1) Dear Alice,

What are the symptoms of gonorrhea?

2) Hi Alice,

How long of a time frame could you have gonorrhea and not know it? The doctors say you can't track how long you have had it so how do we know? I feel my last partner gave it to me and that was nine months ago. Is that possible?

Thanks. I can't get much information in regards to this subject so I have no idea. And it can't be received from sitting on a toilet or anything of that sort, correct?

Dear Readers,

Glad you’ve both come to get up to speed on the who, what, where, and when of gonorrhea, a sexually transmitted infection (STI) caused by the bacteria Neisseria gonorrhoeae. It’s often passed from one person to another via contact with mucous membranes, typically during vaginal, anal, or oral sex. It can also be passed to a baby during childbirth. It’s not, however, transmitted through casual contact such as sharing towels, holding hands, kissing, or even sitting on a toilet seat. Symptoms of an infection, the time between when a person becomes infected, and when they experience symptoms often vary by sex assigned at birth (more on those points in a bit). It’s key to note that most people who become infected won't experience any symptoms — also referred to as being asymptomatic. This makes regular STI screenings and sexual health check-ups all the more critical for sexually active folks so that treatment can be accessed as soon as possible, even though there may no tell-tale signs of infection. Keep reading for even more of the key details on this STI.

First, more about when symptoms may show up: For those who do report them, the period of time between becoming infected and experiencing symptoms, referred to as the incubation period, is often different between those assigned male at birth and those assigned female at birth. Though the ranges seem to vary by source, it’s been noted that for those assigned male at birth, it may take between 1 to 14 days for symptoms to appear and may be upwards of several weeks to 30 days for some folks. A similar incubation period is indicated for those assigned female at birth, but they're also more likely to be completely asymptomatic. There is no research or reports indicating a longer incubation period. So, Reader 2, it may be worth considering other more recent contact you may have had or whether what you’re experiencing has been confirmed to be due to a gonorrhea infection (a number of other STIs have similar symptoms).

If a person does experience symptoms and longer-term health issues:

  • For those assigned male at birth: They might experience a yellowish, white, or green discharge from the penis. Urination might be painful, include the feeling of "burning," or be more frequent. Swelling may occur near the urethra (opening where urine exits the body) or the testicles. Untreated, gonorrhea can lead to epididymitis which, in turn, can result in infertility in rare cases.
  • For those assigned female at birth: The urethra or cervix (opening to the uterus, at the top of the vagina) can be affected; sometimes the infection is so mild that it goes unnoticed, particularly with inflammation of the cervix. Other symptoms include an atypical yellow or bloody vaginal discharge, bleeding between menstrual periods, painful urination, pain during sex, or lower abdominal discomfort. If the infection is left untreated, it can lead to pelvic inflammatory disease (PID), possibly resulting in ectopic pregnancy, pelvic abscesses, or infertility.

Symptoms of an infection resulting from oral sex could include sore throat, swollen lymph nodes near the neck, or no symptoms at all. When transmitted by anal contact or sex, there can be inflammation of the anus, itchiness, puss-like or bloody discharge, feeling the need to have a bowel movement often, or no noticeable signs whatsoever. Further, gonorrhea infections of any kind increase the risk for getting or passing HIV (human immunodeficiency virus) and in rare, untreated cases, this bacterial infection may lead to serious health issues if it spreads to the blood, skin, and other major organs. Joint issues, blindness, and infections of the blood may result for babies who contract the infection during childbirth.

Whether symptoms are present or an infection is suspected, gonorrhea can be diagnosed by a health care provider. This is typically done with a urine or a tissue sample (where cells are swabbed from discharge or affected mucous membranes such as the vagina, urethra, anus, or mouth). If a positive result is found, antibiotics are the standard treatment; depending on the strain of an infection, different types of antibiotics or treatment combinations may be prescribed. Since people who have gonorrhea are also often infected with chlamydia, they and their partner(s) may need to be treated for both infections at the same time. When treating gonorrhea, it’s critical to take the full course of antibiotics and, if instructed, return for a check-up to ensure that the treatment has been effective. Due to the growing concern about resistant strains of this STI, it's wise to follow up with a provider sooner if after taking the medication for a few days, the symptoms haven't changed. Also, those actively treating a gonorrhea infection are advised to postpone vaginal, oral, or anal sex until after finishing treatment to avoid re-infection. Even if a previous case of gonorrhea has been treated and cured, it's possible to be reinfected again in the future. On that note, prevention is key; safer sex (especially with condoms!) and regular check-ups can go a long way in guarding against or promptly treating gonorrhea and other STIs.

For more information about symptoms, testing, treatment, and prevention of STIs, you can visit a health care provider, local health department clinic, or a health center such as Planned Parenthood.

Take care,

Alice!

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