Gonorrhea (Photo: Bill Schwarts/CDC)

Sexually Transmitted Infections: Part 1 Gonorrhea

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By Yolanda Evans, MD, MPH
From Seattle Children’s Teenology 101 weblog

Part of normal adolescence is the development of new relationships. Teens have strong ties with peers and also began to have romantic relationships.

Many teens also choose to start having sex. In fact nearly half (47%) of all high school students have had sex before. With sex comes consequences: intense feelings, possible heart break, as well as the risk of pregnancy and sexually transmitted infections.

Unfortunately, 15-24 year old’s account for almost half of the 19 million new sexually transmitted infections (STI) that occur each year (even though this age group is only a quarter of the US population), but I want to be clear that any person who has sex is at risk for an STI. In this post, I’ll focus on gonorrhea.

Gonorrhea

Gonorrhea CDC-Bill Schwarts

Gonorrhea bacteria amongst white cells. Photo by Bill Schwartz/CDC

Gonorrhea is an STI caused by a bacterium. The CDC estimates that about 700,000 people are infected each year. It’s spread by having sex; that means oral, anal, and/or vaginal sex and can also be spread from an infected mother to an infant (leading to serious illness in the baby).

The symptoms can vary. Most women have no symptoms at all or they may have pain or burning with urination, vaginal discharge or bleeding. It might be mistaken for a urinary tract infection.

Men are more likely to have pain or burning with urination and white/yellow/green discharge from the penis.  People with an infection of the throat may have sore throat or no symptoms at all and rectal gonorrhea infection could cause painful bowel movements or itching, burning, and discharge.

Untreated gonorrhea can cause a painful infection called epididymitis in males and can lead to an infection of the fallopian tubes called pelvic inflammatory disease (PID) in females.

PID can cause scarring of the fallopian tubes that leads to infertility or a life threatening pregnancy outside of the uterus called an ectopic pregnancy.

In both males and females untreated gonorrhea can also lead to a life threatening infection that affects the joints.

Screening for gonorrhea is relatively easy. Anyone with symptoms, a partner who has been diagnosed with gonorrhea, or anyone diagnosed with another STI should be screened. There is now a test that looks for the bacterial DNA in urine, so a person only needs to provide the urine.

Depending on the situation, a medical provider may still obtain a swab from a woman’s cervix (the entrance to the uterus or womb) or a man’s penis but the ability to detect the bacteria in the urine has made screening something that is not painful or uncomfortable. To look for infection in the rectum or throat, a medical provider will need to obtain swabs of these areas.

Fortunately, gonorrhea can be cured if treated appropriately, but antibiotic resistance is increasing. If your teen is diagnosed with gonorrhea or any treatable STI, they should take all the medication provided and should not share medication or take another person’s dose.

The good news is that gonorrhea can be prevented!  Not having sex is the only way to prevent any STI 100% of the time, but knowing the status of your sexual partner and using latex condoms with every sexual act (including oral and anal sex) also reduce the risk of getting gonorrhea.

About Yolanda Evans, MD, MPH

Yolanda-Evans-MD-MPH_avatar-100x100My work is a ‘dream come true’ and it’s what I’ve wanted to do for as long as I can remember. I have the privilege of getting to know some amazing teens and hearing things about them that they may not have told anyone before. When I’m not working, I like trying new foods, traveling around the world, spending time with family and friends, and enjoying the fresh Washington air (though not quite as fresh as Alaska where I grew up, but very close!) – Yolanda Evans, M.D., Adolescent Medicine at Seattle Children’s

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