Gonorrhea

What Is Gonorrhea? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Joseph Bennington-Castro
By Medically Reviewed by
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Medically Reviewed
Gonorrhea is a commonsexually transmitted disease (STD)根据疾病控制与预防中心（CDC），每年在美国发生约114万新感染。

在15至24岁的孩子中尤其常见。

The disease is caused by the gonorrhea bacteriaNeisseria gonorrhoeae, and is sometimes called “the clap” — for reasons unknown — or “the drip,” because of the vaginal, penile, or rectal discharge it can cause.

淋病具有高度传染性，是美国第二常见的通知疾病。

You can get it by having unprotected vaginal, anal, or oral sex with someone who has it. It can spread even if a man doesn't ejaculate during sex.

淋病的体征和症状

In women, gonorrhea often doesn't cause symptoms. If a woman does experience symptoms, they are typically mild and can be mistaken for a bladder or vaginal infection.

According to Planned Parenthood, symptoms in women may include:

  • Strong-smellingvaginal discharge
  • Pain and burning while peeing
  • Peeing more often than usual
  • Pain during vaginal sex
  • Sore throat
  • Fever and severe lowerabdominal pain, if the infection has spread to the fallopian tubes and stomach area
Men with gonorrhea also often don’t have any symptoms. If symptoms are present, they can include the following:

  • Pain and burning while peeing
  • Peeing more often than usual
  • White, yellow, or green discharge from the penis
  • Red or swollen urethral opening
  • Sore throat
Rectal gonorrhea can cause anal discharge, itching, pain, bleeding, as well as painful bowel movements in men and women.

Gonorrhea in the throat can cause a sore throat (pharyngitis) or swollen lymph nodes but it usually doesn't lead to any other symptoms, according to the Mayo Clinic.

However, in rare cases, it can be passed on to other people through kissing or oral sex.
Both men and women can get gonorrhea in the mouth, urethra, eyes, and anus, and in women it can also infect the cervix, uterus, and fallopian tubes.

Both sexes can also have the infection and not know it, which is one reason that regular STD testing is a good idea if you have any risk factors for acquiring a gonorrhea infection.

Untreated gonorrhea, even if it’s causing no symptoms, can lead to serious health problems and complications.

Causes and Risk Factors of Gonorrhea

The cause of gonorrhea, theNeisseria gonorrhoeaebacteria, can infect the mucous membranes of the reproductive tract in men and women, as well as those of the mouth, throat, eyes, and rectum.

There are several factors that can increase a person’s risk for getting gonorrhea:

  • Being a sexually active female under 25
  • Being a man who has sex with men
  • Having a new sex partner
  • Having multiple sex partners or having sex with someone who has multiple sex partners
  • Not using condoms consistently or correctly
  • Having a history of gonorrhea or another sexually transmitted disease

How Is Gonorrhea Diagnosed?

使用实验室测试对淋病进行诊断，该测试需要尿液样本或尿道（男性）或子宫颈或子宫颈或vagina(for women). If a person has had anal or oral sex, and a rectal or pharyngeal infection is suspected, a swab specimen may be collected from the throat or the rectum for testing.

推荐的淋病测试方法是核酸扩增测试，该测试检测Neisseria gonorrhoeae在提供的尿液或拭子样品中。根据LabTestSonline的数据，在第二种类型的实验室测试（称为培养物）中，将样品放在容器中，以查看淋病细菌是否在几天内生长。

If you think you may have gonorrhea, make an appointment to see your healthcare provider. Healthcare providers at public health or STD clinics and Planned Parenthood can also perform gonorrhea tests.

希望对淋病进行测试的男性和女人也可以使用在家测试套件。要执行测试，您需要收集尿液样本或从患处取拭子。然后，您将样本邮寄到指定的实验室，通常通过电子邮件或短信发送正面或负面结果的通知。该类型的测试可从包括letsgetchecked.comandNurx, or at number ofwebsites listed by GoodRx, with prices starting around $80 for a testing kit.

Since a person may have gonorrhea without displaying symptoms, regular testing can help to detect the disease before it causes complications. This is particularly important for people who are at increased risk of contracting the disease, defined by the CDC as those who have a new sexual partner, more than one sex partner, a sex partner who has a sexually transmitted infection (STI), previous or coexisting sexual infections, or those who are using condoms inconsistently outside a monogamous relationship.

