Gonorrhea is a sexually transmitted infection (STI) that is caused by the bacterium Neisseria gonorrhoeae. It can infect both men and women and is spread through unprotected vaginal, anal, or oral sex with an infected partner. Gonorrhea can cause serious health complications if left untreated, so recognizing the signs and symptoms is important for getting appropriate treatment. Two of the most common signs and symptoms of gonorrhea are outlined below.
Painful or Burning Urination
One of the most common symptoms of gonorrhea, especially among men, is a painful or burning sensation when urinating. The urethra, the tube that carries urine from the bladder to outside the body, becomes inflamed and irritated as a result of the infection. Typically the burning feels more intense at the tip of the penis. Urination may also be frequent and urgent as the inflammation causes a persistent feeling of needing to void. In some cases, a urethral discharge may be present as well – this appears as a thin, milky white or yellowish fluid from the penis. However, discharge is more common among women with gonorrhea.
Women may also experience painful urination with gonorrhea, although the symptoms tend to be less obvious. The opening of the urethra, located above the vagina, can become inflamed and sore. Urination may be especially painful during menstruation. Women often do not have any symptoms of gonorrhea at all, which allows it to go undetected.
Treatment for Painful Urination
As gonorrhea is caused by a bacterial infection, it is treated through antibiotics. Treatment includes injection of ceftriaxone along with a course of oral azithromycin or doxycycline. It is critical to complete the full antibiotic regimen as prescribed, even if symptoms improve quickly, in order to fully eliminate the infection. All sexual partners from the past two months should also be notified, tested, and treated to prevent spreading or reinfection.
In addition to antibiotics, over-the-counter pain relievers can help ease the burning and discomfort while urinating. Drinking more water will dilute urine and make it less irritating as well. However, antibiotics are necessary to cure the infection.
Anal or Rectal Pain, Itching, and Discharge
Like other STIs, gonorrhea can infect the mucous membranes of the anus and rectum through unprotected anal intercourse. As a result, rectal gonorrhea often causes anal pain, itching, and discharge in both men and women.
An infected person may notice itching, redness, and soreness around or inside the anus. Bowel movements may become painful. Mucous-like anal discharge may also be present, which can appear yellow, green, or bloody.
Rectal gonorrhea does not always cause symptoms, especially among women. But when present, these painful and uncomfortable symptoms can impact daily activities and may be mistaken for other conditions like hemorrhoids or anal fissures.
Getting Treated for Rectal Gonorrhea
Just as with urethral infections, rectal gonorrhea requires antibiotic treatment. Oral medications, and sometimes anal suppositories, are used to cure the infection. Prompt treatment eliminates the bacterium and resolves symptoms like anal discharge, itching, and pain with bowel movements.
Over-the-counter remedies like warm baths, hygiene, and topical pain relievers can temporarily alleviate discomfort from the infection. But antibiotics are still needed to fully cure rectal gonorrhea.
Throat Infection and Sore Throat
The bacterium that causes gonorrhea can also infect the throat and cause a sore throat. This occurs most commonly after performing oral sex on an infected partner. The back of the throat, including the tonsils and back of the tongue, becomes colonized with gonorrhea bacteria.
A sore and scratchy throat develops, which may be very painful when swallowing. The tonsils can become visibly inflamed and red. White or yellow throat discharge is also common. Lymph nodes in the neck may become swollen and tender to the touch as the body fights the infection.
Antibiotics to Treat Throat Gonorrhea
Like other forms of the illness, a throat infection requires prescription antibiotic therapy. Gargling salt water and taking over-the-counter analgesics may temporarily reduce the pain, but will not eliminate the gonorrhea bacteria. Only antibiotics specifically tailored to treat gonorrhea, like ceftriaxone and azithromycin, can fully cure an infection of the throat.
Vaginal Infections and Discharge in Women
Among women, one of the most common symptoms of gonorrhea is increased vaginal discharge. The discharge is typically green or yellow in color with a foul odor. Burning and itching around the vulva is also common. The cervix may become inflamed and painful.
As the infection spreads into the uterus and fallopian tubes, pelvic pain and cramping can occur as well. Women with gonorrhea often have painful periods with heavier flow. Spotting may occur between periods. Pain or burning during urination is less common for vaginal gonorrhea in women than it is for men.
Treating Vaginal Gonorrhea
Vaginal gonorrheal infections can be more complicated to treat due to the spread into the female reproductive organs. Antibiotic injections and pills are still used to treat the initial urethral and cervical infection. However, if the fallopian tubes have become infected, hospitalization may be required for intravenous antibiotic treatment.
All sexual partners from the past 60 days should be notified, tested, and treated to prevent reinfection or further spread. While waiting for symptoms to resolve, over-the-counter vaginal pain relievers and feminine hygiene products can provide some comfort.
Fever, Rash, and Joint Pain
In addition to localized infections, some individuals with gonorrhea can develop systemic symptoms like fevers, rashes, and joint pain. This occurs when the infection spreads through the bloodstream and affects the whole body.
Fever is a common symptom, especially among women, and may be accompanied by general body aches, chills, and sweats. A rash made up of flat red bumps may appear on the torso, arms, and legs. Multiple joints can become swollen, warm, and extremely painful to move.
