Gonorrhea: Overview

Gonorrhea, also called "the clap," is a highly contagious sexually transmitted disease (STD). It is the second most reported infectious disease in America (after chlamydia), according to the U.S. government. The gonorrhea bacteria spread through the body fluids associated with sexual activity. These bacteria inflame body tissues in women and men.

More than 335,000 cases of gonorrhea were reported to the Centers for Disease Control and Prevention (CDC) in 2003, the last year for which figures are available. However, the CDC estimates that this number accounts for only half of the nation's gonorrhea cases.

Transmission of gonorrhea

Transmission of gonorrhea can occur during any kind of sexual contact with an infected person ?- vaginal, oral or anal. Ejaculation by a male partner during sex is not necessary to spread gonorrhea.

Nonsexual transmission of gonorrhea can also occur. A pregnant woman with gonorrhea can transmit it to her baby during childbirth, frequently causing an eye infection. In addition, an infected person can transmit the bacteria from the original infection site by touching that area and then touching another susceptible body part, either on herself or someone else, such as the eyes. However, it cannot be spread through kissing.

In women, the gonorrhea bacteria frequently enter the body during vaginal intercourse. The disease usually first infects the opening of the uterus (the cervix) or the urethra (the tube just above the vagina that leads to the bladder). Most women experience no symptoms.

Gonorrhea bacteria cannot easily adhere to membranes of the vagina in adult women. However, in girls who have not reached puberty, the gonorrhea bacteria can adhere to these vaginal membranes and cause an infection of the vagina called vulvovaginitis.

Gonorrhea infection in the anal area may be caused by anal sex or movement of the bacteria from the genitals to the anus. Oral sex may cause gonorrhea of the throat.

The gonorrhea bacterium can only live briefly away from a moist surface. It cannot survive on or be transmitted from inanimate objects or surfaces.

Consequences of gonorrhea

If gonorrhea is left untreated, it can spread to other organs. In women, gonorrhea most commonly spreads into the upper reproductive organs, such as the uterus, fallopian tubes and ovaries. Inflammation in those sites can cause pelvic inflammatory disease (PID).

If untreated, PID may scar the reproductive organs and make it difficult or impossible for a woman to get pregnant (infertility) or to carry a pregnancy to term (miscarriage). The scarring also increases the possibility of an ectopic pregnancy, a dangerous condition where a pregnancy develops outside the uterus (frequently in a fallopian tube). Like gonorrhea, PID may produce no symptoms but can cause serious damage.

In extreme cases that are left untreated, gonorrhea can spread to other parts of the body and infect the brain and spinal cord (meningitis), heart (endocarditis) or joints (arthritis).

People with gonorrhea also frequently have chlamydia, another STD that may have few symptoms. Gonorrhea has fewer complications for men, most commonly infecting the urethra.

Risk factors for gonorrhea

Factors known to increase risk for gonorrhea include:

• Age. Gonorrhea is most prevalent among sexually active people under age 30. In 2003, more than 75 percent of the cases reported to the Centers for Disease Control and Prevention were among people ages 15 to 29.
• Sexual activity. People who engage in unprotected sex, have multiple partners or high-risk partners, or have sex with people who have multiple or high-risk partners are more likely to contract gonorrhea.
• History of STDs. People who have had other STDs are at greater risk for contracting gonorrhea.