Gonorrhea is a disease of men and women, transmitted mainly through sexual contact. The forms of the disease can be different. Basically, the symptoms are worn out, that is, fuzzy, because the disease does not heal in time. The lack of treatment, as is known, leads to complications. In addition, while a person is sick, he infects everyone around him, with whom he has unprotected sex acts.
To treat a gonorrhea at women it is necessary, and it is obligatory. Because the main and most sad result of it can be infertility – the inability to conceive a child.
Epidemiology
It is an infectious disease that is transmitted with unprotected coitus. Gonorrhea is classified as a venereal disease, and its causative agent is Neisseria gonorrhoeae, in other words, gonococcus. Annually, the World Health Organization fixes 62 million diseases.
Ways of transmission of gonorrhea:
- petting
- genital-anal contact
- genital-oral coitus
- traditional sexual intercourse
- household way
Through everyday objects, getting infected is very, very difficult. This happens if a person admits gross violations of hygiene rules, for example, is wiped off by someone else’s towels, wears someone else’s underwear, etc. The way of transmission from the mother to the child is also relevant, when the baby passes through the birth canal during childbirth.
In the external environment, the causative agent of the disease can not live long. For him, the temperature is more than 55 ° C, and ultraviolet radiation. Gonococci are contagious (in medicine this is called contagiousness), so with unprotected sex with a sick person the chance of getting infected is about 70%.
Rarely a woman podvvatyvaet gonorrhea alone, in most cases, also found infection chlamydia or Trichomonases. Women’s risk groups:
- women under 25 years old
- women of easy virtue
- presence in the body of STDs
- those who already had gonorrhea 1 or more times
- pregnant women
- those who do not use or rarely use condoms
- leading antisocial lifestyle (using drugs or abusing alcohol)
Classification
Forms:
- fresh (infection occurred less than 2 months ago, occurs in acute or subacute forms)
- chronic (from the moment of infection it took more than 60 days, can be subacute, but mostly it is latent or asymptomatic)
Gonococci affect gradually all large areas of the body. Because there is a fresh or chronic ascending gonorrhea. As a result of it, an inflammatory process develops in such organs:
- pelvic peritoneum
- fallopian tubes
- ovaries
- endometrium of the uterus
Symptoms
From the moment of infection to the first signs of the disease is a minimum of 3-7 days, a maximum of 2-3 weeks. On average, the patient can mark the first symptoms within 5 days. The incubation period depends on the state of immunity of a particular person. If the body has a small opportunity to rely on infection, then the symptoms are early (1-2 days from the time of infection). This happens if a woman recently underwent chemotherapy, was treated with steroid medications or was ill with anything infectious.
The incubation period is 3 weeks if the immunity is strong, as well as in the case of self-medication and antibiotic therapy for the treatment of other STDs. These reasons can underlie the fact that a person will not notice the first manifestations of gonorrhea
Symptoms in Women
Symptoms depend on the place of primary infection in the body. If the infection occurred during sexual intercourse (which is the case most often), the pathogens of the disease are first localized in the urethra, then migrate to the genital tract, the pathological process mainly affects the cervix.
When the infection rises higher, the inflammation affects the tubes and ovaries, then the mucous uterus suffers. Sometimes even the peritoneum becomes inflamed. Also, the mucous membrane of the rectum of a woman suffers.
Gonorrhea can provoke pharyngitis during sexual contacts of the oral-genital nature with an infected man. A typical symptom of the disease in such cases is a discharge that has an unpleasant odor and a white or yellow shade. Pathological excretions in medicine are called “whites”. Their consistency is thick. Such leucorrhoea with gonorrhea sick women are often confused with nonspecific colpitis or thrush. Some resort to self-treatment, and then the symptoms become unclear, and in the future it will be more difficult for the doctor to make a correct diagnosis.
Also the manifestation of gonorrhea in women is cervicitis. In the vagina and in the perineum there is a tickling sensation, burning or itching. A gynecologist on examination sees that the cervix has a bright red shade, there is swelling. There are visible leucorrhoea, which are separated from the cervical canal by the patient. This sign tells experts that it is worth suspecting gonorrhea. Preliminary diagnosis can be gonorrheal cervicitis.
With an ascending infection, there is an inflammatory process in the appendages and uterus. Then, in the lower abdomen, there is a drawing or sharp pain. Allocations become purulent in nature, inclusions of blood are visible, because the affected mucous membrane of the uterus covers. Body temperature is 38-39 ° C. There are manifestations of intoxication of the body:
- bad appetite
- nausea and vomiting
- malaise
- weakness
In such cases gonorrheal endometritis and salpingoophoritis develop. During coition, there are unpleasant sensations. This is dyspareunia.
When the infection affects the urethra, they diagnose cystitis, urethritis, pyelonephritis. In this process, the release of the bladder causes pain, burning. The patient wants to often go to the toilet on a small one. There is congestion and swelling of the urethra. When palpation, pain occurs. Typical false urge to urinate (I want to go to the toilet, but not a drop of urine does not go out, because the bladder is not full). When in such cases the infection rises higher, the pathological process affects the kidneys and bladder of the woman.
Proctitis
Proctitis, provoked by gonorrhea, is manifested by false urge to defecate, painful process of bowel movement and unpleasant sensations in the anus (burning and itching). From the anus is released a substance that has a yellow tone, there are veins of blood in it. When the doctor conducts an examination, from notes that the anal is abnormally red, and in the folds there is pus.
Pharyngitis
Pharyngitis, provoked by gonococci, is similar in its manifestations to banal angina. Typical symptoms are:
- elevated body temperature
- enlargement of submandibular lymph nodes
- sore throat when swallowing
- sore throat, independent of swallowing
The course of gonorrhagic pharyngitis in most cases is hidden, or the symptoms are very poorly expressed. Probability is only hoarseness of the voice and perspiration in the throat of a sick woman, other manifestations are absent. The doctor fixes red swelling palatine tonsils and a yellow-gray coating on them.
