Gonorrhea in women

Overview

Gonorrhea is a sexually transmitted bacterial infection of the mucous membranes due to Neisseria gonorrhea. The bacteria are spread via sexual contacts with asymptomatic carriers/ill individuals. The incubation period lasts for 2-7 days. In women the lining of the cervix is usually a primary infection site, later – other periurethral glands and the ducts of Bartholin’s glands may also be infected and the bacteria may spread even further infecting the uterus, Fallopian tubes, and abdominal cavity. The vagina is left uninfected due to the specific features of the vaginal mucous membrane. It is considered that asymptomatic disease is very common in females, accounting for about 80% of gonorrhea infections. If untreated, a person may eventually develop infection complications or infertility.

Causes

Neisseria gonorrhea are kidney-shaped aerobic bacteria which appear as Diplococcus – as they group in pairs with the adjacent sites concave.  

Risk factors                                  

  • Having unprotected vaginal, anal, or oral sexual intercourse;
  • Having multiple sexual partners;

Symptoms

In most cases, women experience the first symptoms of the disease within 10 days after acquiring the infection.

Gonococcal cervicitis usually manifests with the following symptoms:

  • Purulent vaginal discharge;
  • Painful voiding (typically without frequency and urgency);
  • Intermenstrual bleeding, sometimes following sexual intercourse;

Women who have anal sex may develop a rectal gonococcal infection. Sometimes pharyngeal gonorrhea as the result of oral sex is observed, although it is usually asymptomatic.

Complications

  • Gonococcal conjunctivitis is a common complication of gonorrhea with purulent discharge from the eyes, pain, and swelling of the eyelids. A person transmits the infection to the eyes while touching the eyes with dirty hands;
  • Acute salpingitis develops when bacteria reach the Fallopian tubes and cause the acute inflammation of the tubes lining, the disease may become chronic and result in the narrowing of the salpinges. Untreated gonorrhea causes pelvic inflammatory disease which eventually leads to the Fallopian tube obstruction and infertility;
  • Disseminated gonococcal infection develops often in women with no genital symptoms. As the bacteria spread all over the body the joints and the skin are involved causing arthritis and pustular lesions on the skin;

Diagnosis

Top view of colorful tablets and capsules pills in blister packs. Treatment

Gonococcal infection should be treated with antibiotics. Single-dose of 2 antibiotics is usually enough for the uncomplicated disease. The earlier the treatment is initiated, the better the outcomes are.

Applicable medicines

  • Ceftriaxone 250 mg single intramuscular injection plus
  • Azithromycin 1 g taken by mouth;

Prevention

  • Having one healthy sexual partner who was tested for sexually-transmitted diseases;
  • The latex condoms should be used the right way as the wrong technique increases risk of infection;
  • As there are also asymptomatic cases of infection, it is recommended for every sexually active person to get tested for sexually transmitted infections and if necessary initiate treatment as soon as possible;
  • To prevent further spreading of the disease an infected person should abstain from sex for at least a week after the end of treatment;