Treating Disseminated Gonorrhea
When gonorrhea spreads systemically through the bloodstream, intravenous antibiotics are used in a hospital setting. Ceftriaxone, cefotaxime, and spectinomycin are common IV medications for disseminated gonococcal infections. Along with antibiotics, rest, hydration, and over-the-counter pain-relievers can help manage fever, rash, and joint pain until the infection is cured.
Epididymitis in Men
One of the most serious complications of gonorrhea among men is epididymitis, an infection of the coiled tube at the back of the testicles. It is characterized by inflammation, swelling, and tenderness of the epididymis, along with fever and chills.
The scrotum becomes red, hot, and extremely painful, particularly when standing or walking. Nausea and vomiting may occur as well. Left untreated, the infection can spread to the prostate gland and other reproductive organs leading to scarring, abscesses, and infertility.
Importance of Treating Epididymitis
Treating epididymitis as soon as possible is critical for preserving fertility and preventing complications. Along with antibiotics, bed rest, scrotal support, cold compresses, and over-the-counter pain medication can help manage symptoms. In severe cases, surgical drainage of abscesses may be necessary. IV antibiotics are sometimes administered for extensive infections.
Infection of the Eyes
Gonococcal infections can sometimes spread to the eyes, causing conjunctivitis. Symptoms of gonorrhea-caused conjunctivitis include eye pain, redness, swelling, and discharge from the eyes. Pus-like drainage, sensitivity to light, and feeling like something is in the eye are common signs.
Left untreated, eye infections can spread quickly and cause permanent vision damage. Eye discharge can turn dark yellow or green as the infection progresses. The eye tissue can become inflamed and swollen, resulting in severe pain and light sensitivity.
Treating Gonococcal Conjunctivitis
Gonorrheal eye infections require prompt antibiotic therapy, usually given in the form of antibiotic eye drops or injections. Along with antibiotics, using a warm compress and over-the-counter eye drops can help soothe eye discomfort and irritation until the infection resolves. Avoiding touching or rubbing the eyes prevents further spread.
Increased Vaginal Bleeding
Among women, gonorrhea can cause increased bleeding between periods or heavier flow during menstruation. Intermenstrual bleeding occurs when the infection spreads into the uterus and cervix, causing inflammation that disrupts the menstrual cycle.
Period blood itself may become heavier or remain longer than usual. Excess vaginal bleeding may lead to anemia if left untreated over time. The menstrual blood may also take on a yellow, green, or brown appearance as the discharge mixes with infected cervical and uterine tissues.
Stopping Abnormal Vaginal Bleeding
Antibiotic treatment for gonorrhea will stop the vaginal bleeding that results from spread of the infection into the female reproductive organs. Over-the-counter medications like NSAIDs, heating pads, and tampons can help manage heavy periods until the antibiotics have time to work. If bleeding becomes severe, intravenous treatment in the hospital may be required.
Epididymo-orchitis
Epididymo-orchitis refers to inflammation of both the epididymis and testicles due to gonorrheal infection. It causes swelling, redness, and a burning sensation inside the scrotum. Fever, nausea, and vomiting may occur as the infection spreads.
The scrotum becomes extremely tender to the touch. Pain and swelling increases over several days and the area may feel hot. Urination can become difficult and frequent. Testicular swelling can sometimes become significant enough to require drainage.
Treating Inflammation of the Reproductive Organs
Epididymo-orchitis requires prompt antibiotic treatment, usually administered both orally and by injection, to stop the swelling and progression of the infection. Along with antibiotics, bed rest, scrotal elevation, cold compresses, and over-the-counter pain medication can help relieve symptoms. In severe cases, surgery may be needed to drain pus from the swollen tissues.
Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) occurs when gonorrhea spreads into the uterus, fallopian tubes, and other reproductive organs. It causes pelvic pain, cramping, fever, and vaginal discharge. Nausea, vomiting, and heavy periods may occur as well.
If left untreated, PID can lead to scarring and abscesses in the pelvic cavity along with chronic pelvic pain. It is one of the leading causes of female infertility worldwide. Prompt antibiotic treatment is crucial for preventing long-term complications.
Managing PID
Along with antibiotics, getting rest, applying heating pads, and taking over-the-counter pain medication can help alleviate symptoms while undergoing treatment for PID. Intravenous antibiotics in the hospital may be required for more severe infections. Surgery is sometimes needed to repair damage or drain abscesses resulting from PID.
Conclusion
Gonorrhea can cause a wide range of symptoms in men and women depending on how and where a person is infected. Some of the most common signs include painful urination, genital discharge, anal itching and soreness, and sore throat. Without treatment, gonorrhea can spread to the reproductive organs, eyes, joints, and throughout the body potentially leading to serious complications.
While antibiotic therapy is needed to fully cure gonorrheal infections, over-the-counter remedies can help temporarily manage certain symptoms for comfort. Recognizing the signs and getting prompt treatment is crucial for curing gonorrhea fully and preventing permanent damage. Practicing safe sexual practices and getting regularly tested for STIs can prevent infection in the first place.
