Par Eric Charette | 08 June 2021

Gonorrhea

Gonorrhea is the second most widespread bacterial STBBI in Québec. It is transmitted during unprotected sex and presents itself with symptoms if it infects the genieourinary system. Luckily, its antibiotic treatment is offered at no cost in Quebec.

Causes

Gonorrhea is an infection caused by the bacteria Neisseria gonorrhoea. The bacteria is generally transmitted by secretions from the vagina, penis, mouth or anus. This is why unprotected sex is one of the main risk factors for gonorrhea. Gonorrhea can also be transmitted from a pregnant mother to her baby during birth, risking serious complications for the baby.

Who is at risk of infection?

Gonorrhea is the second most widespread bacterial STBBI in Québec. Over the past several years, we have seen a growing number of gonorrhea infections, most often affecting people aged 15 to 24 years who are sexually active. Also, between 10–20% of men and 20–30% of women who are diagnosed with a genitourinary gonorrheal infection are also infected by Chlamydia trachomatis (see “Chlamydia”).

Simply being sexually active puts a person at risk of this infection. Nevertheless, the following activities can increase your risk of infection:

  • having sex without a condom
  • having sex with multiple partners
  • sharing sex toys

Symptoms and complications

In men, urethral infection is usually symptomatic. In women, cervical infections may be symptomatic. Infections of other sites are generally asymptomatic. When symptoms do appear, they are typically observed two to seven days after the at-risk exposure, and can vary depending on the site of the infection.

Possible symptoms, by site of infection, include:

  • Genital tracts: burning while urinating or after sex, urethral itching, unusual discharge or odour
    • For women: unusual vaginal bleeding. In more advanced cases, it is possible to have abdominal pain accompanied by fever and/or nausea.
    • For men: painful or swollen testicles
  • Throat: sore throat or throat discomfort
  • Rectum: abnormal secretions, pain or cramps, bleeding, ulcerations
  • Eye: pain, discharge, itching

There are many potential long-term complications of untreated gonorrhea. These include infertility, increased risk of ectopic pregnancy, chronic testicular infection, chronic abdominal pain and permanent scarring of the urinary tract. Without treatment, gonorrhea can infect the circulatory system, cause damage to joints (septic arthritis) and even cause meningitis.

It is important to note that a gonorrhea infection can increase your risk of being infected by or transmitting HIV.

Screening and treatment

How to test: The most common samples are swabs of sites exposed during sexual activity (such as the vagina, anus and throat) and urine samples.

When to test: The window period ends seven days after exposure.

Gonorrhea is treated with antibiotics. Treatment will completely eradicate the infection unless there is resistance to antibiotics. Treatment is free for those affected, as well as their partners, as part of a program for free medication to treat sexually transmitted infections.

When diagnosed, it is also recommended to inform and treat all sexual partners from the last 60 days.

Likewise, a period of abstinence for seven days following treatment for gonorrhea is necessary because a person continues to be contagious for several days after starting medication. Once cured, there is no longer a risk of transmitting gonorrhea to other sexual partners. However, even after treating the infection, it is possible to be re-infected.

Since a treatment-resistance phenomenon is currently being observed, it is warranted to re-test two weeks following treatment to confirm that the infection has been eradicated.

Protection

There is no vaccine to protect against gonorrhea. The best means of protection is to use condoms, regardless of the type of sex. Since it is possible to be infected and not have any symptoms, routine screening is recommended for anyone who is single and sexually active, especially when there have been new partners or unprotected sex.

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