Gonorrhoea
Gonorrhoea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. It primarily affects the mucous membranes of the reproductive tract, but gonorrhoea can also infect the rectum, throat, eyes, and joints. Though highly infectious, it is curable with antibiotics when diagnosed early. However, untreated gonorrhoea can result in severe complications such as infertility, pelvic inflammatory disease, and increased susceptibility to HIV.
Commonly referred to as “the clap,” gonorrhoea is one of the most widespread bacterial STIs globally. It affects both men and women and is especially prevalent among sexually active adolescents and young adults. The rise in antibiotic-resistant strains of Neisseria gonorrhoeae has made awareness, testing, and prevention even more important.
How It Spreads
Gonorrhoea spreads through unprotected vaginal, anal, or oral sex with an infected person. It can also be passed from a pregnant woman to her baby during delivery, potentially causing serious eye infections in newborns.
Key modes of transmission include:
Unprotected sex with multiple partners
Inconsistent or incorrect use of condoms
Oral-genital contact, which can lead to pharyngeal infections
Sharing of sex toys without proper cleaning or condom use
Because it can infect areas without visible symptoms, many people are unaware they are carrying the infection, increasing the risk of unknowingly transmitting it to others.
Who Is at Risk?
Anyone who is sexually active can contract gonorrhoea, but risk is higher among:
People with new or multiple sexual partners
Those with a history of other STIs
Individuals who do not use condoms regularly
Men who have sex with men (MSM), a group with elevated pharyngeal and rectal infection rates
Adolescents and young adults, due to higher rates of unprotected sex
Routine STI testing is encouraged for high-risk groups to facilitate early detection and treatment.
Sites of Infection
Gonorrhoea can affect multiple parts of the body:
Genitals: Urethra in men; cervix, uterus, and fallopian tubes in women
Rectum: Especially in people engaging in anal sex
Pharynx: From oral-genital contact
Eyes: Through hand-to-eye contact or during childbirth
Joints: Rarely, systemic spread can cause septic arthritis
The diversity of infection sites underscores the need for comprehensive sexual health screening when gonorrhoea is suspected.
Symptoms
Symptoms typically appear within 2 to 14 days of exposure, but many infected individuals—especially women—experience no symptoms at all.
In Men:
Burning sensation when urinating
White, yellow, or green penile discharge
Painful or swollen testicles (less common)
In Women:
Increased vaginal discharge
Painful urination
Vaginal bleeding between periods
Lower abdominal or pelvic pain
Rectal infections may cause:
Anal discharge
Itching or soreness
Painful bowel movements
Pharyngeal gonorrhoea is usually asymptomatic but may cause a sore throat or swollen lymph nodes.
Consequences of Untreated Gonorrhoea
If left untreated, gonorrhoea can lead to:
Pelvic inflammatory disease (PID) in women, causing chronic pelvic pain, infertility, or ectopic pregnancy
Epididymitis in men, a painful condition that may affect fertility
Disseminated gonococcal infection (DGI), where the bacteria spread to joints or the bloodstream
Increased HIV risk, as gonorrhoea makes mucous membranes more susceptible to infection
Pregnant women with untreated gonorrhoea risk passing the infection to their newborns, resulting in blindness or serious systemic infections.
Social Stigma and Mental Health
As with many STIs, gonorrhoea can cause significant emotional stress:
Shame, guilt, or anxiety about disclosure to partners
Relationship strain or fear of judgement
Delayed healthcare-seeking due to embarrassment
Public education and access to non-judgemental healthcare services are essential to reducing stigma and improving outcomes.
Prevention
Preventing gonorrhoea involves consistent use of condoms and open communication with sexual partners. Key strategies include:
Using condoms for all types of sexual contact
Limiting the number of sexual partners
Regular STI testing, especially after a new partner
Prompt treatment of infected individuals and their partners
Avoiding sexual contact until treatment is complete
In healthcare settings, especially maternity wards, newborn eye prophylaxis remains standard to prevent neonatal gonococcal infection.
Global Trends and Resistance
According to the World Health Organization (WHO), more than 80 million new gonorrhoea cases occur annually worldwide. Alarmingly, resistance to traditional antibiotics is on the rise, prompting the development of new treatment guidelines and the need for global surveillance.
New strains have shown resistance to:
Penicillin
Tetracycline
Fluoroquinolones
Even extended-spectrum cephalosporins in rare cases
This highlights the need for early detection, proper treatment adherence, and reporting of treatment failures.
Conclusion | Gonorrhoea
Gonorrhoea is a common yet potentially serious STI that affects individuals worldwide. With timely diagnosis and appropriate antibiotic therapy, it is entirely curable. However, if neglected, gonorrhoea can lead to long-term reproductive complications and increased HIV transmission risk. Public health awareness, regular testing, and responsible sexual practices are critical to stopping the spread of this infection.
