What does gonorrhea look like in women? Gonorrhea in women

Even in the enlightened 21st century, when everyone knows everything about genital infections and methods of contraception, gonorrhea is the most common sexually transmitted disease. In many ways, the problem is caused precisely by female infection, since often the disease is asymptomatic. A woman has been leading a normal life for months, changing sexual partners, and not suspecting that each of them has “rewarded” her infection.

The causative agent of the disease is the gonococcus bacterium, which in its prevalence is second only to chlamydia (the causative agent of chlamydia). Gonococcus can enter a woman's body in the following ways:

• sexual Is the most common route of infection. Possible with unprotected vaginal, anal sex, the lowest risks - with oral. In the vast majority of cases, a woman becomes ill during sexual intercourse. The source of infection is most often the vagina and urethra. It can also be the rectum (for anal intercourse) and the oral cavity (for oral). Moreover, with oral contact, the chances of getting sick are less, since saliva has an antibacterial effect and kills most of the gonococcal bacteria.
• from an infected mother to a fetus... Infection occurs when the fetus passes through the infected birth canal.
• domestic - a rather rare route of transmission of the pathogen. As a rule, it is carried out through a washcloth, bed linen, dirty linen and other items of use of an infected person. The likelihood of contracting gonorrhea in a household way (through hygiene products, dishes, etc.) is almost excluded, since gonococcus is not able to live outside the human body and quickly dies. However, there is a possibility of transmission of the disease from adult to child if they sleep in the same bed with a clear violation of hygiene standards.

Gonorrhea is classified by age - fresh (the disease lasts no more than 60 days) and chronic. The latter can be asymptomatic, latent, subacute. Gonococci cannot be satisfied with the affected area for a long time and are prone to spreading. So gradually from the vagina the bacterium "conquers" the uterus, ovaries, fallopian tubes.

Types of gonorrhea in women

The causative agent of gonorrhea disease is gonococcus bacteria, which tend to spread. Clinicians distinguish two types of gonorrhea: fresh and chronic ascending.

Sharp

Acute gonorrhea - the time of infection is two months. This view It is divided into several forms: acute, subacute and sluggish (torpid) - asymptomatic or asymptomatic.

Chronic

Chronic gonorrhea is a period of infection of more than 2 months or of unknown age. May cause endometriosis of the uterus, fallopian tubes and pelvic peritoneum, as well as inflammation of the ovaries.

Hidden

Latent and asymptomatic - occurs without any symptoms. Most often it is detected by chance during laboratory diagnostics.

In addition, gonococcal carriage is possible, this is a form of infection in which the pathogen is present in the human body, but the manifestations of the disease are not detected.

First signs and incubation period

The incubation period of the disease lasts from several days to 3 weeks. Symptoms appear no earlier than 5 days after infection. How quickly the disease spreads and makes itself known depends on the patient's age, concomitant diseases, and immunity. With depleted protective functions of the body, the first signs may appear as early as two days after infection. In pregnant women, gonorrhea spreads especially quickly, which is associated with increased blood flow to the genitals and a decrease in the body's immunity. The danger is also that expectant mothers have almost no signs of infection.

Female gonorrhea in the first stage is often asymptomatic. But in most cases, implicit signs of gonorrhea in women are still there. Often they are attributed to the onset of thrush and other non-dangerous disorders of the genital area, which is why treatment does not start on time, and the disease moves on to the next stage. The symptomatology of the disease depends on the place where the virus enters the body.

When visiting a doctor, women complain of pain in the urethra and a sudden burning sensation. Often there is a frequent urge to urinate, and over time - specific discharge from the vagina. As a rule, their appearance is accompanied by:

• Discomfort in the vagina.
• Burning sensation.
• Itching.
• Pains of varying degrees in the lower abdomen.

Rarely, in the acute stage of the disease, symptoms such as:

• Sore throat.
• Temperature increase.

During the examination, the gynecologist notes minor lesions of the mucous membrane of the uterus, as well as hyperemia (edema) around the opening of the urethra. In addition, purulent discharge is visible from the lumen of the cervix.

To confirm the disease, the doctor prescribes a series of laboratory tests of material taken from the genitals.

In the video in this article, the doctor shares information about the signs of gonorrhea, including in women.

The main symptoms

After infection with this infection, characteristic discharge appears - this is the first and classic symptom of this ailment. Most often they are thick, yellow or white, have an unpleasant pungent odor. In most cases, women take such manifestations for thrush or colpitis and begin to self-medicate, which significantly erases the clinical picture of a venereal disease.

