What is Gonorrhea?
Gonorrhea is a sexually transmitted disease (STD) that is caused by a bacterium known as Neisseria gonorrhoeae. It thrives in warm and moist areas like the genital tracts, mouth and anus.
Gonorrhoea is a common STD in Singapore. MOH reports an incidence rate of 33.4 per 100,000 population in 2016.
What are the symptoms of Gonorrhea infection?
In men, up to 60% of patients with urogenital Gonorrhea might not have any symptoms (asymptomatic). Symptoms of urogenital Gonorrhea in male may include:
- Discomfort, itchy along the urinary tract
- Painful urination
- Penile discharge
- Testicular Pain (Epididymitis)
In women, up to 70% of patients with urogenital Gonorrhea might not have any symptoms (asymptomatic).
Symptoms of urogenital gonorrhea in female may include:
- Vaginal itch, discharge or bleeding
- Painful urination
- Abdominal/Pelvic Pain
- Pain during sexual intercourse
What are the complications of Gonorrhea infection?
Untreated Gonorrhea infections for females can lead to Pelvic Inflammatory Disease with abdominal pain and abnormal vaginal bleeding. It can cause infertility if the sexual organs are scarred by the infection. Gonorrhea can also lead to multiple complications during pregnancy for the infected mother and can even be passed on to her baby.
For men, untreated Gonorrhea infection can result in scarring of the urinary tract and urinary obstruction. Testicular/Epididymal infection can also cause infertility if left untreated.
What is Oral/Throat Gonorrhea and how is it transmitted?
Oral/Throat Gonorrhea is the infection of the pharynx by the same bacterium and it is commonly transmitted through oral sex. It is an oral STD.
How common is Oral/Throat Gonorrhea and what are the symptoms?
A recent study in 2016 has estimated the prevalence of throat Gonorrhea infection to be as high as 30% for straight woman, 15.5% for straight men and 17% for homosexual men.
The most common presentation of throat Gonorrhea is a sore throat. Some patients may have swollen neck lymph nodes. However, the majority of patients do not present with any symptoms at all.
Oral ulcers are not a presentation of throat Gonorrhea. If oral/peri-oral ulcers are present, other STDs such as Herpes and Syphilis need to be considered.
I do not practice oral sex. Why should I be screened for Throat Gonorrhea?
Throat Gonorrhea transmission can occur even in the absence of reported oral sex.
Even though the majority of throat gonorrhea are asymptomatic, in 0.5% to 3% of infected patients the bacterium can penetrate the mucosae and enter the bloodstream, leading to a widespread infection. This blood-borne invasion (Disseminated Gonococcal Infection) can lead to to a variety of dangerous conditions including:
- Multiple joint inflammation
- Tendon Sheath inflammation
- Skin dermatitis
- Joint Infections
Hence, even in the absence of oral sex or symptoms, patients with new or multiple sex partners or a sex partner with a diagnosed STD should go for STD screening.
How is Gonorrhea screening performed?
Gonorrhea Testing. NAAT (Nucleic Acid Amplification Test) is routinely performed to detect N.gonorrhoeae. The doctor will swab the suspected area of infection (throat/anus/vagina) or request a urine sample for diagnosis of gonorrhea infection. It has been shown to be superior to traditional methods of culturing the bacteria with far more rapid results.
How is Gonorrhea treated and how can I prevent Gonorrhea infection?
Gonorrhea is treated with a single antibiotic injection and a course of oral antibiotics.
Gonorrhea transmission can be prevented by observing safe sexual practices. This includes the use of barrier protections like condoms or dental dams, cutting down the number of sexual partners as well as ensuring regular STD screening for both the patient and their sexual partners.