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Oral Gonorrhea / Throat Gonorrhea – What do you need to know

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.

Next read: WHAT IS ANTIBIOTIC RESISTANT GONORRHEA OR SUPER GONORRHEA?


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Why Do I Have Abnormal Vaginal Discharge?

Let’s talk a little about normal vaginal discharge first.

The vagina is a muscular passage which leads from the vaginal opening to the cervix, which is the entrance to the womb. There are naturally occurring “good” lactobacillus and other bacteria which are part of the normal vaginal flora. The walls of the vagina have glands which produce secretions for the cleansing of the vaginal canal. Normal vaginal discharge is a result of these secretions. It is usually clear or whitish and largely odourless and may change slightly throughout your menstrual cycle.
 

via GIPHY
 

How to identify abnormal vaginal discharge and what you should be worried about?

However, when you notice a major change from your usual vaginal discharge, this abnormal vaginal discharge may indicate that something is wrong.
Signs that your vaginal discharge may be abnormal include different coloured discharge – greenish, yellowish, greyish or even brownish discharge, the presence of a bad vaginal odour, changes in discharge consistency such as thicker, clumpy discharge or large amounts of watery discharge.
If this discharge is accompanied by abdominal pain, fever, or spotting/bleeding after sexual intercourse or bleeding when your period is not due yet, then these are all alarming features that should Fprompt you to consult a doctor.
Abnormal vaginal discharge is one of the most common female health problems and it should not be something you feel you have to suffer in silence about. Most ladies will experience this at some point in their life and while it can be an extremely distressing and uncomfortable problem, it is very treatable.
 
 

You probably have a vaginal infection.

The top cause of abnormal vaginal discharge is a vaginal infection, also known as vaginitis. Other rare causes of abnormal vaginal discharge include cervical abnormalities such as cervical cancer.
The next question, then, would be what sort of infections you have to worry about if you are experiencing abnormal vaginal discharge. These can broadly be divided into Sexually Transmitted Infections (STIs) and non-Sexually Transmitted Infections (STIs).
The most common causes of abnormal vaginal discharge are non-sexually transmitted infections- Bacterial Vaginosis and yeast infections. These all occur when there is disruption to the delicate balance of your healthy vaginal flora and can be triggered by a multitude of factors.
However, if you have had unprotected sexual intercourse, particularly if you are unsure of your partner’s infection status (whether this be a casual partner or a long-term partner), then your abnormal vaginal discharge may very well be due to a Sexually Transmitted Disease (STD) such as Chlamydia, Gonorrhoea, Trichomonas, and various types of Mycoplasma and Ureaplasma bacteria.
Regardless of the underlying cause of your abnormal vaginal discharge, proper evaluation is crucial as it allows you to receive the appropriate treatment, which is important not just in relieving your discomfort but also in preventing more serious, long-term complications (like Pelvic Inflammatory Disease) that can occur with certain infections.
 
 

Why does the abnormal vaginal discharge keep coming back?

This is a very common question and recurrent abnormal vaginal discharge can be an extremely frustrating and distressing issue.
Recurrent yeast infections and bacterial vaginosis tend to be responsible for the above phenomenon and can be triggered by a variety of factors which upset the balance of your vaginal flora.
 

1) Hormonal Fluctuations

  • For some ladies, they may find that the hormonal fluctuations during their peri-menstrual period (before or after menses), may cause them to be prone to recurrent yeast infections.
  • Pregnancy

 

2) Weakened Immune System

  • If you have diabetes or are undergoing any other sort of medical treatment that affects your immunity, you may be more prone to recurrent yeast infections.

 

3) Sexual Lifestyle

  • Sexual intercourse can trigger off bacterial vaginosis – in fact, the number of sexual partners which one has had is actually a risk factor for bacterial vaginosis, with every new partner that a lady has increased the risk of Bacterial Vaginosis infections.
  • Other habits like using spermicide may also kill off the good lactobacilli in the vagina and lead to increased susceptibility to infection

 

4) Medications

  • Being on the combined oral contraceptive pill does increase your risk of recurrent yeast infections
  • Antibiotic usage (for instance, taking something for a bacterial throat infection) can also (ironically) upset the delicate balance down there

 

5) Hygiene Habits

  • Use of vaginal douche washes or feminine washes with harsh chemicals can disrupt your natural vaginal balance and lead to increased yeast and BV infections
  • Tight underwear, pantyliners or menstrual pads which trap humidity and moisture may also place you at increased risk for a yeast infection

 
As can be seen, not all triggers may be entirely avoidable but good habits- like avoiding feminine douche washes, wearing breathable cotton underwear, minimising antibiotic use unless medically indicated, and using condoms- do play a part in helping you maintain a healthy vagina.
If you keep having abnormal vaginal discharge that comes back with a vengeance after the initial episode, do speak to your doctor about additional treatment that may be suitable for you.
 
