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Gonorrhea

Gonorrhea is a sexually transmitted bacterial disease caused by neisseria gonorrhea bacteria. Any sexually active person can be infected with gonorrhea. The infection can affect any gender of sex and any age group but most prevalent among those from 15 to 30 years of age. Gonorrhea transmission can occur through contact with the penis, vagina, mouth, or anus. Ejaculation does not have to occur for gonorrhea to be transmitted. Besides sexual contact, another method of infection is an infected mother who may pass the gonorrhea to her baby at birth. The bacterium thrives in warm, moist areas of the reproductive tract. In women, it's the cervix, the uterus and the fallopian tubes. Gonorrhea can also breed in the urethra of both women and men, as well as in the mouth, throat, eyes and anus.


Symptoms of Gonorrhea

Not everyone who is infected will have indications. Some may be infected for several months without showing any indications. If any, signs and symptoms of gonorrhea will appear within 2 to 10 days after exposure to an infected partner. Symptoms of gonorrhea in women in the genital tract may include:


  • Frequent urination
  • Pain or burning sensation when passing urine
  • Vaginal discharge that is yellow or bloody in color
  • Bleeding between menstrual periods
  • Heavy bleeding with periods
  • Pain during sex
  • Redness and swelling of the genitals
  • Burning sensation or itching of the vaginal area
  • Irritation and/or discharge from the anus.

Advanced symptoms in women may indicate development of Pelvic inflammatory disease. The symptoms of which are cramps and pain, bleeding between menstrual periods, vomiting and fever.

Symptoms of gonorrhea in men in the genital tract may include:


  • A burning sensation when urinating
  • A white, yellow or green discharge from the penis
  • Painful or swollen testicles
  • Inflammation or infection of a duct in the testicles
  • Infection or inflammation of the prostate gland.

Besides, genital tract gonorrhea can affect other sites in the body. The symptoms vary depending on the infected site.

Rectum: anal itching, pus-like discharge from the rectum and having difficulty during bowel movements.

Eyes: Eye pain, sensitivity to light, pus-like discharge from one or both eyes.

Throat: Sore throat and swollen lymph nodes in the neck.

Joints: The affected joint or joints may be warm, red, swollen and extremely painful while making movements.

Symptoms usually will develop within 2 weeks after exposure. If you experience a burning sensation while urinating or notice a pus-like discharge from penis, vagina or rectum seek medical attention. Even if you do not experience any of the symptoms but is experienced by your partner or if already diagnosed with gonorrhea, contact family physician or a general practitioner. It is also best to seek medical attention if you have had sex with someone who you suspect of having gonorrhea. Abstain from sex until you see your doctor.


Detecting gonorrhea

Gram stain: Before grain stain test, women are often given a pelvic exam and then sample of discharge from the cervix is collected and is placed on a slide. In men, the sample of fluid is taken from the penis. The sample is stained with a dye. The healthcare provider will use a microscope to look for bacteria on the slide. The test results can be obtained immediately. This test is more accurate for men than women.

Swab of affected area: A swab of your throat, urethra, vagina or rectum may be collected to detect the genes of the bacteria.
Urine test: Helps identify bacteria in your urethra.
Other tests: Other tests to detect sexually transmitted infections are likely to be recommended as gonorrhea increases risk of these infections.


Treating gonorrhea

Gonorrhea is treated with antibiotics (non-penicillin antibiotic such as ceftriaxone). Many people who have gonorrhea also have another sexually transmitted disease (STD) called Chlamydia. Doctors often give a combination of antibiotics to treat both STDs. The affected individual should take the medications as prescribed and completes the course of medication. The medications prescribed by the doctor will stop the infection; it will not repair any permanent damage already done due to the infection. Both the affected individual and the sex partner must be treated for gonorrhea even in the absence of symptoms of gonorrhea.


  • Don't skip medications and do take medications until finished.
  • Do notify your sexual contacts.
  • Do take sitz baths to relieve discomfort.
  • Do wash hands frequently and thoroughly.
  • Don't drink too much of caffeine and alcohol.
  • Do use latex condoms during sexual intercourse.
  • Don't resume sexual activity till the infection is cured.