Chronic gonorrhea
Symptomatics erased. The patient may not notice any disturbing signs at all. Typical symptoms are only these:
- pain in the lower abdomen of the pulling character
- pain in the lower back, radiating to the lower limb (they sometimes arise, they are fickle)
- vaginal discharge
Chronic course of the disease provokes a violation of the cycle in a woman. There are blood flow from the genital organs in the absence of planned critical days. The critical days themselves are more abundant, more days pass than before infection with gonococci. With a monthly infection, the infection can worsen, which is manifested:
- urethritis
- adnexitis
- endometritis
- cervicitis
Gonococci comfortably “feel” themselves in the cylindrical epithelium. Then that part of the vagina, where the flat epithelium is located, is not affected by the infection. But there are exceptions: pregnant women and girls who have vulvovaginitis.
Complications of gonorrhea
Gonorrhea significantly impairs the quality of life of a woman, and is also likely to cause complications:
- infertility
- bartholinite
- decreased libido
- complication of pregnancy and the postpartum period (chorionamionitis, antenatal fetal death, child’s death in the first 24 hours after delivery, purulent-septic diseases after childbirth, high risk of ectopic pregnancy, early discharge of amniotic fluid, etc.)
- transmission of infection to a child who will be born in the coming months
- gonorrheal conjunctivitis
- disseminated gonorrhea
Diagnostics
A gynecologist may suspect a gonorrhea according to the manifestations described above. But for many reasons, confirmation of the diagnosis requires a series of studies. Strokes from the vagina, cervical canal, urethra and rectum are done, and then a microscopic examination with coloring is performed. For diagnosis in the home, special express tests are used.
Confirmation of the diagnosis in some cases is carried out by the culture method, ELISA, RSK, RIF, PCR. If in the assigned analyzes it was not possible to detect the pathogen, they resort to provocation of the disease (if the doctor believes that the patient may have a latent or chronic form of the disease). For this, a provocation is used:
- alimentary
- biological (using pyrogenal and / or vaccine with gonococci)
- chemical
- physiological
- thermal
Basically, two or more provocative methods are combined to produce a faster and more accurate result. Smears take three times: in a day, 2 days and 3 days after the procedures.
Prevention
If you had coitus without condoms with a person whose health you do not know, or if there was rape, you need to prevent the infection with sexually transmitted infections. The earlier you resort to preventive measures, the less likely that you will pick up something from your partner.
After an unprotected act, if possible, you need to urinate 1 or more times (the more, the better, so you can specially drink more water). Urine will purify the pathogens of gonorrhea from the urethra. Wash the genitals and the inner thighs with soap. Enter into the urethra 1-2 ml Miramistin or Betadina from a bottle with urological attachment (immediately after sexual intercourse, after no more than 2 hours). The same solutions should be introduced into the vagina in an amount up to 5 ml.
It is necessary to treat the inner surface of the thighs and the skin of the perineum with an antiseptic. In the absence of Betadine or Miramistine, douching with a mildly concentrated aqueous solution of potassium permanganate is recommended. Miramistin reduces tenfold the risk of infection with genital herpes, syphilis, trichomoniasis, and gonorrhea.
It is necessary on the first or second day after unprotected PA (not later!) To contact a doctor who prescribes medicines to prevent STDs. After 2 weeks, it is best to give a doctor a smear to analyze by PCR for urogenital infections.
Treatment
For treatment, antibacterial therapy is needed, but not only. You need to treat both sex partners at the same time. For the period of treatment you need to exclude any alcoholic beverages and sex. Antibiotics:
- fluoroquinones
- cephalosporins
- penicillins
The fresh form of the disease is treated with a single dose or with the administration of an antibiotic:
- Cefixime 0.4 g or ciprofloxacin 0.5 g (tablets, need to swallow)
- Sumamed 2 g (or similar preparations, for example, Ecomed, Azicide, Hemomycin, Azitrox)
- Ceftriaxone 0.25 g or gentamicin 2.0 grams, recommended intramuscular injection (prick in the muscle)
Drugs for the treatment of acute ascending gonorrhea in women:
- ofloxacin
- josamycin
- ciprofloxacin
- ceftriaxone
- bicillin
- rifampicin
- clindamycin
- tetracycline
Also for treatment is required gonococcal vaccine and immunostimulants:
- prodigiosan
- levamisole
- methyluracil
- pyrogenal
The help of the disease is helped by autohemotherapy. Since often with gonorrhea a person becomes infected with chlamydia or trichomonads, the doctor may include Metronidazole or Doxycycline in the treatment regimen. The courses are relatively short.
Also, complex therapy includes local therapy. The urethra can be washed with a solution of silver nitrate. Do syringing of the vagina with decoction of chamomile, miramistin, chlorhexidine, protargol, manganese solution. In the past 10 years, the World Health Organization has noted that gonococci have become immune to a number of antibacterial drugs, mainly from a number of tetracyclines.
Alternative therapeutic schemes are being developed. Combine the intake of azithromycin and injections of gentamicin. Another scheme: the administration of hemifloxacin in combination with Azithromycin. If there are complications, a sick woman can prescribe an operation. If pelvioperitonitis is detected in an acute form, and the symptoms do not disappear during treatment, then laparotomy is done during the day. Remove the appendages, wash the abdominal cavity of the patient. Acute bartholinitis is opened, after which the wound is washed and drained.
Be attentive to your health! Use barrier means of contraception and refuse from promiscuous sexual life. If you have the first anxiety symptoms, contact a qualified gynecologist.