Gonorrhea
Gonorrhea is the second most common bacterial STI in Quebec. It is transmitted through unprotected sexual intercourse. It usually causes symptoms if it reaches the genitourinary region. Fortunately, antibiotic treatment is available free of charge to everyone in Quebec.
Causes
La gonorrhée est une infection causée par la bactérie Neisseria gonorrhoea. La bactérie se transmet habituellement par des sécrétions provenant du vagin, du pénis, de la bouche ou de l’anus. Les relations sexuelles non protégées constituent l’un des principaux facteurs de risque d’infection par la gonorrhée. Elle peut également être transmise d’une mère enceinte à son enfant lors de l’accouchement avec un risque de complications graves pour le bébé.
Who is at risk of infection?
Gonorrhea is the second most common bacterial STI in Quebec. For several years, there has been an increase in the number of cases of this infection, and it has been noted that the group most often affected is between the ages of 15 and 24 and is sexually active.
Between 10% and 20% of men and between 20% and 30% of women with genital gonococcal infection are also infected with Chlamydia trachomatis (see “Chlamydia”).
Simply being sexually active puts a person at risk of this infection. However, the following activities increase the risk of infection:
- Sex without a condom
- Sexual relations with several partners
- Sharing sex toys
Symptoms and complications
In men, urethritis is usually symptomatic. In women, cervicitis may be symptomatic. Infection at other sites is usually asymptomatic. When symptoms are present, they usually occur two to seven days after exposure and vary depending on the site of infection.
Possible symptoms, by site of infection, include:
- Genital tract: burning of the bladder or after intercourse, itching of the urethra, unusual odours or discharge
- For women: unusual vaginal bleeding. In more advanced cases, abdominal pain accompanied by fever and/or nausea is possible
- For men: testicular pain or swelling
- Throat: throat discomfort
- Rectum: abnormal secretions, pain or cramps, ulcerations
- Eye: pain, discharge, itching
There are many potential long-term complications associated with untreated gonorrhea. These include infertility, an increased risk of ectopic pregnancies, chronic testicular infection, chronic abdominal pain, or permanent scarring of the urinary tract. If left untreated, gonorrhea can infect the bloodstream, cause joint damage (septic arthritis), and even cause meningitis.
It is important to note that gonorrhea infection can increase the risk of becoming infected with and transmitting HIV.
Screening and treatment
How to screen? The most common specimens are direct samples taken from sites exposed by sexual activity (such as the vagina, anus and throat), as well as urine samples.
When to screen? The window period ends seven days after exposure.
Gonorrhea is treated with antibiotics. Treatment will completely eradicate the infection, except in cases of resistance to antibiotic therapy. Treatment is free for the infected person and their partners under the Free Medication Program for the Treatment of Sexually Transmitted Infections.
Once the diagnosis has been made, it is recommended that all sexual partners from the past 60 days be notified and treated.
Also, a period of abstinence following treatment is necessary, as a person remains contagious for some time after starting treatment. Once cured, there is no longer any risk of transmitting gonorrhea to other sexual partners. However, even after a treated episode, it is possible to be re-infected.
Since resistance to gonorrhea treatment is currently being observed, it is advisable to check the sample two weeks after treatment to confirm that the disease has been eradicated.
Protection
There is no vaccine to protect against gonorrhea. The best way to protect against gonorrhea is to use a condom at all times. Since it is possible to be infected and still have no symptoms, routine screening is recommended for all sexually active single people, especially in the presence of new partners or during unprotected sex.