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Gonorrhea in Women: A Complete Guide

Sexually transmitted diseases are fairly common and can affect anyone, regardless of race, gender, social status, demography or education. Seduced into smugness by the notion that "it cannot happen to me", most of the sexually active teenagers and youth are astounded when they are diagnosed with an STD. One of such sexually transmitted diseases is gonorrhea. Gonorrhea is a bacterial STD common in both men and women. If left untreated, it may cause infertility.
Gonorrhea symptoms

What is gonorrhea?

Gonorrhea is basically a sexually transmitted disease (STD), that one can get by having sex with someone who is infected with it. Gonorrhea is caused by bacterium Neisseria gonorrhoeae and can infect both men and women. 

It is a common infection especially among young people aged 15-24 years. The bacteria usually grow in moist and warm areas of the body. The effects of gonorrhea can be seen in the urethra, fallopian tubes, cervix, uterus, vagina, penis, rectum, eyes, and throat, and joints.

It spreads only through sexual activity and cannot be transmitted from toilet seats or door handles. 

How common is gonorrhea?

Gonorrhea is a widespread sexually transmitted disease. An estimated 820,000 men and women are infected every year in the United States of America.

Gonorrhea infection is the second most commonly reported bacterial STD in the United States of America.

Effects of gonorrhea in females

Several effects of gonorrhea in women have been recorded. 

Infection in the uterus and the fallopian tubes can result in a painful infection of the pelvis known as PID i.e. Pelvic Inflammatory disease. PID leads to scarring in the fallopian tubes. In this case, the fertilized egg might not be able to pass into the uterus. As a result, the implantation of the embryo will take place in the tube resulting in a tubal pregnancy. This is a serious complication that can lead to miscarriage and even death of the mother.

Symptoms of pelvic infection in women include fever, pelvic pain, and pain during intercourse. If left untreated, gonorrhea causes infertility and can lead to difficulty in becoming pregnant. It can also result in ectopic pregnancies – a pregnancy where the embryo attaches itself outside of the uterus.  

If the infection is severe enough, a tubo-ovarian abscess can be formed. It can be fatal, so a major surgery may be required.

Is gonorrhea contagious?

Yes, gonorrhea is contagious. The infection spreads when people have multiple sexual partners and when people do not use condoms or any other protective measures while sexual intercourse. The bacteria that cause gonorrhea is spread by means of body fluids, like fluid from the vagina or semen.

If you have gonorrhea during pregnancy, you may have a greater risk of miscarriage.

A mother may transmit the infection to her newborn child during the delivery process. The infection can affect the infant's eyes.

Gonorrhea signs and symptoms

Gonorrhea causes

Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. 

Gonorrhea passes from one individual to another through unprotected oral, vaginal, or anal sex. The infection most often affects the vagina, urethra, rectum or throat. In females, gonorrhea can also cause infection in the cervix and it spreads during sexual intercourse.

How can you catch gonorrhea?

People catch gonorrhea from having unprotected sexual intercourse with someone who has the infection. Gonorrhea infection spreads when semen(cum), vaginal fluids and pre-cum, may get inside your anus, mouth (during oral sex), or genitals. 

There are 3 ways to get gonorrhea:

  • vaginal sex
  • anal sex
  • oral sex

Gonorrhea can also spread by touching your eyes with hands carrying infected fluids. 

The infection can also spread to an infant at the time of birth if the mother has it. Gonorrhea does not spread through casual contact. You cannot catch gonorrhea from kissing, hugging, shaking hands, sharing food and drinks, sneezing and coughing.

Gonorrhea symptoms in women

Women infected with gonorrhea may not show any signs or symptoms, especially in the initial stages of the infection. Even if a woman has symptoms, they will be quite mild and mostly mistaken for vaginal or urinary infection. However, common gonorrhea symptoms in females include painful/frequent urination (also called dysuria), burning and itching in the vaginal area, bleeding from vagina between periods and thick, increased vaginal discharge (watery, creamy, or slightly green).

Some other signs and symptoms of gonorrhea in females include fever, and lower stomach aches and. Rectal infections include painful bowel movements, anal itching, bleeding, soreness, and discharge.

Signs and transmission of gonorrhea

Gonorrhea treatment in women

Any woman who is sexually active can get the infection. Diagnosis is important for your health practitioner to offer you the right medication (antibiotics).  Partners of women who have had the infection must get the right treatment for gonorrhea since their sex partners may be infected as well. Proper medication and treatment of the partners also prevents reinfection in the women. Women who suffer from PID need more aggressive medication that is effective to eradicate the bacteria responsible for causing gonorrhea. Women with severe complications caused due to the infection often require hospitalization and intravenous administration of antibiotics.

Can gonorrhea be treated?

Yes, gonorrhea infection can be cured with the appropriate medication — antibiotics. Antibiotics have the potential to completely eradicate the bacteria, although they will not reverse any damage done by the infection or scarring of the fallopian tubes). However, with the growing resistance to the standard antibiotic therapy, gonorrhea is becoming more difficult to cure.

Gonorrhea is one of the most widely spread sexually transmitted infections. Signs that you have gonorrhea include abnormal vaginal discharge and lower abdomen pain. The best protection against this sexually transmitted infection are abstinence, sexual intercourse with only one partner (monogamy), and proper condom usage. 

Since the bacteria can thrive in the throat, condoms or dental dams should be used during the vaginal-oral contact as well. Prevention of the spread of STDs depends on the counseling of at-risk men/women and the timely diagnosis and treatment of infections.

Alirol, E., Wi, T. E., Bala, M., Bazzo, M. L., Chen, X. S., Deal, C., ... & Hook, E. W. (2017). Multidrug-resistant gonorrhea: A research and development roadmap to discover new medicines. PLoS medicine, 14(7), e1002366.
Curran, J. W., Rendtorff, R. C., Chandler, R. W., Wiser, W. L., & Robinson, H. (1975). Female gonorrhea: its relation to abnormal uterine bleeding, urinary tract symptoms, and cervicitis. Obstetrics and Gynecology, 45(2), 195-198.
Hart, M. (1971). Gonorrhea in women. JAMA, 216(10), 1609-1611.
Piszczek, J., St. Jean, R., & Khaliq, Y. (2015). Gonorrhea: Treatment update for an increasingly resistant organism. Canadian Pharmacists Journal/Revue des Pharmaciens du Canada, 148(2), 82-89.
Torpy, J. M., Lynm, C., & Golub, R. M. (2013). Gonorrhea. JAMA, 309(2), 196-196.
Walker, C. K., & Sweet, R. L. (2011). Gonorrhea infection in women: prevalence, effects, screening, and management. International journal of women's health, 3, 197.
Yorke, J. A., Hethcote, H. W., & Nold, A. (1978). Dynamics and control of the transmission of gonorrhea. Sexually transmitted diseases, 5(2), 51-56.

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