Epididymitis

The epididymis is a tube in the male reproductive system connecting the vas with the testicles. When the epididymis gets inflamed, it results in epididymitis. This is the result of a bacterial infections such as gonorrhea and chlamydia. In other cases, it can be due to E coli and similar infections. Examination of a patient suffering from epididymitis will usually reveal tender lymph nodes in the groin and tenderness in the area of the testicles. Doppler ultrasound, tests for chlamydia and gonorrhea and blood count might reveal epididymitis.


Cervicitis

An inflammation of the cervix mainly due to an infection is Cervicitis. The infected cells of the cervix become irritated and may become red, swollen and ooze mucus and pus. They could bleed easily when touched. The most important cause of Cervicitis is sexually transmitted disease although many women do not test positive for any type of infection though contracted with Cervicitis.


Symptoms of Cervicitis

Many women do not exhibit any symptoms and if tested may be positive for Cervicitis. If present, the signs and symptoms include:


  • Vaginal discharge which could be grayish or pale yellow.
  • Abnormal vaginal bleeding or bleeding after sex, between periods.
  • Pain during sexual intercourse.
  • Pelvic or abdominal pain, fever in some cases.
  • Vaginal irritation
  • Pain in the vagina
  • Pressure or heaviness in the pelvis.

Serious symptoms might indicate a life-threatening condition and immediate medical care should be sought. If Cervicitis is suspected during pregnancy, there could be life-threatening symptoms including - high fever, severe nausea and vomiting and severe pelvic pain.


Causes of Cervicitis

Cervicitis is most often caused by an infection caught during sexual activity. Some sexually transmitted diseases include gonorrhea, Chlamydia, Herpes Virus and Trichomoniasis. Other possible causes for Cervicitis are:


  • Use of a diaphragm or cervical cap insertion into the pelvic area.
  • Allergy to condoms and latex
  • Chemical exposure
  • Many sexual partners
  • High risk sexual behavior
  • Sex at an early age.

When the vagina is overwhelmed by unhealthy and harmful bacteria, it can cause Cervicitis. Hormonal imbalance with relatively low estrogen or high progesterone may interfere with the body's ability to maintain healthy cervical tissue. Cancer treatment and radiation therapy can also cause Cervicitis.


Diagnosing Cervicitis

A doctor first gets a closer look at the cervix when Cervicitis is suspected. Then the doctor will swab the cervix, collect vaginal fluid and see how it bleeds. The patient's sexual history is noted. A routine examination of the cervix is conducted if you are pregnant or the doctor thinks that there is high risk for sexually transmitted disease like gonorrhea or Chlamydia. Inspection of the discharge under a microscope may show Trichomoniasis or Bacterial Vaginosis. Pap smear is also done. Rarely, colposcopy and biopsy of the cervix is necessary to rule out cancer.


Reducing risk of Cervicitis

You can reduce or lower the risk of Cervicitis by:


  • Avoiding known allergens.
  • Avoiding sexual intercourse.
  • Monogamous sexual partner.
  • Following instructions while using diaphragm or cervical cap.
  • Getting tested for STD infections annually.
  • Getting vaccinated against human papilloma virus.
  • Using condoms during sexual intercourse.

Treatment

If sexually transmitted infection is not the cause, then you do not need treatment for Cervicitis. If an infection is suspected, the main goal would be to eliminate the infection and prevent it from spreading to the uterus and fallopian tubes, in case of pregnancy.

In case of bacterial infections such as Chlamydia, Gonorrhea and others, antibiotics are used for treatment. Antiviral drugs may be used to treat herpes infections. Hormonal therapy with estrogen and progesterone may be used in women who have reached menopause. When such treatments fail, and Cervicitis is still present for a long time, then cryosurgery, electro cauterization and laser therapy are adopted.


The doctor would prescribe the line of treatment depending upon the cause of infection. The doctor may advice antibiotics, antifungal medications and antiviral medications. The doctor may also recommend treating the partner to rule out chances of infection again. It is recommended to avoid sexual contact till the partner has finished treatment.


If medications such as Antibiotics do not work in some cases, there are other options available recently:
Loop Electro surgical Excision Procedure (LEEP)
Cryotherapy, Electrocoagulation or Laser to cauterize the affected tissue.


Tips to prevent Cervicitis

Avoid chemical irritants such as deodorant tampons. When inserting any foreign objects into the vagina, make sure that they are properly placed. Be in a monogamous sexual relationship. Use latex condom every time of sex to lower the risk of getting sexually transmitted infections. A condom must be properly used every time.


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Collection of Pages - Last revised Date: August 24, 2019