal swab for suspected cervical gonorrhoea is your best option.
Men, however, are most often diagnosed through urine tests. And, for suspected gonorrhoea from oral or anal s-e-x, swabs of the mouth and throat or rectum can also lead to a diagnosis.
But, if you’re not showing any signs or symptoms of the STI, it’s possible you won’t be properly diagnosed until you have a routine STI test (during your annual exam with your gynae, for example), or if the infection spreads and begins causing pain from PID, says Dr Fenske.
How is gonorrhoea treated?
Some good news: Gonorrhoea is totally treatable and a relatively easy STI to deal with, says Dr Fenske. Your doctor will likely give you a one-time shot of an antibiotic called Ceftriaxone along with one large pill dose of Azithromycin.
“There have been rising levels of resistance of gonorrhoea infections to antibiotics,” says Dr Fenske, “and the two antibiotics together provide the best coverage for treatment.”
According to the CDC, if your symptoms continue for more than a few days after receiving treatment, head back to your doctor, as you may have a strain that’s resistant to certain antibiotics. “When uncomplicated gonorrhoea infections are treated with antibiotics, it clears up within one day.”
Make sure you and your partner(s) wait at least a week after finishing treatment, assuming you’re no longer symptomatic, to have s-e-x again. After that, you’re in the clear.
How can you prevent getting gonorrhoea?
Like most STIs, the best way to protect yourself against gonorrhoea is through abstinence or a long-term monogamous relationship with a partner in which you’ve both been tested, according to the CDC.
But, because that’s not always entire possible, latex or polyurethane condoms and dental dams are your second best bet if you’re having s-e-x with multiple partners, says Dr Fenske.
Of course, -gonorrhoea can still be spread by s-e-xual contact before a condom goes on. To truly be safe, get tested with each new partner before having s-ex, so you know for sure where you stand, and get tested regularly on your own too.