Gonorrhea in Women

What is gonorrhea?

Gonorrhea is a common sexually transmitted disease. Popular names for gonorrhea are clap, drip, dose, and strain.

How does it occur?

Gonorrhea is caused by bacteria. The infection is passed from person to person during sex. It is very contagious. The bacteria can enter the body through any body opening, such as the mouth, vagina, penis, or rectum.

In women, the infection usually starts in the cervix. The cervix is the opening of the uterus inside the vagina. The bacteria may infect the throat or rectum after oral or anal sex.

What are the symptoms?

Many women infected with gonorrhea have no symptoms. If symptoms occur, they usually appear 2 to 10 days after exposure to the disease. Symptoms of gonorrhea include one or more of the following:

• thick, creamy, yellow vaginal discharge
• burning or pain when you urinate
• bleeding or spotting between periods
• menstrual periods that are heavier than usual
• abdominal pain
• pain during sex
• fever.

Sometimes, after weeks of no symptoms, lower abdominal pain will begin. It may start just when you have intercourse but then become daily. This can mean that gonorrhea has infected the female organs in the pelvis--the uterus, ovaries, or fallopian tubes.

How is it diagnosed?

Other infections can cause symptoms similar to gonorrhea. A lab test of discharge from your cervix or a test of your urine will be done to check for gonorrhea. Depending on which kind of testing is available and how far the lab is from where you are being tested, you may have test results the same day or it may take 2 to 3 days.

You should have an abdominal and pelvic exam to determine how far the infection may have spread. During the pelvic exam, tests can be done for gonorrhea as well as other sexually transmitted infections. Your healthcare provider will be able to tell if your uterus, ovaries, or fallopian tubes are tender and probably infected.

What is the treatment?

Gonorrhea is treated with antibiotic medicine, usually given as a shot. Many people with gonorrhea also have chlamydia (another sexually transmitted disease). Because of this, you may be given more than one drug to treat both diseases.

Tell your sexual partner or partners about their risk of infection. They also should be treated even if they don't have symptoms.

How long will the effects last?

If only the cervix is infected, proper treatment should clear up the infection in about 10 days.

The effects of the disease depend on:

• how long you have had gonorrhea
• how much the infection has spread
• if you have had gonorrhea before.

If not treated, gonorrhea in women can spread through the uterus to the fallopian tubes and ovaries, causing pelvic inflammatory disease (PID). PID can cause frequent abdominal pain and infertility, as well as increase the risk of a tubal pregnancy (a pregnancy outside the uterus). Further complications of untreated gonorrhea include spread of infection into the bloodstream and to other parts of the body, such as the joints, where it can cause pain and swelling (arthritis); or it can lead to meningitis, endocarditis (an infection inside the heart), and even death.

A baby can be infected during childbirth if the mother has gonorrhea. When the baby passes through the birth canal, the bacteria can get into and infect the baby's eyes.

How can I take care of myself?

• Follow the full treatment prescribed by your healthcare provider.
• Take aspirin, acetaminophen, ibuprofen, or naproxen to reduce pain.
• Tell everyone with whom you have had sex in the last 3 months about your infection. They must also be treated, even if they have no symptoms. Do not have sex before both you and your partner have finished all the medicine and your provider says it is OK.
• Follow your provider's instructions for follow-up visits and tests. Your provider may need to make sure that the infection is gone.
• Call your provider right away if:
  • You develop severe abdominal pain.
  • You develop a fever over 101.5°F (37.8°C).
  • You feel you are getting sicker instead of better.
• Ask your provider if you have been tested for other sexually transmitted diseases that you may have gotten when you were infected with gonorrhea.
• If you have finished all of your antibiotics but still have symptoms, you need to contact your healthcare provider. Sometimes with PID a longer course of antibiotics is needed to get rid of all the Infection. This is important to try to prevent infertility and tubal pregnancies, which are fatal for the baby and dangerous for the mother.

How can I prevent the spread of gonorrhea?

• Follow your healthcare provider's instructions.
• Make sure you tell your sexual partner(s) that they have been exposed to gonorrhea. They need to be treated.
• Take all of your antibiotics
• Do not have sex until your provider says it's OK.
• Always use condoms before and during oral, vaginal, and anal intercourse.

How can I help prevent gonorrhea?

• Reduce the risk of infection by always using latex or polyurethane condoms during foreplay and vaginal, oral, or anal intercourse.
• Have just 1 sexual partner who is not sexually active with anyone else. Make sure your partner has been tested for gonorrhea and other sexually transmitted diseases.
• If you have had unprotected sex (without a condom), see your healthcare provider to be checked for sexually transmitted diseases even if you do not have any symptoms.
• If you have been sexually assaulted and are at risk for having been infected with gonorrhea, you should be checked for sexually transmitted infections and treated to prevent infection.