---

Gonorrhea: The Silent Threat of a Common Sexually Transmitted Infection

Introduction
Gonorrhea is one of the most prevalent sexually transmitted infections (STIs) worldwide. Caused by the bacterium Neisseria gonorrhoeae, it is often referred to as “the clap.” Despite being common, gonorrhea carries significant health risks if left untreated, leading to infertility, pelvic inflammatory disease, and even systemic infections. Its growing antibiotic resistance has also raised major public health concerns.

Epidemiology
Globally, gonorrhea affects more than 80 million people annually, according to the World Health Organization. It is particularly common in young adults aged 15–29 years. Both men and women are at risk, but women often experience fewer early symptoms, making the infection harder to detect.

Transmission
Gonorrhea spreads primarily through:

• Vaginal, anal, and oral sex with an infected partner.

• Perinatal transmission from mother to child during childbirth, leading to neonatal conjunctivitis.

Condom use significantly reduces the risk, but inconsistent or incorrect use continues to fuel its prevalence.

Clinical Manifestations
Symptoms differ between men and women:

• In men:

  • Painful urination (dysuria).

  • Urethral discharge (yellow, green, or white).

  • Testicular pain in severe cases.

• In women:

  • Vaginal discharge.

  • Pelvic or abdominal pain.

  • Irregular menstrual bleeding.

  • Many women remain asymptomatic, increasing the risk of undetected transmission.

Complications
If untreated, gonorrhea can result in severe long-term consequences:

• Pelvic Inflammatory Disease (PID) in women, leading to infertility and ectopic pregnancy.

• Epididymitis in men, which can also impair fertility.

• Disseminated Gonococcal Infection (DGI), where bacteria spread through the bloodstream, causing arthritis, skin lesions, and systemic illness.

Antibiotic Resistance: A Global Concern
One of the most alarming aspects of gonorrhea is its resistance to multiple antibiotics. Historically treated with penicillin, tetracycline, and fluoroquinolones, the bacterium has developed resistance to each. Today, the CDC recommends dual therapy with ceftriaxone and doxycycline, but emerging resistance to cephalosporins threatens future treatment options. This “super gonorrhea” has become a critical public health issue.

Diagnosis
Diagnosis is made through:

• Nucleic Acid Amplification Tests (NAATs), the most sensitive method.

• Culture tests to confirm antibiotic susceptibility.

• Swabs from genital, rectal, or throat sites depending on exposure.

Prevention

• Consistent condom use.

• Regular STI screening for sexually active individuals.

• Prompt treatment of infected individuals and their partners.

• Public health education to reduce stigma and encourage safe practices.

Conclusion
Gonorrhea remains a major global health challenge, not only because of its prevalence but also due to the alarming rise of antibiotic-resistant strains. Public health strategies must focus on prevention, early detection, and innovative research into new treatments and vaccines. Without action, gonorrhea may evolve into an untreatable infection with devastating reproductive and systemic consequences.