Gonorrhea

Also known as: GC, "Clap", VD, "Drip", Urethritis, Pelvic Inflammatory Disease, PID
Pronunciation: gone-or-ree-ah

Intro
With more than one million new cases reported each year (that doesn't include unreported cases that double this figure), gonorrhea is the most common STD worldwide and the most commonly reported communicable disease in the U.S. It can infect many different parts of your body: mouth, throat, urethra (the tube in your penis), anus or vagina.

What is it?
Gonorrhea is a sexually transmitted bacterial infection caused by Neisseria gonorrhoeae. In men, the bacteria often infects your urethra, the tube inside your penis that carries urine or semen. In women it can infect your vagina, uterus and fallopian tubes. It can also infect your mouth, throat and anus. You can be infected in several places at once.

Diagnosis
Gonorrhea is often diagnosed by culturing the discharge. If the discharge is minimal, a doctor might pass a tiny swab into your urethra to obtain a sample. I know you're probably squirming, but it doesn't hurt -- honest. Because the bacteria are extremely sensitive to drying and require a high concentration of carbon dioxide to grow, cultures must be performed under very strict conditions. Otherwise the bacteria won't grow and you will think you don't have gonorrhea when in actuality you do. Doctors also frequently send a swab to the laboratory for DNA analysis. A positive DNA test means you are infected. This test is probably more accurate than a culture because it does not have to be performed under such strict conditions. Gonorrhea in your mouth, throat and anus (common locations) is often difficult to diagnose because your doctor might not think of the problem and the symptoms are often atypical and cause less pain and discharge than when it infects your penis or vagina.

If you have a sore throat or bottom, be sure to tell the doctor about your sexual practices so that adequate cultures are taken. If your doctor doesn't think to culture these areas because he/she doesn't know you've had anal or oral sex, then the diagnosis won't be made and you won't be treated.

Symptoms
Symptoms generally appear two to five days after infection. In men, the most common symptom is a greenish, yellow penile discharge. Although usually profuse, you might notice only a stain on your underwear. The discharge is often accompanied by dysuria (a burning pain with urination). In women, gonorrhea infects the vagina and quickly spreads into the uterus and tubes. Symptoms include severe lower abdominal and pelvic pain with fever and nausea. This condition is known as pelvic inflammatory disease (PID). When gonorrhea infects your mouth, throat or anus, the diagnosis can be more difficult to make. Throat and mouth infections resemble that typical "sore throat" that you often get. The pain may also be minimal or go away fairly quickly. If your doctor doesn't know you have given oral sex, he/she might not think of gonorrhea as a possible cause. If the doctor doesn't think of gonorrhea, you won't be treated. In your anus, gonorrhea might be present as an anal discharge or bloody bowel movement. You might also complain of pain, but that is less common. Again, if you don't tell your doctor you've had anal sex, he/she might not think to culture you for gonorrhea.

How do you get it?
Gonorrhea is spread via sexual contact: specifically anal, oral or vaginal contact. You can get gonorrhea without penetration. A condom will help protect you, but most men and women don't use condoms for oral sex or during foreplay, when a lot of rubbing can occur and the discharge can seep into your anus, urethra or vagina.

How to treat it?
Gonorrhea is treated with antibiotics. Originally, penicillin was the drug of choice, but over the years, gonorrhea has become increasingly resistant to this type of antibiotic. You must notify all sex partners so they can be treated as well.

Prevention
Because the bacteria has strict requirements for growth -- a warm, dark, moist carbon dioxide rich environment -- washing after sex with soap and water will go a long way in preventing infection. A condom will help protect you, but it must be worn for foreplay and oral sex. If you are about to have sex with a partner who has a greenish yellow discharge coming out of his/her penis or vagina, suggest he/she get tested for gonorrhea before you do the nasty. Pre-cum is usually clear but the discharge from gonorrhea isn't.

Incubation period
Symptoms begin two to five days after infection.

Sex
Gonorrhea is easily passed during sex with an infected partner. Penetration is not necessary and oral sex is a frequent way gonorrhea passes between partners. Gonorrhea also makes it easier to catch or transmit HIV.

Prevalence
Worldwide, gonorrhea is the most common STD. In the United States, gonorrhea is the most commonly reported communicable disease.

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