The CDC recommends that the following groups of people get tested for gonorrhea regularly:

  • 25岁以下的性活跃女性应每年进行一次测试。
  • Sexually active women over 25 who are at increased risk should be tested once yearly.
  • All pregnant women under 25 should be tested early in their pregnancy, as should pregnant women over 25 if they are at increased risk.
  • Men who have sex with men should be tested at least once yearly, regardless of condom use.
  • Men who have sex with men and are at increased risk should get tested every three to six months.
  • People living with HIV should be tested for gonorrhea at their first HIV evaluation, and subsequently at least once yearly.
  • People with HIV每年应多次筛查淋病风险增加的人（取决于个人风险行为和当地流行病学）

Prognosis of Gonorrhea

When gonorrhea is diagnosed and treated in a timely way, people usually make a complete recovery. In some cases where treatment is delayed andpelvic inflammatory diseasedevelops, it can cause infertility, scarred fallopian tubes (which increase the risk of tubal pregnancy in women),ectopic pregnancy(whereby pregnancy occurs outside the womb), and chronicabdominal pain。

Duration of Gonorrhea

Gonorrhea gets better very quickly withantibiotictherapy — usually within a few days. However, if your symptoms persist for longer than a few days after you are treated, contact your healthcare provider.

如果未经治疗，淋病可能会引起严重的健康问题，其中一些可能会持续一生。

People with gonorrhea who are cured of it once with antibiotics can still get the infection again.

Treatment and Medication Options for Gonorrhea

Over the years, gonorrhea has become resistant to almost all of the classes of antibiotics once used to treat it. Successful treatment now relies on the one remaining class of antibiotics —cephalosporins——这是有效的,每疾控中心。

Medication Options

As of December 2020, the CDC recommends a single 500-milligram (mg) intramuscular dose of the antibioticRocephin (ceftriaxone) 对于简单的淋病。治疗与Chlamydia trachomatiswithoral doxycycline(100 mg twice daily for seven days) should be administered whenchlamydial infectionhas not been excluded.

Be sure to tell those who you have sex with that you are being treated for gonorrhea so they can be treated, too. This will help you avoid passing it back and forth to each other.

您在治疗后七天不应该发生性关系，您应该避免与伴侣发生性关系，这些伴侣在接受测试后才接受淋病治疗，并在必要时接受治疗。

Alternative and Complementary Therapies

只要服用药物，淋病就可以用抗生素治愈。没有任何替代疗法被证明可以治愈该疾病。

漱口水李斯特碱似乎有可能帮助控制淋病。在一项发表在《期刊》上的2017年小型研究中Sexually Transmitted Infections,researchers instructed men with pharyngeal gonorrhea (gonorrhea of the throat) to gargle with Listerine for one minute.

一群对照组吞噬了盐水溶液。吞咽后五分钟，这些人收到咽拭子，看看李斯特林对李斯特的影响有什么影响N. gonorrhoeaebacteria in their throats. The researchers found that men who’d gargled with Listerine were significantly less likely to have positive tests than the men who’d gargled with saline. Even so, all the men in the study were then treated with antibiotics to cure their gonorrhea.

While the Listerine study raises intriguing possibilities, it does not prove that Listerine cures gonorrhea. People who test positive for gonorrhea should still be treated with antibiotics. In addition, Listerine is not intended to be used in body cavities other than the mouth.

Prevention of Gonorrhea

The only way to absolutely keep yourself safe from catching gonorrhea is to avoid having vaginal, anal, or oral sex. However, since many people wish to have sex at some point in their lives, that may be unrealistic.

但是，有一些方法可以降低同时保持性活跃的同时患疾病的风险，例如：

  • Using a condomduring vaginal or anal sex
  • Using a condom (for men) or a dental dam (for women) during oral sex
  • 彻底洗sex toys— or changing the condom on them — before a new person uses them
  • Not having sex with anyone until you’ve finished your treatment (if you are currently being treated for gonorrhea)

Also, having sex with fewer partners can help reduce your chances of getting gonorrhea.

Preventing Gonorrheain Infants

Gonorrhea in a pregnant woman can increase the risk for miscarriage and premature birth, according to the American Pregnancy Association.

患有淋病的孕妇也可以在分娩过程中将其传递给婴儿，这可能导致严重的眼部感染，可能导致失明，关节感染或婴儿感染致命的血液感染。

由于这些原因，建议妇女在第一次产前访问中筛查淋病，以便如果有的话，可以尽快对待。

如果出生后在婴儿中检测到淋病，则可以用Rocephin, notes the CDC.

Complications of Gonorrhea

Women with untreated gonorrhea are at risk forpelvic inflammatory disease (PID), which may cause no symptoms or may cause pain in the pelvis, lower abdomen, or lower back. If left untreated, PID can lead to:

  • Chronic pelvic pain
  • Infertility
  • Ectopic pregnancy, in which the fertilized egg implants outside the uterus, possibly leading to internal bleeding or a ruptured fallopian tube and miscarriage
Complications of gonorrhea in men may includeepididymitis, an inflammation of the epididymis, a long coiled tube at the back of the睾丸that stores sperm and carries it between the睾丸and the vas deferens, which conveys it to the urethra. Epididymitis can cause testicular or scrotal pain, and, if left untreated, infertility.

