Transmission, symptoms and screening for gonorrhea

Gonorrhea (sometimes called “the clap”) is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. This bacterial infection is on the rise in Canada and is becoming increasingly resistant to antibiotics. Gonorrhea is more often asymptomatic in women compared to men and can be transmitted without the individual being aware that he is infected. An individual can be infected more than once by the bacteria.

Gonorrhea is transmitted during unprotected sexual intercourse (vaginal, oral or anal with or without penetration) with an infected person. The infection can also be transmitted by sharing sexual toys. Gonorrhea can be transmitted from a mother to her baby during delivery.

Most people who are infected do not experience any symptoms. Symptoms usually appear between 2 and 7 days after exposure to the bacterium.

In women, symptoms can include:

• A burning sensation when urinating
• A vaginal discharge (thick and yellowish) or abnormal vaginal bleeding
• An anal discharge or itching
• Pain or bleeding during sexual intercourse
• Lower abdominal pain
• A sore or swollen throat

In men, symptoms can include:

• A burning sensation when urinating
• Itching or discharge from the penis or anus (thick and greenish-yellow)
• Testicular pain and swelling
• A sore throat or swelling of the throat

Anyone who has unprotected sex is at risk of a gonorrhea infection and should consult a health care professional for screening if necessary. Gonorrhea is detected by identifying the bacteria responsible in a sample of urine or secretions from the vagina, cervix, urethra or anus. Various assay techniques can be used, but by far the most widely used is nucleic acid amplification using the polymerase chain reaction (PCR) assay.

• Urine sample
• Swabbing of the throat, urethra, cervix or rectum with a cotton swab

Gonorrhea is treated with a combination of antibiotics. The combination of two antibiotics is necessary because some strains of gonorrhea are resistant to several antibiotics and because individuals are often also infected with chlamydia. Treatments are generally highly effective, so individuals who are infected should seek treatment as soon as possible to avoid complications, which may include the following:

• Infertility
• Chronic lower abdominal pain
• Ectopic pregnancy (pregnancy in the fallopian tubes)
• Testicular infection
• Increased risk of contracting and transmitting HIV