Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. As a significant public health concern, gonorrhea is monitored by Santé publique France and is the focus of prevention and screening programs tailored to the most at-risk populations.

Sexual transmission

The mode of transmission is strictly from person to person, almost always during foreplay or sexual intercourse (vaginal, anal, oral-genital, or oral-anal sex). Gonococcus does not confer immunity, so reinfection is common.

Symptoms

In men, acute urethritis is the most common form; the incubation period is 2 to 5 days. The infection presents as purulent urethritis with intense burning during urination and dysuria. Local and regional complications (orchiepididymitis with the risk of reduced fertility, prostatitis, urethral stricture) have become very rare.

In women, up to 70% of cases are completely asymptomatic. When symptomatic, the infection presents as cervicovaginitis with leukorrhea, often associated with urethritis. The condition may progress to Bartholinitis or salpingitis, potentially complicated by tubal infertility and a risk of ectopic pregnancy.

There are also anorectal forms (purulent anorectitis) and pharyngeal forms (most often asymptomatic) in both men and women. Generalized forms are rarer: arthritis, septicemia, endocarditis, perihepatitis in women, ophthalmic involvement (via hand-to-eye transmission), skin involvement, and meningitis.

Since the absence of symptoms is common, it is recommended to get tested if you have engaged in risky behavior (such as unprotected sex with a new partner). Testing for gonorrhea is performed using a urine sample in men and a self-collected vaginal swab in women, as well as an anal swab in cases of anal intercourse and a throat swab in cases of oral intercourse.

For more information: https://www.cnr-ist.fr

Consequences that can be serious

Without diagnosis and treatment, gonorrhea can lead to significant complications with serious consequences: chronic pelvic pain, weakening of the mucous membranes and increased risk of HIV infection, mother-to-child transmission, prostatitis, urethral stricture, arthritis, septicemia, endocarditis, perihepatitis in women, eye infections (through hand-to-eye transmission) and skin infections, meningitis…

Antibiotic treatment

The standard treatment is an injection of an antibiotic (ceftriaxone).
The patient must inform their sexual partners so they can be screened and treated for gonorrhea, in order to break the chain of transmission.

Condoms and screening to combat gonorrhea

To combat sexually transmitted infections such as gonorrhea, condoms, along with testing, are the most effective means.

Screening is the only way to establish a diagnosis. If the result is positive, it allows for the prescription of appropriate antibiotic treatment, thereby reducing the risk of complications and further transmission. Simple and painless, it is performed via a swab test for women and via a swab test or urine analysis for men.

Screening can be performed following a consultation with your primary care physician, gynecologist, or dermatologist-venereologist, who will refer you to a laboratory, or for free at the Free Centers for Information, Screening, and Diagnosis (CeGIDD) and family planning or family education centers.