Gonorrhea in women

Gonorrhea (commonly known as “the clap”) is an infectious disease transmitted sexually. It ranks second among all sexually transmitted infections in women and men. The causative agent of gonorrhea is the bacterium Neisseria gonorrhoeae (gonococcus). It can affect the organs of the reproductive system, the rectum, and the oropharynx. The main manifestations of gonorrhea in women include itching, burning, redness of the genital organs, changes in vaginal discharge, and local fever. In almost half of cases, the disease develops silently or presents with mild symptoms.

With timely diagnosis and appropriate therapy, gonorrhea is successfully treated. The risk of complications arises with a prolonged course of the disease and its progression to a chronic form. In such cases, it may cause the spread of infection to the internal reproductive organs and kidneys, provoke the formation of adhesions in the small pelvis, and lead to other disorders.

Gonorrhea is transmitted sexually. Infection can occur from an infected partner during vaginal, oral, or anal sexual contact. It should be taken into account that in some cases gonococcal infection in women may develop in a mild form and remain undiagnosed. To reduce the risk, it is recommended to always use barrier contraception; however, it does not provide 100% protection.

Specialists at «Оксфорд Медікал» note that household transmission is theoretically possible when visiting public saunas, baths, or swimming pools, as well as when using shared towels and other personal items. However, in practice such cases do not occur. It has been proven that gonococci die very quickly in the external environment.

Another route of gonorrhea transmission is from mother to child. The bacterium can be transmitted to the baby during intrauterine development or while passing through the birth canal. In such cases, the disease is diagnosed shortly after birth.

Risk factors for gonorrhea infection include:

• frequent change of sexual partners;

• refusal to use barrier contraception (condoms);

• presence of sexually transmitted infections in a partner;

• failure to follow intimate hygiene rules.

Unlike many other sexually transmitted infections, weak immunity, harmful habits, and other lifestyle factors are not considered risk factors for gonorrhea. It has been confirmed that infection occurs after contact with the pathogen even in individuals with strong immunity and no other diseases.

During the consultation, the gynecologist listens to the patient’s complaints and reviews her medical history. This helps the specialist form a clinical picture of the disease and determine which examinations are necessary to establish an accurate diagnosis.

During the appointment, the doctor also performs:

• a gynecological examination;

• collection of swabs and scrapings from the urethra, vagina, and cervix.

Laboratory diagnostics allow confirmation or exclusion of the diagnosis. Tests are performed using several methods. The most commonly used include:

• polymerase chain reaction (PCR) analysis — detects bacterial DNA in the sample and is considered the most accurate diagnostic method;

• bacteriological culture — the sample is placed on a nutrient medium and left for a certain period, after which the grown cultures are evaluated and, if necessary, tested for sensitivity to different groups of antibiotics;

• bacterioscopic analysis with Gram staining — the sensitivity and specificity of the method reach 90–100% when examining urethral discharge but decrease to 30–50% when diagnosing genital samples.

As additional diagnostics, a woman may be prescribed tests for other sexually transmitted infections, since combinations of several infections are often detected, as well as general blood and urine tests, pelvic ultrasound, and other examinations if necessary. These are required to assess the stage of the disease and its spread, and to exclude the development of complications.

For preventive diagnostics, usually only analysis of urogenital discharge is performed.

Gonorrhea is treated with medication. The course of therapy is developed individually by the doctor. The stage of the disease, the presence of concomitant pathologies, or complications are of great importance.

With timely diagnosis, gonorrhea is successfully treated with antibacterial drugs. The doctor may prescribe antibiotics for oral or intramuscular use (injections). The duration of treatment averages 7–10 days; however, in some cases, a single high-dose administration of the medication is recommended.

During antibiotic therapy, the symptoms of gonorrhea should decrease within a few days. If this does not occur or the condition worsens, it is necessary to consult a doctor again. The reason may be gonococcal resistance to the selected drugs. In such cases, antibiotics from another group are prescribed.

Chronic gonorrhea in women requires more complex and prolonged treatment. In addition to antibacterial therapy, it may include symptomatic medications and treatment of associated inflammatory processes. In the presence of complications, appropriate additional therapy is carried out.

Special attention is required for the treatment of gonorrhea in pregnant women, as the infection poses a risk to the fetus and may lead to intrauterine infection or transmission to the child during childbirth. In such cases, therapy is selected taking into account the stage of pregnancy and the safety of medications for both mother and child. Treatment is carried out under mandatory medical supervision with subsequent laboratory confirmation of effectiveness.

The effectiveness of therapy is monitored through laboratory tests. The first tests are назначаются immediately after completion of the antibiotic course, and subsequent tests are performed after 2–3 months. In cases of chronic infection, follow-up examinations are recommended monthly during the first six months after treatment.

With timely diagnosis, gonorrhea can be treated fairly quickly; however, many patients seek medical attention when the infection has significantly progressed. In the early stages, the disease may be asymptomatic or accompanied by mild discomfort that many women do not pay sufficient attention to.

The risk of complications arises when gonorrhea spreads to other organs or becomes chronic. In such cases, it may cause:

• chronic pelvic pain;

• cervical erosion;

• bartholinitis — inflammation of the Bartholin gland;

• formation of adhesions in the small pelvis;

• impaired patency of the fallopian tubes;

• premature labor;

• menstrual cycle disorders;

• joint involvement;

• difficulties with conception and infertility;

• ectopic pregnancy;

• pregnancy loss;

• transmission of infection to the newborn child.

To reduce the risk of infection and prevent gonorrhea, specialists recommend following simple rules:

• undergo screening examinations at least once a year;

• get tested when changing a sexual partner;

• use barrier contraception;

• maintain proper intimate hygiene.

Following these recommendations significantly reduces the risk of infection and allows timely detection of the disease even in the absence of pronounced symptoms. It is important to remember that gonorrhea in women may remain asymptomatic for a long time; therefore, regular preventive check-ups and a responsible attitude toward sexual health are key factors in preserving reproductive function and preventing complications.