Remember that you are not alone – abnormal vaginal discharge is common – and treatable!
Don’t let your discomfort about the topic keep you from treatment.
 
Take Care!

Other Interesting Reads:

    1. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
    2. 11 Causes of Dyspareunia (Pain During Intercourse)
    3. How Do I Get an Anonymous HIV Testing?
    4. What is HPV Vaccination (Gardasil 9)
    5. 10 Causes of abnormal Vaginal Lumps and Bumps
    6. An Overview of Gonorrhoea
    7. What is the Treatment for Cold Sores? What causes Cold Sores?

 
 

What is Rapid Chlamydia & Gonorrhea PCR STD Testing?

Chlamydia and gonorrhoea are 2 common Sexually Transmitted Infections (STIs) which can infections in various parts of the body such as penis, vaginal, anus, throat and eyes.
Most commonly you will experience discharges from the penis/ vaginal or discomfort when passing urine.
However, the majority of men may not have any symptoms and for women, 50% may also not have symptoms.
The infection will stay in the body for a few weeks after the symptoms have been treated.
In rare instances, Gonorrhoea and Chlamydia can continue to cause damage to the body, specifically the urethra and testicles. Pain may also spread to the rectum. An overview of Gonorrhoea

At Dr Tan and Partners, we recognize that symptoms like abnormal vaginal discharges, penile discharge or discharge from the rectum can cause quite a bit of worry.
Thus, we have introduced a Rapid STD testing (next day results) that can detect these 2 infections within a day.
Which means that you can get the necessary treatment quickly as well.
All it requires is a urine sample or swab from the vaginal/ throat/ anal

This Rapid STD Testing detects for the presence of the DNA of the 2 organisms, making the test very sensitive

If you think you may have symptoms suggestive of chlamydia or gonorrhoea infection or if you think you may have been exposed and you are interested in an STD Screening, please visit a doctor for further evaluation.

Take Care!


Other Reads:

  1. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  2. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  3. HPV Infection & HPV Vaccination for Men who have sex with Men
  4. STD Risk for Receptive Unprotected Anal Sex in Men
  5. Low HIV Risk Doesn’t Mean No HIV Risk
  6. HIV PrEP for Travel – How You Need to Know
  7. An Overview on STD from an STD Doctor
  8. Everything You Need to Know about Herpes Simplex Virus
  9. How Do I Treat Oral Herpes (Cold Sores)
  10. Syphilis Symptoms – Painless Sore & Ulcers
  11. HIV Symptoms – What You Need to Know
  12. 10 Common HIV related Opportunistic Infections

An Overview of Gonorrhoea Symptoms

Gonorrhoea symptoms in Men & Women can include discharge, painful urination and itch. Some people who are infected may not display any signs or symptoms.

What is the Cause of Gonorrhea?

Gonorrhoea is one of the most common Sexually Transmitted Infection (STI) in women.  It can cause infections in the vagina, rectum, and throat.
Gonorrhoea is known to be easily transmittable via both penetrative and oral sex. It can infect the reproductive system and less commonly, the throat or eyes. A maternal to child transmission is also possible here.
Similar to Gonorrhoea, Chlamydia is a common sexually transmitted disease caused by bacteria called Chlamydia trachomatis. Gonorrhoea is caused by the bacterium Neisseria gonorrhoeae.

In women, gonorrhoea affects the cervix and its functions 90% of the time.

via GIPHY

What are the risk factors for contracting Gonorrhea?

  • Multiple sexual partners
  • New sexual partner
  • Unprotected sex
  • Men that have sex with Men (MSM)
  • A sexual partner who has an STI
  • Having concurrent STI

What are the Gonorrhoea Symptoms:

Gonorrhoea can be a silent infection in most of the population. Often time, women and men with Gonorrhea will not display any signs and symptoms.
Gonorrhoea Symptoms & Chlamydia Symptoms can be overlaping.

