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Sexually transmitted diseases (STDs) are those diseases transmitted primarily through sexual means, which may include oral, anal, or genital contact; osculation (kissing); or manual stimulation. STDs are also referred to as sexually transmitted infection (STI), venereal diseases (VD), and reproductive tract infections (RTI). Though other diseases may also be transmitted through sexual contact, the term STD is reserved for an infection spread primarily through sexual means. The source of infection may be bacterial, fungal, viral, or parasitical. Depending upon the infecting agent, the resulting disease may remain localized at the site of infection (such as the genitalia or sex organs) or may spread to other parts of the body. Though symptoms may vary, both men and women are susceptible to STDs.

The most reliable method for the prevention of all STDs is abstinence or limiting sexual activity to monogamous, long-term relationships with partners who have been tested and are free of infection. Consistent and correct use of latex condoms may help to prevent the transmission of many STDs but may be ineffective in preventing others.

Gonorrhea is caused by the bacterium Neisseria gonorrhoeae that infects the warm, moist areas of the reproductive tract, including the uterus, the cervix, and the fallopian tubes. The bacterium may also infect the urethra, anus, mouth, and eyes of either sex. Transmission of the disease is through sexual contact with the penis (with or without ejaculation), vagina, mouth, or anus. Gonorrhea can be spread from infected mothers to their infants during vaginal delivery. Previous infections of gonorrhea provide no immunity against reinfection.

Symptoms of gonorrhea are often mild or absent. In women they may include pain or burning during urination, increased vaginal discharge, and/or vaginal spotting between menstrual periods, but very often clinical manifestations are nonspecific and can easily be mistaken for a vaginal or bladder infection. In men the first signs of infection may occur two to five days after infection but may take as long as 30 days to develop. Symptoms may include burning during urination, discharge from the penis, and swollen testicles accompanied by pain. Gonorrhea infections of the rectum may be asymptomatic or may manifest with a discharge, rectal bleeding, itching, soreness, and/or painful bowel movements and may affect both women and men. Oral infections usually do not manifest symptoms but if present may include a sore throat.

Untreated, gonorrhea can cause serious and permanent health concerns in both men and women. In men the disease can cause epididymitis, a painful inflammation of the epididymis that may result in infertility. In women it may lead to pelvic inflammatory disease (PID), a serious condition that can cause damage to the fallopian tubes and lead to infertility and an increased risk for ectopic pregnancy (a condition in which the fertilized egg implants outside the uterus). Gonorrhea may also cause serious blood-borne disease that results in joint pain, fever, and other systemic (bodily) symptoms. People who have gonorrhea are more susceptible to contracting HIV and are also more likely to transmit HIV to uninfected partners.

Children infected during vaginal delivery may develop blindness, joint infection, or severe blood infection. Immediate treatment of the disease in pregnant mothers helps to reduce the possibility of transmission of gonorrhea to the baby. For this reason pregnant women are routinely screened for gonorrhea, and the eyes of all newborns are treated with a topical antibiotic (formally with silver nitrate) to prevent infection. Antibiotics usually cure gonorrhea, but the emergence of drug-resistant strains makes treatment more difficult. Many people with gonorrhea are frequently infected with chlamydia or other STDs, thus requiring multiple antibiotic therapies. All sexual partners must be treated to prevent disease spread. Treatment will resolve the infection but will not repair the damage already done by the disease. Consistent and correct use of latex condoms can reduce the risk of transmitting gonorrhea.

Reference:

Holmes, King K.; P. Frederick Sparling; Per-Anders Mardh; et al., eds. 1999. Sexually Transmitted Diseases. 3rd edition. New York: McGraw-Hill.

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