Gonorrhoea Treatment in Delhi, India

Gonorrhoea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. It primarily affects the genital tract but can also impact the throat, eyes, and rectum. Gonorrhoea spreads through sexual contact with an infected person and can lead to symptoms such as pain during urination, abnormal discharge from the genitals, and, in some cases, no symptoms at all. If left untreated, it can cause serious health problems, including infertility and an increased risk of contracting other infections. Prompt diagnosis and treatment with antibiotics are crucial to prevent complications.

Gonorrhoea is caused by the bacterium Neisseria gonorrhoeae. The infection is transmitted through sexual contact with an infected person, including vaginal, anal, and oral sex. It can also be passed from an infected mother to her baby during childbirth. The bacteria infect the mucous membranes of the genital tract, urethra, throat, and rectum, leading to a range of symptoms and potential complications if left untreated.

Risk factors for gonorrhoea include:

• Unprotected Sex: Engaging in sexual activities without using condoms increases the risk of contracting gonorrhoea.
• Multiple Sexual Partners: Having multiple partners raises the likelihood of exposure to the infection.
• Previous STIs: A history of other sexually transmitted infections can increase susceptibility to gonorrhoea.
• Sexual Partner with Gonorrhoea: Being in contact with a partner who has gonorrhoea or any other STI heightens the risk of transmission.
• Drug Use: Certain practices, such as sharing needles or engaging in risky sexual behaviours under the influence, can elevate risk.

Understanding these factors can help in taking preventive measures to reduce the likelihood of contracting gonorrhoea.

Symptoms in Males

• Painful Urination: A burning sensation when urinating.
• Discharge: A yellow, green, or white discharge from the penis.
• Swelling or Pain: In the testicles or the area around the penis.

Symptoms in Females

• Painful Urination: Similar to males, a burning sensation can occur.
• Abnormal Discharge: A thick, yellow or green discharge from the vagina.
• Pelvic Pain: Discomfort or pain in the lower abdomen.
• Bleeding: Irregular bleeding between periods or after sexual intercourse.

Other Gonorrhoea Symptoms

• Sore Throat: If the infection affects the throat.
• Rectal Discomfort: Pain, itching, or discharge from the rectum.
• Eye Infections: Conjunctivitis, or eye infection, if the bacteria come into contact with the eyes.
• Joint Pain: In rare cases, gonorrhoea can spread to the joints, causing joint pain and swelling.

Medical History and Physical Examination

• The healthcare provider begins by asking about symptoms, sexual activity, and any possible exposure to gonorrhoea or other sexually transmitted infections. A physical examination may be performed to check for signs such as discharge, inflammation, or pelvic pain in women.

Laboratory Tests

• Urine Test: A urine sample is collected and tested for the presence of Neisseria gonorrhoeae. This non-invasive method is commonly used for detecting gonorrhoea in the urethra, especially in men.
• Swab Test: A swab is taken from potentially infected areas like the urethra, cervix, throat, or rectum. The sample is then analysed in a lab to detect the bacteria. This test is essential for diagnosing gonorrhoea in areas beyond the urethra.
• Blood Tests: While not typically used to diagnose gonorrhoea directly, blood tests may be ordered if complications or co-infections are suspected. These tests help assess overall health and identify any systemic effects or related infections.

Antibiotic Therapy

• First-Line Treatment: Gonorrhoea is primarily treated with a single dose of antibiotics administered via injection. This approach effectively clears the infection in most cases, targeting the bacteria responsible for the condition. Alongside the injection, an oral antibiotic is often prescribed to address any potential co-infection, such as chlamydia.
• Alternative Antibiotics: If a person is allergic to first-line antibiotics or if antibiotic resistance is a concern, alternative medications may be prescribed. Patients need to follow the prescribed treatment exactly to ensure the infection is fully eradicated and to avoid antibiotic resistance.

Treatment for Antibiotic-Resistant Gonorrhoea

Antibiotic-resistant gonorrhoea requires a more robust approach to treatment. When standard antibiotics fail, doctors may prescribe higher doses, use a combination of different antibiotics, or opt for alternative medications tailored to the resistance pattern. Treatment duration might be extended to ensure the infection is fully cleared. Close monitoring and follow-up testing are essential to confirm the infection is eradicated and to prevent the spread of resistant strains.

Pelvic Inflammatory Disease (PID)

In women, untreated gonorrhoea can spread to the uterus, fallopian tubes, and ovaries, leading to pelvic inflammatory disease (PID). PID can cause chronic pelvic pain, infertility, and an increased risk of ectopic pregnancy, where a fertilised egg implants outside the uterus. Early PID treatment is crucial to prevent long-term complications like chronic pelvic pain, infertility, and ectopic pregnancy. 

Epididymitis

In men, untreated gonorrhoea can cause inflammation of the epididymis, the tube that carries sperm from the testicles. This condition, known as epididymitis, can lead to severe pain, swelling, and, in some cases, infertility if not treated promptly.

Disseminated Gonococcal Infection (DGI)

Gonorrhoea can spread through the bloodstream to other parts of the body, causing disseminated gonococcal infection (DGI). DGI can lead to symptoms such as fever, joint pain, and skin lesions. It can also result in more severe conditions, including septic arthritis (infection of the joints) and endocarditis (infection of the heart lining).

