Gonorrhea

In many cases, gonorrhea causes no visible symptoms, especially in women. This asymptomatic characteristic makes the infection difficult to detect without a targeted test. When symptoms do appear, they vary depending on biological sex and the location of the infection.

In women

Gonorrhea can cause increased vaginal discharge, pain or burning during urination, bleeding between periods or after sexual intercourse, and abdominal or pelvic pain. These signs can be subtle and are often confused with other urogenital infections such as cystitis or bacterial vaginosis.

In men

The symptoms are generally more obvious. They often manifest as pain or burning during urination, a yellow-green purulent discharge from the tip of the penis, and sometimes unilateral testicular pain or swelling.

In both sexes, gonorrhea can affect other areas. In the rectum, it causes anal pain, itching, discharge, or bleeding. An infection of the throat (pharyngitis) can cause a sore throat or go completely unnoticed. Finally, in rarer but more serious cases, the bacteria can spread to the joints, causing pain, redness, and swelling.

Gonorrhea is caused by a bacterium, Neisseria gonorrhoeae, also known as gonococcus. This bacterium is transmitted through unprotected vaginal, oral, or anal sex with an infected person. It colonizes the mucous membranes of the genitourinary system, but can also reach the rectum, throat, and eyes. In newborns, it can manifest as conjunctivitis, which is transmissible during childbirth and can lead to blindness if left untreated.
Transmission occurs through direct contact with infected secretions: semen, vaginal fluids, or even the presence of the bacteria on the mucous membranes. Asymptomatic carriers greatly contribute to the silent spread of the infection

Certain situations increase the likelihood of contracting gonorrhea. Sexually active people under the age of 30, especially women, as well as men who have sex with men (MSM), are considered to be at increased risk.
Having multiple sexual partners, frequently changing partners, or having a partner who has other sexual partners also increases the risk. Having a personal history of STIs is an additional vulnerability factor.
These risk factors justify regular screening, even in the absence of symptoms.

The diagnosis of gonorrhea is based on the analysis of biological samples. The most commonly used test is the nucleic acid amplification test (NAAT), performed on a urine sample or a local swab (cervix, urethra, rectum, or throat) depending on the site(s) of exposure.
In women, a cervical swab is often taken, while in men, a urine sample is sufficient in most cases. In cases of anal or oral sex, rectal or throat swabs are recommended.
Over-the-counter self-tests can detect an infection, but they are not a definitive diagnosis: medical confirmation is essential

Gonorrhea is an infection that can be cured with targeted antibiotic treatment. Treatment consists of a single intramuscular injection of ceftriaxone. When co-infection with Chlamydia trachomatis cannot be ruled out, additional antibiotic therapy with doxycycline is also prescribed. Treatment must be administered quickly after diagnosis, even in the absence of symptoms, in order to limit transmission. It is also recommended that recent sexual partners (within the previous 60 days) be treated to avoid cross-reinfection. Finally, sexual abstinence is recommended for seven days after treatment and until symptoms have completely disappeared, in order to prevent further transmission. In cases of persistent infection, a new test, accompanied by a culture with antibiogram, can detect possible antibiotic resistance.

If left untreated, gonorrhea can have serious consequences. In women, the infection can spread to the uterus and fallopian tubes, causing pelvic inflammatory disease (PID), which can lead to infertility (due to damage to the fallopian tubes), ectopic pregnancies, and chronic pelvic pain.
In men, gonorrhea can lead to epididymitis, an inflammation of the tube that carries sperm. If left untreated, this condition can affect fertility. The bacterium Neisseria gonorrhoeae can also enter the bloodstream and cause disseminated infections, such as septic arthritis, gonococcal dermatitis, or, more rarely, systemic infections such as meningitis or endocarditis.
In newborns, transmission during childbirth can lead to severe purulent conjunctivitis (neonatal ophthalmia), with a risk of blindness if left untreated.

Correct use of condoms significantly reduces the risk of infection, regardless of the type of intercourse (vaginal, anal, or oral). Regular screening is recommended for populations at risk. Finally, an innovative preventive strategy has recently been validated for at-risk populations: taking doxycycline post-exposure (doxy-PEP) within 72 hours of sexual intercourse can reduce the risk of gonorrhea by nearly 50%.

It is strongly recommended that you consult a healthcare professional as soon as certain symptoms suggestive of Neisseria gonorrhoeae infection appear:

• burning sensation when urinating;
• abnormal discharge from the penis, vagina, or rectum;
• pelvic or abdominal pain in women;
• testicular swelling in men.

Even in the absence of symptoms, a consultation is essential if a partner has been diagnosed as positive, or in the case of unprotected sexual intercourse with a partner whose status is unknown. Prompt treatment is not only important for the health of the infected person, but also to avoid infecting others

Can gonorrhea heal on its own?
No. Gonorrhea does not disappear spontaneously. Without treatment, it can persist in the body, develop into more serious forms, and lead to complications such as infertility or widespread infections. Antibiotic treatment is essential to cure the infection.

Can you be infected with gonorrhea without knowing it?
Yes, in fact it is quite common. The majority of women, and a significant number of men, do not show any noticeable symptoms. This explains why the infection can go unnoticed and be transmitted to others without the infected person knowing.

After treatment, am I immune to gonorrhea?
No. A cured infection does not protect against reinfection. It is possible to be infected several times during one's lifetime, especially if risky sexual practices continue.

Should both partners be treated at the same time?
Yes. To avoid cross-reinfection, it is essential that all recent sexual partners (within the last 60 days) be tested and treated, even if they have no symptoms. This is an integral part of the management strategy.

Do condoms really protect against gonorrhea?
Yes, if used correctly and consistently, condoms significantly reduce the risk of gonorrhea transmission, regardless of the type of sexual intercourse (vaginal, anal, or oral). 

How is the screening test performed?
Screening is based on a urine sample or a swab (vaginal, anal, or throat) depending on sexual practices. The most commonly used test is the nucleic acid amplification test (NAAT), which is both fast and very reliable.

Can gonorrhea affect parts of the body other than the genitals?
Yes. Gonorrhea can also infect the rectum, throat, eyes (especially in infants), and, more rarely, the joints or blood. These extragenital forms require specific diagnosis and appropriate treatment.