Gonorrhea

What is gonorrhea?
Gonorrhea is a sexually transmitted disease (STD) believed to infect more than 700,000 persons in the U.S. each year. According to the U.S. Centers for Disease Control and Prevention (CDC), in 2006 120.9 per 100,000 persons in the United States were infected with gonorrhea. Infection rates are highest among sexually active teenagers (especially 15- to 19-year-old women), young adults (especially 20 to 24 year-old men), and African Americans. Overall, about three out of four reported cases occur in people younger than 30.

What are the symptoms?
Both men and women may have no symptoms at all. When signs of infection occur in men, they typically appear two to five days after contact with an infected partner, although in some cases, they don’t occur until as long as 30 days later. Symptoms include a burning sensation when urinating, a white, yellow, or green discharge from the penis and sometimes, painful or swollen testicles.

Symptoms among women tend to be mild and easily mistaken for signs of a bladder or vaginal infection: a painful or burning sensation during urination, increased vaginal discharge, or vaginal bleeding between periods. Whether or not symptoms occur, gonorrhea in women can lead to serious complications, including pelvic inflammatory disease (PID), an infection of the uterus, fallopian tubes and other female reproductive organs. PID can lead to infertility, increase risk of ectopic pregnancy and abscess formation, and contribute to chronic pelvic pain. In the United States, about one million women develop PID every year. Pregnant women with gonorrhea may pass the infection to their babies during delivery. This can lead to blindness, joint infection, or a life-threatening blood infection in babies. Treating gonorrhea before delivery can reduce the risk of these complications.

In men, complications include epididymitis, a painful condition of the ducts attached to the testicles. Untreated epididymitis can lead to infertility.

In both men and women, gonorrhea can infect the rectum, causing discharge, anal itching, soreness, bleeding, painful bowel movements or no symptoms at all.

You can be infected with gonorrhea during oral sex; symptoms from infections of this type include a sore throat, pain on swallowing and redness of the throat and tonsils.

What are the causes of gonorrhea?
Gonorrhea is caused by infection with the bacterium Neisseria gonorrhoeae that can flourish in the warm, moist areas of the reproductive tract, mouth, throat, eyes, and anus. Gonorrhea can be spread and contracted through any contact with the penis, vagina, mouth, or anus of an infected individual. Ejaculation does not have to occur to become infected. Even if you have been treated for gonorrhea, you can be re-infected as a result of sexual contact with someone who is still infected.

What is the conventional treatment?
A number of antibiotics can cure gonorrhea, although drug-resistant strains of the bacterium are making successful treatment more difficult. Be sure to take the entire course of antibiotics prescribed – otherwise, some of the drug-resistant bacteria may survive. Since many people with gonorrhea also have chlamydia, another STD, antibiotics for both infections are usually given at the same time. If you have been diagnosed with gonorrhea, you should be tested for other STDs.

What therapies does Dr. Weil recommend?
Antibiotic treatment is needed to eliminate infection. Afterwards, follow these guidelines to prevent future episodes of gonorrhea and other STDs:

• Limit the number of your sexual partners in order to minimize your chances of contracting STDS.
• Know the sexual histories of your partners and be especially careful with those who have had many partners, have used drugs intravenously, have had sexually transmitted diseases, or who have practiced or been subjected to high-risk sex (that is, sex that is injurious, traumatic, and/or involves exchange of bodily fluids).
• Avoid exchanges of bodily fluids, especially blood and semen, which are common carriers of viruses. Abstain or use condoms whenever there is doubt about safety. Condoms are not a guaranteed solution to the problem of sexual safety, but they can dramatically lower the risk of contracting gonorrhea, AIDS and other sexually transmitted infections.