Disseminated Gonococcal Infection

Gonorrhea can also spread throughout the body, in a condition called systemic, or disseminated, gonococcal infection (DGI).

Symptoms of DGI commonly include joint or tendon pain, askin rash和发烧。DGI的更高级阶段引起败血症或感染性关节炎，其中细菌直接侵入关节空间Merck Manual。

If gonorrhea spreads to the joints, it can cause a type of arthritis known as gonococcal arthritis, which is typically experienced in large joints such as the knees, wrists, or ankles. Gonococcal arthritis is treatable with antibiotics, according to CreakyJoints.org.

Research and Statistics: How Many People Have Gonorrhea?

报告的淋病病例的数量可以取决于许多因素超出了感染的实际发生，包括诸如不同位置的筛查实践差异或使用不同类型的测试之类的东西。但是，报告的病例仍然是追踪疾病并确定感染正在增加或下降的区域的有用方法。

2018年，总共有583,405例淋病病例，比2017年报告的数量增加了约5％。

At that time, over 90 percent of reported gonorrhea cases were in people between the ages of 15 and 44, with the highest percentage in the 20- to 24-year-old age group for both men and women.

因为COVID-19 pandemic破坏了常规检测性病在吗United States in 2020, public health officials are concerned that current STD rates are higher than reported. A survey carried out by the国家联盟的性病found that by March 2020, 83 percent of STD public health programs had deferred STD services or field visits, 62 percent were unable to maintain existing STD caseloads, and 66 percent of clinics reported a decrease in the number of STD screenings and tests carried out. A subsequent June 2020 survey found that 78 percent of the STD Health Department workforce had been redeployed to COVID-19 response efforts.

Black and Hispanic Americans and Gonorrhea

Reports from the CDC indicate that disparities exist in the rates of STDs among white Americans and racial minority groups. There are several factors that could be contributing to these disparities, including unequal access to healthcare, and specifically tosexual healthservices.

In 2018, the rate of reported cases of gonorrhea in Black Americans was 7.7 times the rate among whites.

Past research has suggested that racial disparities in household income are associated with racial disparities in gonorrhea rates, although why that is remains unknown.

In Hispanic Americans, the rate of gonorrhea was 1.6 times higher than in whites in 2018.

缺乏保险可能证明是护理性病的障碍；根据CDC的数据，西班牙裔美国人在2017年的健康保险范围最低。

Related Conditions

Gonorrhea is one of many diseases transmitted through sexual contact, and it shares symptoms with certain other infections of the bladder, vagina, and penis.

Tests for gonorrhea administered by your healthcare provider can help to rule out other potential infections.

衣原体会导致类似症状

而淋病和chlamydiaare both sexually transmitted bacterial infections, they are caused by different bacteria. Still, the two diseases have many similarities: They can both affect reproductive organs in men and women, as well as the urethra, throat, and rectum. Also, both infections are spread the same way, have symptoms that resemble each other, and are treated with antibiotics, according to the American College of Nurse-Midwives.

Using condoms correctly each time you have sex can help to prevent bothgonorrhea and chlamydia。

HIV Risk Rises With Untreated Gonorrhea

If gonorrhea goes untreated, it may increase a person’s chances of getting ortransmitting HIV，引起艾滋病的病毒。

Treating gonorrhea helps reduce that risk and protect your overall health but by itself will not prevent a person from contracting HIV. Practicing safer sex and limiting your number of sexual partners can help reduce the risk of contracting HIV.

我们喜欢的资源

If you are sexually active, whether or not you have gonorrhea, it’s important to educate yourself about safe sex and STDs. Take some time to learn how to practice safe sex, how often you should get tested for STDs and other genital infections, and familiarize yourself with what’s normal for your body. Here are some resources to get you started.

American Sexual Health Association (ASHA)

This website offers straightforward information about sex andsexually transmitted diseases， 包含gonorrhea。

Clinical Trials

Browsing the ClinicalTrials.gov site is one way to stay up to date with the latest research on diagnosing, treating, and preventing gonorrhea.

Planned Parenthood

This organization provides information about signs, symptoms, prevention, and treatment of gonorrhea. Many Planned Parenthood locations also offer tests for gonorrhea; you can find a health center near youon the Planned Parenthood website。

学到更多About Sexuality and STD Resources

Additional reporting byBecky Upham。

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