Gonorrhea is caused by Gram negative bacteria Neisseria gonorrhoeae, also known as gonococcus. It is a sexually transmitted infection (STI). Gonorrhoea has been referred to as the “clap” in history.

Transmission of gonorrhea

Gonococcus is present in the discharge from the penis and vaginal fluid of the infected men and women. Routes of transmission of infection include:

• It can be passed from person to person by having unprotected vaginal, oral or anal sex
• It can also be transmitted by sharing sex toys and vibrators with an infected individual without washing or covering them with a condom at each use
• Gonococcus can be transmitted from a pregnant woman to her baby

Incubation period

The incubation period is usually taken as being between 2 and 5 days but may be up to 10 days. Incubation period is the time taken from exposure to the infection and appearance of the symptoms.

Symptoms of gonorrhoea infection

Around 50% women and 10% men may show no symptoms of the infection.

In men:

• • In more than 80% men there is discharge from the urethra. The discharge may be clear, watery or may be yellowish pus filled.
  • In over 50% of men with the infection there is pain on urination or dysuria
  • There is pain or tenderness of the epididymis, testes and genitals in case of inflammation.
  • In case of a rectal infection 12% may experience discharge from the anus and pain and itching around the anus. 7% individuals with infection may experience bleeding
  • In case of an infection of the pharynx or back of the throat more than 90% do not show any symptoms.
  • Infection of the eyes can cause pain, swelling, irritation and discharge. This is called gonococccal conjunctivitis.

In women:

• • Infection of the cervix or endocervical infection. Around 50% of women with a cervix infection may have no symptoms. In the rest the most common symptom is discharge from the vagina. The discharge may be clear, watery or may be yellowish pus filled.
  • A quarter of patients experience lower abdominal pain. 
  • Some women experience bleeding between periods or heavy menstrual bleeding due to the infection. The bleeding from the cervix is easily induced.
  • In 12% of women with the infection there is pain on urination or dysuria. However, there is no urgency to urinate frequently. This is a symptom seen in urinary tract infections.
  • Rectal infections usually show no symptoms in women. It occurs due to spread of the vaginal secretions to the rectum or due to anal intercourse with an infected partner
  • In over 90% infected women with gonococcal infection of the pharynx, there are no symptoms.
  • Infection of the eyes can cause pain, swelling, irritation and discharge. This is called gonococccal conjunctivitis.

In children:

• • Acute inflammation of the conjunctiva (acute conjunctivitis) is a common finding.
  • There is usually a pus filled discharge from both the eyes.
  • The eye lids are swollen and the eyes are suffused with blood vessels and appear red.
  • The condition in new-borns who have acquired the infection from their mothers is called ophthalmia neonatarum and begins in less than 48 hours after birth.

Symptoms if left untreated

Left untreated, infertility and pelvic inflammatory disease can occur in women with gonorrhoea infection. In men, if left untreated complications like inflammation of the epididymis (epididymitis); prostate gland (prostatitis) and urethral structure (urethritis) may occur. Other complications include affliction of joints or septic arthritis, blurring of vision etc.