STIs: Gonorrhea & Gonorrhea Treatment

Gonorrhea is a Sexually Transmitted Infection (STI) caused by a bacteria known as Neisseria gonorrhoeae or gonococcus. It is colloquially known as ‘the clap’. It is one of the 2 most common sexually transmitted infections in Singapore (the other common STI is chlamydia).

Neisseria gonorrhea bacteria can be found in the fluid discharges from the penis or vagina. It can be spread via unprotected sexual intercourse be it – vaginal sex, anal sex or oral sex. Sex toys or vibrators that are not cleaned properly after use can be a source of spread as well.

Those who have multiple sexual partners, or frequently change sexual partners without the use of barrier method of contraception are at risk.

Symptoms of Gonorrhea STI

Symptoms typically occur within 2 weeks after exposure and infection, though it can occur much later beyond the window period. Even if you have no symptoms, you should consider going for a gonorrhea test if you have reason to believe you have been afflicted by the disease.

One can have no symptoms. 1 in 10 men has no symptoms. 1 in 2 female has no symptoms.

In female, one can present with

  • Unusual vaginal discharge – it can be thin, watery, colorless like to green and yellow in color
  • Painful and burning sensation on urinating
  • Lower abdominal pain or discomfort
  • Abnormal bleeding: bleeding in between menses, heavier menses, bleeding after sex

In men, one can present with:

  • Unusual discharge from the penis – it can be white, yellow or greenish in color
  • Painful and burning sensation on urinating
  • Pain and swelling over the foreskin
  • Painful testicles

Gonorrhea can cause symptoms over the rectum (back passage), throat or eyes, leading to symptoms such as

  • Pain and unusual discharge from the anus
  • Sore throat
  • Red eyes with abnormal discharges

Should I get tested for Gonorrhea STI?

You should, if:

  • You or your partner have gonoorrhea symptoms
  • You had unprotected sex with a new partner
  • You or your partner had unprotected sex with other people
  • Your partner told you they have STIs
  • You have other concurrent STIs
  • You are pregnant or planning to conceive

If you fall under any of these categories, speak to a healthcare professional to get a gonorrhea test.

Diagnosis of Chlamydia STI

Testing for Female

  • Gonorrhea swab test – This involve an internal examination, where the trained clinician will insert a speculum (plastic device) into your vagina, and use a brush swab to collect the sample from your cervix.

Testing for Men

  • Urine sample test – You are advised to provide a urine sample for PCR testing of gonorrhea bacteria. It is important to hold your urine for at least 2 hours beforehand, as recent urination can wash the bacteria away affecting the test results.
  • Swab test – This may be offered to collect sample from discharges over the tip of penis

In cases where the concerns of rectum, throat, or eyes are infected, your doctor may offer swab tests to collect samples from the affected areas.

Currently, there is a single test to detect Neisseria Gonorrhea and Chlamydia Trachomatis bacteria. This is to screen concurrently for both STIs under one setting. Speak to your doctor on CTNG PCR DNA swab/ urine tests. Testing if you are exposed to sexual contact with someone who has gonorrhea is highly recommended for both your and your partner’s well being.

Gonorrhea treatment

Treatment for gonorrhea include:

  • Single antibiotics injection (Ceftriaxone) and single antibiotics tablets (Azithromycin)
  • You may be offered other types of antibiotics treatment if you have drug allergies or bacteria resistance towards the offered antibiotics.
  • You are advised to follow up in the clinic 2 weeks after treatment with repeat swab or urine test to ensure clearance.
  • You should abstain from sexual contact until the treatment of the disease has been completed.
  • Sexual partners should be advised for treatment for gonorrhea as well

Why should we treat Gonorrhea STI?

In women, Gonorrhea can spread in the reproductive organs, affecting the womb, the cervix, fallopian tubes or even the ovaries, causing pelvic inflammatory disease. In the long term, this can lead to chronic pelvic pain and discomfort, increase the risk of ectopic pregnancy and infertility.

If you have untreated gonorrhea and you are pregnant, the infection can be passed down to the baby, increasing the risk of permanent blindness in the baby.

In men, untreated Gonorrhea can cause infection of the urethra, painful testicles and prostate gland inflammation. When it comes to gonorrhea symptoms, men and women present differently, so it is important to visit a doctor for so that it does not worsen into more severe health problems.

Gonorrhea infection can seed in the back passage (rectum), the throat (in cases of oral sex) or even the eyes, causing conjunctivitis. Rarely, Gonorrhea can spread into the bloodstream causing infection of the blood (septicemia), and affect the joints (Gonococcal arthritis).

How to prevent getting Gonorrhea?

  • Use barrier contraception (male condoms or female condoms) every time during sexual intercourse
  • Do not share sex toys, wash and cover them with a condom before anyone uses them

Importantly to note that: Previous successful treatment of gonorrhea does not give you immunity against future Gonorrhea infection, so practice safe sex. See a doctor immediately and do engage in sexual activities if you suspect you have any sexually transmitted infections.

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