Itching, unusual losses, pain during intercourse… Gonorrhea, “gonococcal” or “hot piss” is a sexually transmitted infection that is caught during intercourse with a protected person. Contagious, it must be treated quickly to avoid contaminating other partners.
There gonorrhea Or gonorrhea is a sexually transmitted infection increasing due to multiplication of partners during sexual life, for a few years. According to the latest figures published by Public Health France, 21,750 cases of gonorrhea were diagnosed in 2021 in a general medicine consultation, +45% compared to 2020. And 13,800 cases in CeGIDD. The annual incidence rate is estimated at 0.3 cases per 1,000 residents. THE men accounted for 81% of cases declared in 2021. Among them 33% heterosexual, 67% homosexual. THE gonococcus does not induce immunityso we can catch it multiple times.
What is gonorrhea?
“In France, we speak rather of gonorrhea. The term of gonorrhea is a Anglo-Saxon term“I would like to point out from the outset Dr. Jean-Marc Bohbot, gynecologist, infectious disease specialist, Medical Director of the Institut Fournier in Paris. Gonococcal disease is a sexually transmitted disease. She touches the sexual organs, the anus but can also reach the throat and, in babies infected during childbirth, the eyes. “It’s a disease on the rise. The latest INVS report published in 2018 with data from 2016 reports a 300% increase in the number of gonorrhea in France, as for Chlamydia“Warns Dr. Jean-Marc Bohbot.
What bacteria causes gonorrhea?
THE gonococcusOr Neisseria gonorrhoeae is a bacterium that is localized in the majority of cases to the genitals. This germ responsible for gonorrhea can be transmitted during sexual intercourse to humans, and is often located at the level of the terminal part of the urethra, the conduit which goes from the bladder to the urinary meatus, thus generating urethritis. They can also be responsible for inflammation of the vagina and vulva in women.
THE unprotected sex with partners at risk increase the risk of gonococcal infection Neisseria gonorrhoeae. “This one is caught regardless of the type of sexual intercourse: vaginal, anal, oral. It’s a highly contagious bacteria“, specifies the gynecologist. On the other hand, gonorrhea of the newborn is transmitted during childbirth if the mother is infected.
“Often it is when the partner has gonorrhea that we discover it in a woman”
What are the symptoms of gonorrhea or gonorrhoea?
In the woman : “In women, infection in the throat or anus is completely asymptomatic. At the genital level, the infection can be signaled by itchingof the unusual lossesof the pain during intercourse, of the burning while urinating“, informs Dr. Jean-Marc Bohbot. “But often it is when the partner has gonorrhea that we discover gonorrhea in a woman” he specifies. A pregnant woman infected with gonococcus can in turn infect her child when she gives birth. Gonorrhea in newborns is characterized by an infection of the eyes, which can lead to serious complications (blindness) if left untreated.
In humans: “In humans, gonorrhea is revealed in the majority of cases by a acute urethritis: discharge of pus from the penis, violent urinary burns” indicates the gynecologist. The clinical forms of the disease reaching the throat or the anus are often more difficult to diagnose because of their particular symptoms.
Diagnosis of gonorrhea
To make the diagnosis of gonorrhea in women, we no longer proceed to a urine analysis which is done, but to a vaginal swab. “Today is a vestibular self-sampling test which is offered in all screening centres: the woman takes the sample herself with a swab“, informs De Jean-Marc Bohbot. test results are known in 24-48h. At the house of the man, the diagnosis is made from the first stream of urine. “A diagnosis of gonorrhea involves full screening for all sexually transmitted infections including HIV” warn the gynecologist.
THE treatment consists of a antibiotic treatment. “Ae bite of a cephalosporin allows healing in a few days ” indicates the gynecologist. “As gonococcus is associated in 25-30% of cases with sexually transmitted infections such as Chlamydia, a probabilistic treatment can be carried out while awaiting the results of the analysis: we associate a penicillin injection an anti-chlamydia antibiotic by mouth for a few days“, he describes. Namely: at the global level, there is more and more resistance of antibiotics to gonococci. If a man or a woman has gonococcalhis or her partner(s) should be treated also. A follow-up consultation is required after three days if symptoms persist. Another follow-up consultation after 7 days is systematically organized in order to carry out a microbiological control of the cure (elimination of the bacteria).
Untreated gonorrhea can render a woman infertile.
Prevention: wearing a condom
“Prevention goes through wearing a condom for all types of sexual intercourse, including oral sex which carries a risk of transmitting STIs in either direction” inform the gynecologist. “People who have unprotected sex should be screened for gonococcus at least once a year“he advises.
It is essential not to self-treat in the presence of genital signs (especially for mycosis) because the later the diagnosis of gonorrhea is, the greater the risk of complications.
What are the risks in case of gonorrhea?
► In humans, if gonorrhea is not treated, or treated too late, it can lead to several complications: the most common are urethritis, prostatitis and orchiepididymitis, which corresponds to theinflammation of a testicle and epididymis. Not treated, prostatitis can progress to the formation of an abscess, and epididymitis may be responsible infertility and testicular atrophy.
► For women: The risk of untreated gonorrhea in women is that of sterility. “The infection can affect the tubes. There salpingitis can cause sterility but it has become a rare complication” indicates Dr. Jean-Marc Bohbot. Salpingitis is indicated by pelvic pain, fever, sometimes spotting. “Gonococcal disease can also cause bartholinitis, a vulvar gland loaded with lubricate the vulva during sex” informs the gynecologist. This infection leads to a extremely painful swelling of one lip of the vulva, very significant heat and redness. It is treated with prolonged antibiotic treatment. Gonorrhea is also associated with an increased risk of sexual transmission of HIV.
► During pregnancy: Gonococcal infection can influence the course of pregnancy during the first three trimesters and increases the risk of preterm delivery. The newborn can be contaminated during childbirth if the pregnant woman is infected with gonococcus. It is the eyes that are affected by the infection. “THE purulent ophthalmia of the newborn have become exceptional in France”says Dr. Jean-Marc Bohbot.
Thanks to Dr Jean-Marc Bohbot, gynecologist, infectious disease specialist, Medical Director of the Institut Fournier in Paris.