The Symptoms of gonorrhoea can differ between men and women.

via GIPHY

Gonorrhoea Symptoms in women:

Gonorrhoea Symptoms in Men

  • Penile discharge – colour may vary from white, yellow, green, or occasionally blood-tinged
  • Pain when passing urine
  • Pain in the testicles – rare

Read more about what are the other causes of penile infection & foreskin infection
Depending on the nature of the sexual activity and the severity of the infection, both men and women may experience pain, itchiness or discharge from the anus. They may also have pain, swelling, irritation, or discharge from the eye or both eyes (otherwise diagnosed as conjunctivitis).

How to Treat Gonorrhoea?

As with most bacterial infections, gonorrhoea is treated with antibiotics. The first choice is a wide spectrum antibiotic. It is, however, proving to be getting more resistant to antibiotics.
Gonorrhoea is also challenging to treat because most people who have this STI also have concurrent sexually transmitted illnesses like chlamydia.

via GIPHY
Also, like with any other sexually transmitted illness, treatment must be extended to all partners, and once treatment is completed, routine testing is highly recommended in view of relapse due to the increasing resistant nature of the gonorrhoea bacteria.
Abstinence is recommended during treatment.

What are the Complications of Gonorrhoea

Rarely, untreated gonorrhoea can spread throughout the body giving rise to skin pustules, infection of the joints (fingers, ankles, knees, and toes), brain or heart valves.

Complications of Gonorrhea in Men

More commonly, in men, infections of the epididymis, prostate and urethra are noted. Gonorrhoea can cause subfertility in some patients.

Complications of Gonorrhea in Women

In women, similar to other sexually transmitted diseases, untreated gonorrhoea may cause pelvic inflammatory disease (via an ascending infection involving the uterus, fallopian tubes, and ovaries) in up to 20% of patients. With inflammation, scarring and/or multiple infections, issues of subfertility and extra-uterine pregnancy will arise.
More annoyingly is the chronic, relapsing pelvic pain. This pain is characteristically stubborn and may require multiple analgesic medications in some women.
Read more about Herpes: Everything You Need to Know!

How is Gonorrhea Test Performed?

In most cases, usually for men, a urine sample will be required for the test. However, for female patients, ideally, the doctor will need to take a sample from the cervix ( neck of the womb).
For this, patients will lie down on the examination couch with knees bent and a small plastic instrument called a speculum will be used to open the vagina, then a soft brush will be used to collect a sample from the cervix. This procedure is very quick and painless, with only some minimal
discomfort.
Depending on sexual history, gonorrhoea swab may also be taken from the throat and rectum, in both men and women.

Any preparation needed before the test?

Vaginal douching and rectal douches, as well as creams, should be avoided 1 day before the test.
For the urine test, it is best to not urinate at least 2 hours before the sample is taken.

How long will the results take?

The test is usually performed together with chlamydia screening and results will be ready by the NEXT DAY. This allows treatment to be given as soon as possible when needed.
We can provide Rapid Chlamydia and Gonorrhea STD Testing. STD Test result will be available the following day.
If you are interested in getting a Rapid STD Testing or treatment for gonorrhoea, please visit our clinics and speak to our male and female doctors.
That’s All Folks!


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  1. An Overview of STD – From an STD Doctor
  2. What are the Signs & Symptoms of HIV and AIDS?
  3. STD Symptoms
  4. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  5. Weak Erection? Erectile Dysfunction? Improv Erection with Pills
  6. 11 Causes of Dyspareunia (Pain During Intercourse)
  7. What are the Causes of Genital Ulcers, Genital Warts and Genital Blisters
  8. What is HPV Vaccination (Gardasil 9)
  9. How to Get Rid of Genital Warts?
  10. 10 Causes of abnormal Vaginal Lumps and Bumps
  11. HPV Infection & HPV Vaccination for Men who have sex with Men
  12. STD Risk for Receptive Unprotected Anal Sex in Men
  13. 7 FAQs HIV Preexposure prophylaxis (HIV PrEP)
  14. What is the Treatment for Cold Sores? What causes Cold Sores?
  15. Genital Warts: The Cauliflower-Like Lumps on the Genitals
  16. Syphilis Symptoms (Painless STD Sores & STD Rashes)