Gonorrhea in Women – Signs, Symptoms, Tests and Treatment

Gonorrhea is one the common sexually transmitted bacterial infections that affects both men and women. For most of the 20th century, gonorrhea and was the most common sexually transmitted disease (STD). About 10% of males and over 50% of females infected with gonorrhea are asymptomatic however meaning that they will exhibit no signs or symptoms. This can make it difficult to identify an infected partner and without preventative measures, any sexually active person is at risk of contracting this disease. Gonorrhea can also be transmitted during childbirth (mother-child) where it more commonly causes an eye infection (opthalmia neonatorum).

What causes gonorhhea?

Gonorrhea is a sexually transmitted disease (STD) caused by the Neisseria gonorrhoeae bacterium. It is more commonly transmitted through sexual intercourse – vaginal, oral or anal – but may also be passed from mother to baby during childbirth. Gonorrhoea affects the epithelial lining of the lower genital tract. but may also infect the rectum (anal intercourse or urogenital contamination in women), throat (oral intercourse) or the eyes of adults by making contact with contaminated fingers. With regards to the genital tract in women, gonorrhea affects the urethra, paraurethral glands, Bartholin’s glands, vagina and may even extend to  the cervix. Transmission to the newborns is by direct contact with the vaginal epithelium when passing down the birth canal.

Signs and Symptoms in Women

The incubation period is between 2 to 10 days with a mean of 3 to 6 days. This means that for this period of time from exposure, there are no symptoms. However, symptoms may still not arise afterwards as between 50% to 80% of women with gonorrhea remain asymptomatic. Nevertheless the person is still a carrier and can infect others.

The common symptoms in women with gonorrhea infection of the lower genital tract includes :

  • Painful urination (dysuria)
  • Excessive vaginal discharge
  • Lower abdominal pain
  • Pelvic pain
  • Intermenstrual bleeding or spotting, particularly after intercourse

Other clinical features may depend on the site that is affected :

  • Rectum – rectal bleeding, itchy anus, discharge
  • Eyes – pain, sensitivity to light, discharge from eyes
  • Throat – sore throat, painful swallowing, swollen neck lymph nodes

Diagnosis of Gonorrhea

A urine sample may be sufficient to detect the bacteria but only if it is present in the urine. A vaginal swab is often preferable. Due to the prevalence  and risk of other sexually transmitted infections, it may be advisable for women with gonorrhea to consider additional tests like for HIV.

Treatment of Gonorrhea

Gonorrhea requires antibiotics for effective treatment. Vaginal douches are not effective and gonorrhea should not be treated without the supervision of a medical professional. Failure to treat gonorrhea promptly may lead to Bartholin’s gland abscess, pelvic inflammatory disease (PID) which can lead to infertility or ectopic pregnancy, and disseminated gonococcal infection. These conditions can then complicate treatment. Antibiotics used for treating gonorrhea include   ceftriaxone an spectinomycin. Pregnant women may also be prescribed cefixime and amoxicillin plus probenecid.

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