In addition, gonorrhea in women has the following manifestations:

• Inflammation of the uterus and appendages. The infection spreads higher and the endometrium and appendages are affected. There are pulling or sharp pains in the lower abdomen, purulent discharge with blood, rarely - intoxication (malaise, loss of appetite, etc.).
• Cervicitis - in addition to discharge, a woman is worried about itching, severe burning in the vaginal area. On examination, there is noticeable hyperemia (edema) of the cervix, which becomes scarlet. These symptoms indicate the presence of gonorrheal cervicitis.
• Urethritis, cystitis, pyelonephritis. These diseases are caused by infection of the urethra caused by gonorrheal urethritis. Patients complain of frequent, painful urination. As a bacterial infection ascends, the bladder and kidneys are involved.

Gonorrheal vaginitis

It is characterized by the following symptoms:

• frequent urge to use the toilet;
• discomfort and pain when urinating;
• bloody discharge not associated with menstruation;
• pain in the lower abdomen;
• purulent vaginal discharge.

In some women, all of these symptoms appear at the same time, but it is more likely that only one of them will appear. If at this stage the appropriate treatment is not started, the disease will flow into the chronic stage. Often, the disease is understood above and spreads to the uterus with appendages, while the symptoms intensify, pain in the lower abdomen intensifies. Additionally, the body temperature rises (up to 39 degrees Celsius), general signs of intoxication appear - aches, nausea, fatigue.

Gonorrheal pharyngitis and stomatitis

When infected by the oral route, the following symptoms appear:

• inflammation of the gums;
• small purulent wounds on the oral mucosa;
• sore throat;
• increased salivation;
• redness and enlargement of the tonsils;
• pustular foci on the tonsils.

Due to the similarity of symptoms, gonorrheal pharyngitis is often confused with angina and is prescribed inappropriate treatment because of this. Therefore, it is important to take a smear to determine the pathogen when diagnosing a disease. With strong immunity, throat gonorrhea proceeds with smoothed symptoms. The patient has only a little sore throat, a slight hoarseness of the voice appears.

Gonorrheal proctitis

It develops if the infection has entered through the rectum. This happens with unprotected anal sex, but penetration of the pathogen is also possible during classical intercourse, since the vagina is located in close proximity to the anus. Symptoms of gonorrheal proctitis are subtle, which makes it very difficult to identify the disease.

Warning signs:

• itching in the anus;
• purulent mucous discharge from the rectum;
• streaks of blood in the stool;
• discomfort and pain during bowel movements.

Possible false urge to use the toilet (tenesmus), accompanied by pain. On visual inspection, it is clear that the anus is reddened, and its folds are covered with purulent discharge.

Gonococcal conjunctivitis

This form usually occurs in babies when the disease is passed on to them from an infected mother during childbirth. In this case, the gonorrhea manifests itself very noticeably: the eyelids are very swollen, pus is abundantly secreted, which makes it impossible to open the eyelids without special rinsing. At the same time, the mucous membrane of the eye is very irritated. In the most advanced cases, the spread of the disease to the cornea is not excluded, because of which it becomes cloudy, and vision falls.

Chronic gonorrhea

If the disease lasts more than two months, then they speak of its chronic stage. In this case, the symptoms become less pronounced, the signs are poorly expressed. Occasionally, the disease manifests itself as pulling pain in the lower back or lower abdomen, foul-smelling vaginal discharge. If the disease has spread to the uterus, then the menstrual cycle is disrupted, intermenstrual bleeding appears. At the same time, your periods become more abundant and last 1-2 days longer.

Against the background of chronic gonorrhea, other diseases of the genital area are often exacerbated. For example, thrush, urethritis, endometritis. Usually gonococci are located on the columnar epithelium and rarely affect the vaginal mucosa. However, pregnant women and girls may develop vulvovaginitis.

Complications of gonorrhea in women

Dangerous in gonorrhea is not so much its unpleasant symptoms as the high risk of complications that develop in most cases in the absence of adequate treatment. Most often, among the diseases developing against the background of gonorrhea, women are diagnosed with:

• bartholinitis - damage to the bartholin glands located in the vestibule of the vagina;
• infertility - associated with the developed obstruction of the tubes and damage to the endometrium;
• a sharp decrease in libido and, as a consequence, a drop in the quality of sexual life;
• problems with bearing a child and complications after childbirth - there is a high risk of miscarriage, premature birth, fetal growth retardation, there is a possibility of the child's death in the first days of life, as well as the appearance of purulent-septic diseases;
• infection of a child - the development of gonococcal conjunctivitis in him, inflammation of the inner ear, infection of the genital tract in girls, etc.;
• the penetration of gonorrhea into the blood and the spread of the disease throughout the body, which leads to infection of the joints, skin, internal organs, and the brain.

In the most advanced cases, pelvioperitonitis or purulent peritonitis develops, caused by multiple adhesions in the abdominal cavity. Sometimes this leads to acute intestinal obstruction and requires immediate surgical intervention.

Diagnostics

The vaginal form of gonorrhea is usually diagnosed by a venereologist or gynecologist at a routine examination. In this case, materials are taken for analysis from the vagina, urethra, rectum - depending on the localization of the focus. The smears are examined under a microscope and examined by PCR and PIF. There are special rapid tests that help to identify this disease at home.

