Gonorrhea is a common sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. An estimated 1.14 million new gonococcal infections occur annually in the United States. Here are 3 important facts about gonorrhea that everyone should know:
Fact 1: Gonorrhea can cause serious health complications if left untreated
Gonorrhea is a treatable infection, but if left untreated, it can lead to serious health problems. In women, untreated gonorrhea can spread to the uterus and fallopian tubes, causing pelvic inflammatory disease (PID). PID can lead to chronic pelvic pain, ectopic pregnancy, and infertility. Studies show that 10-15% of women with untreated gonorrhea will develop PID. In men, untreated gonorrhea can lead to a painful condition called epididymitis, which causes inflammation and possible infertility. It can also spread to the prostate gland and cause prostatitis.
Overall, untreated gonorrhea allows the bacteria to spread through the bloodstream (sepsis) and infect other parts of the body, including the joints. Disseminated gonococcal infection, or DGI, can lead to arthritis, skin lesions, and endocarditis (inflammation of the inner lining of the heart). DGI occurs in an estimated 0.5%-3% of gonorrhea cases. Given the potentially severe complications, timely diagnosis and treatment of gonorrhea is essential.
Complications of Untreated Gonorrhea
| Complication | Details |
|---|---|
| Pelvic inflammatory disease (PID) | Infection spreads to uterus and fallopian tubes, causing pelvic pain and raising risk of ectopic pregnancy and infertility |
| Epididymitis | Painful inflammation of the epididymis in men that can lead to infertility if both testicles are affected |
| Prostatitis | Infection spreads to the prostate gland, causing inflammation |
| Disseminated gonococcal infection (DGI) | Gonorrhea spreads through the bloodstream and infects joints, skin, heart, etc. |
Fact 2: Gonorrhea is becoming increasingly resistant to antibiotics
Over the years, Neisseria gonorrhoeae has progressively developed resistance to many of the antibiotics used to treat it. Penicillin and tetracycline were once effective treatments, but resistance emerged in the 1970s and ’80s. Fluoroquinolone antibiotics, such as ciprofloxacin, became the treatment of choice in the 1990s but resistance to this drug class rapidly spread. By 2007, fluoroquinolones were no longer recommended for gonorrhea treatment in the U.S. due to widespread resistance.
Today, the primary antibiotics used to treat gonorrhea are ceftriaxone, often paired with azithromycin. Worryingly, the first U.S. cases of highly drug-resistant gonorrhea with elevated ceftriaxone minimum inhibitory concentrations (MICs) were detected in Hawaii in 2011. Since then, ceftriaxone resistance has spread and increased globally. The WHO predicts that untreatable gonorrhea “superbugs” could emerge worldwide in the near future if new antibiotics are not developed.
Timeline of Gonorrhea Antibiotic Resistance
| Date | Event |
|---|---|
| 1970s to 1980s | Resistance to penicillin and tetracycline emerges |
| 1990s | Fluoroquinolones like ciprofloxacin become treatment of choice |
| 2000s | Fluoroquinolone resistance spreads, these drugs no longer recommended |
| 2011 | First ceftriaxone-resistant gonorrhea cases detected in Hawaii |
| 2010s to today | Ceftriaxone resistance increasing globally |
Fact 3: Proper condom use offers good protection against gonorrhea
Gonorrhea is spread through unprotected sexual contact with an infected partner. Using condoms consistently and correctly offers effective protection against the infection. One study found that consistent condom users were 80% less likely to acquire gonorrhea compared to inconsistent or non-users.
To get the most protection, condoms should be put on before any sexual contact and worn during the entire sex act (vaginal, anal, or oral). It’s also important to use a water-based lubricant with latex condoms to prevent breakage. The female condom also provides protection against gonorrhea for receptive sex partners. Avoid using condoms past their expiration date or if the packaging is damaged.
No type of contraception besides condoms prevents the spread of STIs like gonorrhea. Even while using condoms, it’s recommended to get regularly tested if sexually active, especially if with multiple partners whose STI status is unknown.
Gonorrhea Prevention Tips
| Prevention Method | Details |
|---|---|
| Male latex condom use | Provides protection against gonorrhea if used correctly for all sex acts |
| Female condom use | Offers protection for women receiving vaginal or anal sex |
| Water-based lubricant | Helps prevent condom breakage |
| Regular STI testing | Get tested if sexually active, especially with multiple partners |
In summary, three important facts about gonorrhea are: 1) It can lead to severe complications like infertility if untreated; 2) Antibiotic resistance is rising and untreatable strains may emerge; and 3) Correct condom use helps prevent transmission. Being aware of these facts and getting tested regularly if sexually active can help reduce your risk of contracting this concerning STI.