What is gonorrhea?

Gonorrhea (gon-or-e-uh) is a sexually transmitted disease (STD) caused by a type of bacteria called Neisseria gonorrhoea. Gonorrhea can be transmitted to both male and female partners during vaginal, anal and oral sex from a partner infected in his or her throat, vagina, urethra or anus. Gonorrheal infections are completely curable with antibiotics.

How many people in San Francisco have it?

Over 1,800 people in San Francisco tested positive for gonorrhea in 2003. While this total number represents a decrease from 2002, there was a 7% increase in male pharyngeal (throat) gonorrhea from 2002 to 2003 and a slight increase in male rectal gonorrhea among men who have sex with men. 48% of people infected were white, 18% were African-American and 12% were Latino. Over half of the adolescents diagnosed with gonorrhea were African-American youth. The gonorrheal rates for San Francisco were almost triple that of Los Angeles and the state of California as a whole.

Why worry about gonorrhea?

If you are HIV+ and have genital inflammation due to gonorrhea, the inflamed tissues contain highly concentrated amounts of the virus. If the gonorrheal infection is in your penis, you can shed 8-10 times more HIV in your semen.

If you are HIV- but have gonorrhea, the disease-fighting cells of your immune system are especially susceptible to HIV if you have unprotected sex with an HIV-infected partner. Rectal gonorrhea increases the risk of contracting HIV by ten to twenty times.

In about 1% of people with untreated gonorrhea, the infection can spread beyond the genital area to the bloodstream, skin, heart or joints. This is called Disseminated Gonococcal Infection (DGI). Symptoms include fever, multiple skin lesions, arthritis, infection of the inner lining of the heart, and meningitis. DGI can be treated with antibiotics.

PID (pelvic inflammatory disease), a serious pelvic infection in women, is a more common result of untreated gonorrhea. In PID, the bacteria move from the vagina up through the cervix and into the uterus, fallopian tubes and ovaries. Blockage and scarring can damage the tubes, making a woman who conceives more likely to have a tubal pregnancy. Left untreated, PID can cause infertility. Untreated gonorrhea can also cause chronic menstrual problems, postpartum endometritis, urinary tract infections, miscarriage, and cervical discharge.

Men with untreated gonorrhea can occasionally develop epididymitis, a painful infection of the testicles. Untreated gonorrheal infections can also cause inflammation of the prostate and urethral scarring, sometimes leading to infertility.

What are the symptoms?

Most men develop symptoms of gonorrhea within two to five days after being exposed, with a possible range of one to thirty days. Although most women are asymptomatic (without symptoms), for those who do have symptoms, they usually appear within 10 days after being exposed.

Men who have gonorrhea in the penis or anal area may experience a discharge from the head of the penis or the anus; pain or itching of the head of the penis; swelling of the penis or testicles; pain and/or burning upon urination; frequent urination; anal or rectal itching; white anal discharge; and/or pain during bowel movements.

Women with gonorrhea may have a discharge from the vagina; lower abdominal pain, especially during or after sex; unusual bleeding with cramping; pain or burning with urination.

If you’re infected with gonorrhea in the throat, there are usually no symptoms, except possibly a sore throat.

What is a gonorrhea test like?

There are several different testing options for gonorrhea. Your medical provider will decide which one is best given your situation and the lab facilities available at the clinic or medical practice. Some tests are done on a urine sample, and some on a swab of the secretions from the infected area.

How is gonorrhea treated?

Your provider will give you antibiotics to kill the gonorrheal bacteria in your body. If you are prescribed antibiotics, take all of the pills, even if you feel better before you finish the dosage. Your sex partner(s) need to be examined and treated also, because if you have unprotected sex again, you can be re-infected. If you’re non-monogamous, your partner is also capable of infecting others until he or she gets proper treatment.

What can I do if I have gonorrhea?

It’s important to talk to your partners to maintain your sexual health and that of our community. Also you must abstain from partner sex for one full week from when your antibiotic treatment is started.

How do I avoid getting gonorrhea?

The risk for gonorrhea is directly related to the number of sex partners you have: The more sex paartners, the greater the risk of contracting it. Having more sex with fewer partners reduces your risk of getting gonorrhea.

The only way to be 100% sure of eliminating your risk of contracting gonorrhea or other STDs is to abstain from sex. If you are sexually active, however, using condoms (male or female) for sexual activity is your best bet for protecting yourself. Since gonorrhea can be transmitted during oral sex, primarily mouth-to-penis or penis-to-mouth contact, it would be wise to use a condom when performing oral sex on a man or if you’re a man, having oral sex performed on you. Also, we recommend regular STD checkups at least every six months if you’re sexually active with more than one monogamous partner. Gonorrhea and other bacterial STDs are curable with proper diagnosis and treatment.