Infertility

Both men and women can experience infertility as a result of untreated gonorrhoea. In women, the infection can cause scarring in the fallopian tubes, preventing the egg and sperm from meeting. In men, it can cause blockages or damage to the reproductive tract.

Increased Risk of HIV

Gonorrhoea can increase the risk of contracting or transmitting HIV. The inflammation caused by the infection can make it easier for the HIV virus to enter the body or be passed on to sexual partners.

Complications During Pregnancy

If a pregnant woman has gonorrhoea, the infection can cause complications such as preterm labour, low birth weight, and transmission of the infection to the newborn during delivery. This can lead to serious health issues for the baby, including blindness, joint infections, or life-threatening blood infections.

Gonococcal Conjunctivitis

Gonorrhoea can also infect the eyes, leading to gonococcal conjunctivitis, which causes redness, swelling, and discharge. In severe cases, it can result in corneal ulcers and blindness if not treated in time.

Gonorrhoea is a common sexually transmitted infection (STI) that can be easily prevented. Here are some simple ways to protect yourself:

• Use Condoms: Using condoms during vaginal, anal, and oral sex is one of the most effective ways to reduce the risk of contracting gonorrhoea. Condoms act as a barrier that prevents the exchange of bodily fluids, which is how the infection is transmitted.
• Regular STI Screenings: Regular screenings for sexually transmitted infections are crucial, especially for sexually active individuals with multiple partners or those in high-risk groups. Early detection through screening can help prevent the spread of gonorrhoea and other STIs.
• Mutual Monogamy: Engaging in a mutually monogamous relationship, where both partners are only sexually active with each other, can significantly reduce the risk of contracting gonorrhoea. Both partners must be tested for STIs before entering a monogamous relationship.
• Communication with Sexual Partners: Open and honest communication with sexual partners about STI status and history can help prevent the spread of gonorrhoea. Partners should discuss their sexual health and agree on preventive measures before engaging in sexual activity.
• Avoiding Sexual Activity with Infected Individuals: Abstaining from sexual activity with someone who has symptoms of gonorrhoea or other STIs is essential to prevent transmission. If a partner is diagnosed with gonorrhoea, it's important to avoid sexual contact until they have completed treatment and are confirmed to be free of the infection.

Gonorrhoea during pregnancy can lead to serious complications for both the mother and baby. If the infection is not treated, it may cause issues such as premature birth, low birth weight, and infections in the amniotic fluid. Additionally, gonorrhoea can be passed to the baby during childbirth, which can result in severe eye infections, joint problems, or even serious blood infections in the newborn. Pregnant women with gonorrhoea need to receive treatment promptly using antibiotics that are safe during pregnancy to protect both the mother and the baby. Regular prenatal check-ups are important for detecting and managing the infection early on.

How long does it take for symptoms to appear?

Symptoms of gonorrhoea usually appear within 2 to 14 days after exposure to the infection. However, some people may not show symptoms at all, which makes regular testing important if you are sexually active.

What should I do if I think I have Gonorrhoea?

If you suspect you have gonorrhoea, it’s important to seek medical attention right away. A doctor will conduct tests to confirm the infection and prescribe the appropriate treatment to prevent complications and further spread.

How can I talk to my partner about Gonorrhoea?

Discussing gonorrhoea with your partner can be difficult, but it’s crucial for both your health and theirs. Be honest and direct, explain the situation, and encourage them to get tested and treated if necessary. Reassure them that taking steps together can protect both of you.

Can I get Gonorrhoea from oral sex?

Yes, gonorrhoea can be transmitted through oral sex. The bacteria can infect the throat, leading to symptoms like a sore throat or difficulty swallowing. Using protection, such as condoms or dental dams, can reduce the risk of transmission during oral sex.

Can Gonorrhoea go away on its own without treatment?

Gonorrhoea does not go away on its own and requires proper treatment with antibiotics. Without treatment, the infection can cause serious health complications and can be passed to others.

How does Gonorrhoea affect fertility in men and women?

Gonorrhoea can lead to infertility in both men and women if left untreated. In women, it can cause pelvic inflammatory disease (PID), leading to scarring of the fallopian tubes. In men, it can cause epididymitis, which can result in blocked sperm ducts.

Can you have gonorrhoea without showing any symptoms?

Yes, it is possible to have gonorrhoea without showing any symptoms. Many people with gonorrhoea do not experience noticeable signs, especially in the early stages. This is why regular STI screenings are important for sexually active individuals, even if you feel fine.

Is it possible to get gonorrhoea more than once?

Yes, you can get gonorrhoea more than once. Having gonorrhoea once does not provide immunity against future infections. If you have unprotected sex with an infected partner, you can contract the infection again.

How soon can I have sex after treatment for gonorrhoea?

You should avoid sexual activity until you have completed the full course of treatment and your doctor confirms that the infection is cleared. Typically, this means waiting at least one week after finishing the antibiotics to ensure that the infection is fully resolved. Both you and your partner should be treated and cleared before resuming sexual activity to prevent reinfection.

Is there a vaccine for Gonorrhoea?

Currently, there is no vaccine available to prevent gonorrhoea. The best way to protect yourself is through safe sex practices and regular STI testing.

Can Gonorrhoea be cured?

Yes, gonorrhoea can be cured with antibiotics. It's important to take all the medicine your doctor gives you and follow their instructions to make sure the infection is completely gone.

Reviewed By Dr. Sanjay Dhall, Senior Director of Internal Medicine, on 06 Jan 2025.