MEN'S HEALTH Sexually Transmitted Diseases • Genital warts • Chlamydia • Genital herpes • Gonorrhea • Syphilis WOMEN'S HEALTH Sexually Transmitted Diseases • Genital warts • Chlamydia • Genital herpes • Gonorrhea • Syphilis

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Gonorrhea, a highly contagious sexually transmitted disease (STD), is one of the most commonly reported diseases in the United States, with more than 350,000 cases each year.

Sometimes referred to as the clap, gonorrhea often is characterized by thick discharge from the penis or vagina. However, many people experience no signs or symptoms.

The bacterium Neisseria gonorrhoeae, also referred to as gonococcus, causes gonorrhea. The disease spreads through semen or vaginal fluids during unprotected sexual contact, heterosexual or homosexual, with an infected partner. The more sexual partners you have, the greater your risk. An infected pregnant woman also can pass gonorrhea to her baby during delivery. Casual contact, such as kissing, doesn't spread the disease.

About three out of four reported cases of gonorrhea in the United States occur in people younger than 30. The highest rates of infection often are present in 15- to 19-year old women and 20- to 24-year-old men.

Treatment for gonorrhea involves a course of antibiotic medications to eliminate the infection. Practicing safe sex is important in preventing gonorrhea.

Signs and symptoms of gonorrhea may include:

• Thick, cloudy or bloody discharge from the penis or vagina
• Pain or burning sensation when urinating
• Frequent urination
• Pain during sexual intercourse

The first signs and symptoms of gonorrhea generally appear within two to 10 days after exposure to the bacterium. However, some people may be infected for months before signs or symptoms occur.

How gonorrhea affects men
In men, first there's a tingling sensation in the urethra, the passageway that carries urine from your bladder to the outside of your body. Later, urination becomes painful and you may notice a discharge from your penis. As the infection progresses, urethral pain usually becomes more pronounced and the discharge becomes more profuse and thick.

How gonorrhea affects women
In women, the signs and symptoms, if any, may be so mild you may not realize you have the infection. Often, the only clue that you may have gonorrhea is that someone who you've had sexual contact with develops the disease. The infection usually affects the cervix and other reproductive organs as well as the urethra. In some women, gonorrhea causes frequent, urgent and painful urination along with an abnormal discharge from the vagina or urethra.

Ask your doctor to test for gonorrhea if you:

• Have a discharge from your vagina or penis or have other signs or symptoms of gonorrhea
• Are concerned that a partner may have been exposed to the infection
• Know gonorrhea has been diagnosed in a partner

Testing for sexually transmitted diseases (STDs) isn't part of a routine gynecologic exam for women or a regular physical exam for men. Talk to your doctor if you're concerned that you may have gonorrhea or another STD.

To confirm a diagnosis of gonorrhea, your doctor takes samples for laboratory analysis of any discharge noted during a physical exam. Your doctor may also test you for other STDs, such as chlamydia, syphilis and the human immunodeficiency virus (HIV), the virus that causes AIDS. Other STDs commonly occur along with gonorrhea.

Not receiving adequate treatment for gonorrhea may lead to complications. These may include:

• Inflammation of the testicles. In men, inflammation of the testicles (epididymitis) is an acute condition treatable with antibiotics and pain relievers. If untreated, it may lead to infertility.
• Pelvic inflammatory disease. In women, the bacteria can spread into the uterus and fallopian tubes, causing pelvic inflammatory disease (PID), which may result in scarring of the tubes, greater risk of ectopic pregnancy and infertility. PID may lead to abdominal pain, backache, irregular menstrual periods, pain during intercourse and foul-smelling vaginal discharge. It's a serious infection that requires immediate treatment by a doctor. PID infects more than 1 million women in the United States each year.
• Anorectal gonorrhea. In both sexes, anorectal gonorrhea may result from anal intercourse with an infected person or from the infection spreading from the genital area. It may cause some discomfort in and discharge from the anal area, but in many cases no signs or symptoms are present.
• Irritation of your throat and tonsils. Oral sex can lead to pharyngeal gonorrhea with a sore throat, pain on swallowing and redness of the throat and tonsils.
• Eye inflammation. If the infection spreads to the eye by touching, gonorrhea can cause a red, inflamed eye (conjunctivitis). In babies who contract gonorrhea during childbirth, gonorrheal eye infections can lead to blindness.
• Widespread infection in your body. The bacterium that causes gonorrhea can spread through the bloodstream to cause infection in other parts of your body. Fever, rash, joint pain, swelling and stiffness are possible results.

Doctors prescribe antibiotic medications to treat gonorrhea. Because more and more strains of gonorrhea are becoming drug resistant, it's important that you take the full course of medication. Not taking the full course of medication may allow the most drug-resistant organisms to survive. Although over-the-counter pain relievers may reduce signs or symptoms, these medications won't cure gonorrhea.

To prevent the spread of gonorrhea, use latex condoms and avoid oral sex. Gonorrhea is highly contagious, and yet may cause no signs or symptoms.

If you have gonorrhea, avoid sexual contact until a course of antibiotics completely eliminates your infection. Having had gonorrhea once doesn't provide you immunity from getting it again.

Schedule a follow-up examination with your doctor after you have completed the course of antibiotics so that your doctor can check to see if your infection has been completely eliminated.