Gonorrhea

by Health Canada

Gonorrhea, a sexually transmitted infection (STI) that can cause sterility, is on the rise and growing dangerously resistant to antibiotics.

Gonorrhea is a bacterial infection (commonly known as "the clap") that is transmitted through oral, genital or anal sex with an infected person. It can also be spread from mother to child during birth.

After 20 years of constant decline in Canada, the rates of infection for gonorrhea have risen more than 40 percent over the past five years. The recent rise in gonorrhea infection is attributed to people not consistently using safer sex methods. In addition, drug-resistant strains of the disease are being found across the country. The proportion of samples resistant to ciprofloxacin, one of the leading antibiotics for gonorrhea, has risen more than two hundredfold in the last decade.

Symptoms of Gonorrhea

The symptoms of gonorrhea infection are different in women and men. When first infected, some men will have no symptoms at all. For men who do experience symptoms, these may include:

• A burning sensation when urinating
• Yellowish white discharge from the penis
• Painful or swollen testicles.

Symptoms usually appear two to five days after infection, but it can take up to 30 days for symptoms to appear.

For women, the early symptoms of gonorrhea are often mild and many infected women have no symptoms at all. In other cases, women may mistake the symptoms for a bladder or vaginal infection. For women who do experience symptoms of infection, these can include:

• A burning sensation when urinating
• A vaginal discharge that is yellow or occasionally bloody
• Women with mild or no symptoms are still at risk of serious complications from the infection.

Symptoms of rectal infection include:

• Discharge
• Anal itching
• Soreness
• Bleeding
• Occasionally, painful bowel movements.

Infections in the throat cause few symptoms.

Even without symptoms, gonorrhea can be transmitted to others; anyone at risk should therefore be tested.

The Health Risks of Gonorrhea

In women, untreated gonorrhea can lead to pelvic inflammatory disease (PID). PID effects include abdominal pain, fever, internal abcesses, long-lasting pelvic pain and scarring of the fallopian tubes, causing infertility and increasing the chance of ectopic or tubal pregnancies.

Men can develop scarring of the urethra, making urination difficult and potentially leaving them infertile from genital tract scarring. Both sexes are at risk of the infection spreading through the bloodstream into the joints, causing inflammation and swelling - a type of arthritis called Reiter's Syndrome.

If a pregnant woman has gonorrhea, the infection can be passed to the baby in the birth canal during delivery, causing blindness, joint infection or a life-threatening blood infection. Infection with gonorrhea also increases the risk of transmitting and acquiring HIV.

Testing for gonorrhea infection can be done with a urine test or swab for culture. Gonorrhea can be treated with a single dose antibiotic. Again, resistance of gonorrhea to antibiotic treatment is increasing.

Minimizing Your Risk

Following these suggestions may help you to protect yourself from contracting gonorrhea:

• Learn about safer sex methods.
• Make informed decisions. Talk to your partner(s) about their STI status and the use of protection.
• Correct use of condoms reduces the risk of acquiring gonorrhea and other STIs.
• Get tested for gonorrhea if you are sexually active.
• If you are diagnosed and treated for gonorrhea, be sure to follow your health care provider's treatment and follow-up recommendations. If infected, you should abstain from sex until both you and your sexual partner(s) have completed your antibiotic treatment. You can easily be reinfected if your partner is not treated as well.
• It is important that you or someone from your public health department notify any of your sexual partners who may have been put at risk of infection. They will also need to be tested and possibly treated.

Health Canada's Role

Health Canada's Sexual Health and Sexually Transmitted Infections Section provides national leadership and coordination through programs that develop and support surveillance and targeted research studies. Working with provincial and territorial governments, non-governmental organizations and health care providers, the Section develops evidence-based national standards and policies, promotes the exchange of information and engages in prevention and promotion activities.

About the Author

www.hc-sc.gc.ca
Health Canada is the Federal department responsible for helping Canadians maintain and improve their health, while respecting individual choices and circumstances.