How is gonorrhea contracted? Is it easy to cure?

Author: Wu Hao, Chief Physician, Beijing You'an Hospital, Capital Medical University

Standing Committee Member of the Infection and Immunity Branch of the Chinese Medical Association

Reviewer: Chen Yong, Chief Physician, Beijing Chaoyang Hospital, Capital Medical University

On the street, you may see many advertisements about gonorrhea treatment, and you may be familiar with the word gonorrhea. But do you know what kind of disease gonorrhea is?

Gonorrhea is a purulent inflammation caused by infection of the reproductive organs with gonococci. It is divided into simple gonorrhea and disseminated gonorrhea.

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1. What are the symptoms of gonorrhea?

Simple gonorrhea mainly infects the reproductive tract and urinary tract in women and the urinary tract in men. Disseminated gonorrhea is not limited to the reproductive tract. Spreading to the joints can cause arthritis, spreading to the pelvic cavity can cause pelvic inflammatory disease, and can also cause eye inflammation, pharyngitis, etc.

Gonorrhea only infects columnar epithelial cells. Our skin and female vaginal mucosa are composed of squamous epithelial cells, on which gonococci cannot survive. The cervix is ​​composed of columnar epithelial cells, so the female vaginal wall is generally not infected with gonococci. However, the 1 cm inside the cervix can be infected with gonococci.

Women infected with gonococci have no symptoms, no pus discharge, but more vaginal discharge and occasional back pain. Gynecological examinations show that the cervix is ​​very red.

If a man is infected with gonococci and does not take medicine 24 hours after infection, pus will flow from the urethra. After taking anti-gonococcal drugs, there will be secretions in the urethra, but there will be no pus. There may also be mild urinary pain and urethral discomfort. It is rare for men to spread to the abdominal cavity after being infected with gonococci.

2. How is gonorrhea contracted?

Gonorrhea is the most common sexually transmitted disease and is highly contagious. If either a man or a woman is infected with gonococci, there is a 2/3 chance of contracting gonorrhea after one unprotected sexual intercourse. Some people also believe that after 3-6 times of unprotected sexual intercourse, there is almost a 100% chance of infection.

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95% of gonorrhea is transmitted through unprotected sexual intercourse. There are also some non-contact transmissions, such as a mother with gonorrhea sharing a towel or basin with her child to wash her vulva, which can cause a young girl to be infected with gonorrhea. This situation is very common in clinical practice. Other routes can also be indirectly transmitted in theory, such as gonococci contaminating swimming pools and toilets. In fact, sharing these items generally does not transmit gonorrhea and is rare.

Typical gonorrhea is not difficult to diagnose. If a man has pus and secretions from his urethra, a smear will reveal Gram-negative diplococci, and gonococcal infection can be diagnosed. The symptoms of gonorrhea in women are increased vaginal discharge, but the symptoms are not obvious, so bacterial culture is needed to differentiate it from vaginitis.

Gonorrhea causes little harm to the body and is easy to treat.

3. How to treat gonorrhea?

Gonorrhea is very easy to cure. There are many oral medicines and injections that can treat it. It can be cured by taking an injection once a day or taking the medicine once a day.

There are many kinds of oral medicines. There is a chloramphenicol drug called thiamphenicol. Take ten tablets at a time. Thiamphenicol is only effective against gonococci and is almost ineffective against other bacteria. There are also third-generation or second-generation cephalosporins and quinolone antibiotics that can also treat gonorrhea.

The injection is actually an aminoglycoside antibiotic called spectinomycin. One injection can also cure gonorrhea. There are also penicillin injections. Half of the ordinary penicillins have developed drug resistance and cannot be used to treat gonorrhea. Semi-synthetic penicillins, such as ampicillin, must be used. The most commonly used is the injection of ceftriaxone. This drug has a long half-life. Many patients still feel uncomfortable the next day after taking an injection. It often takes 3 days for the symptoms to completely disappear. Some can be cured with one injection.

Almost all antibiotics are effective against gonorrhea, but the above-mentioned antibiotics can cure gonorrhea.

In addition, the couple is required to be treated together. If they are not treated at the same time, even if the man is cured, he will be infected by the female again and will be infected repeatedly.

Will gonorrhea heal itself without treatment? A small number of cases can heal themselves, but 90%-95% of men will not heal themselves and will have pus discharge, requiring treatment; women have less obvious symptoms and can carry the bacteria for many years, and generally will not heal themselves, and still need medication to be cured.

Gonorrhea can be cured, but if you get infected with gonococci again, it will recur, just like a cold. Gonorrhea is a sexually transmitted disease, mainly transmitted through sex, and is highly contagious. The most important thing to prevent gonorrhea is safe sex. What is safe sex? It means sex without the exchange of body fluids between each other. Then using condoms can almost 100% prevent gonorrhea.

Gonorrhea is not scary, prevention is the most important thing.