The diagnosis of gonorrhea is confirmed only after a series of studies:

• Microscopy of smears from the vagina, urethra and cervical canal.
• RSK - serological method. The study of venous blood is the most effective method when diagnosing this disease in a chronic form.
• Cultural method. Sowing in a special nutrient medium of the discharge taken from the urethra and cervix.
• ELISA - study of the patient's urine.
• RIF - staining of a smear from the cervix with special dyes.
• PCR - examination of smears, urine.

If the diagnosis is confirmed, the attending physician prescribes complex therapy.

In chronic forms of gonorrhea, it is not possible to detect the pathogen in the scrapings. But if this disease is suspected, various provocations are arranged (chemical, mechanical, biological, alimentary, etc.), after which several smears are taken sequentially at intervals of 24 hours.

As soon as a woman finds out that she is sick with gonorrhea, she is obliged to stop any sexual intercourse with her partners. Evasion of this rule is perceived as malicious infecting other people.

If the gonor is localized outside genitourinary system, then it is identified by other specialists - an ophthalmologist with gonococcal conjunctivitis, a dentist or an otolaryngologist with a lesion of the oral cavity. After identifying the gonorrhea in one of the family members, all his household members are sent for diagnosis. In addition, a woman must notify all sexual partners with whom she has had contact recently about her diagnosis.

Treatment of gonorrhea in women

Therapy is selected depending on the stage and location of the infection. The treatment is based on antibiotic drug therapy. If gonorrhea is accompanied by other sexually transmitted diseases, then the course of treatment is extended. The duration of treatment depends on the form of the disease. Acute gonorrhea can be treated with a single dose of medication. With an ascending infection, the course of treatment is delayed by 5-7 days. Chronic gonorrhea takes even longer to heal. In this case, drugs are prescribed that improve immunity, as well as washing the affected area with antiseptics. Sessions of autohemotherapy effectively activate the protective functions of the woman's body.

Acute gonorrhea is the easiest to treat. The course of therapy includes a single dose or administration of an antibacterial drug:

• Sumamed 2 g (Azitrox, Ecomed, Azicid, Zi-factor, Hemomycin).
• Gentamicin 2.0 g - intramuscularly.
• Ciprofloxacin 0.5 g or Cefixime 0.4 g - orally.

Acute ascending gonorrhea is treated with the following drugs:

• Ceftriaxone - once a day for a week.
• Ofloxacin - twice a day for 7 days.
• Ciprofloxacin - twice a day for 7 days.

Therapy of the chronic form of gonorrhea, as a rule, is supplemented with immunity stimulants and an effective gonococcal vaccine (Methyluracil, Prodigiosan, Pyrogenal are used).

In advanced cases and with complications, surgical treatment is indispensable, in which abscesses are opened, wounds are washed and drained, appendages are removed, the abdominal cavity is sanitized - all depending on the stage of the disease.

Expert opinion

Luvanova Arina Viktorovna, specializes in female venereal diseases

During the period of therapy, a woman infected with gonorrhea is prohibited from having sex and drinking alcoholic beverages. During treatment, bacteriological control is carried out. The onset of recovery is determined by the results of scrapings and smears, in which gonococcal bacteria are not observed.

Unprotected coitus: how not to get sick

If you have had sexual contact with an unverified partner, then simple manipulations will help to avoid the development of gonorrhea:

• immediately after intercourse, urinate - preferably several times (urine washes away the causative agent of gonorrhea);
• thoroughly wash the external genitals and thighs with soap, rinse your mouth with an antiseptic solution if there was oral contact;
• in urethra and inject Betadine solution into the vagina or
  Miramistin from a special bottle with a urological nozzle - this must be done as early as possible (within two hours after sexual intercourse);
• treat the skin of the labia and inner thighs with an antiseptic (Miramistin or light pink solution of potassium permanganate works well).

Miramistin is a unique development of Soviet pharmacists that reduces the likelihood of contracting gonorrhea and some other STDs by 10 times.

Sexual infections can occur quite unexpectedly if there are unprotected contacts and inadequate hygiene. Commonly known as gonorrhea, gonorrhea is a disease caused by gonococcus and is common in both women and men. After reading the article, you will learn how you can protect yourself from such an infection and how to treat it if the protection has failed.

Tripper is the most common sexually transmitted disease. In most men, the infection manifests itself already in the first week after infection, but with women the situation is different. With strong immunity, this infection does not make itself felt up to the acute form.

Gonorrhea can affect not only the tissues of the vagina, but also the rest of the mucous membranes of the body:

• Eyes
• oral cavity
• rectum
• in rare cases, lungs and joints

The main route of infection with gonorrhea is unprotected sex. A woman has a 50/50 chance of catching an infection from a sick partner.

A household way of transmission of gonorrhea is also possible, through household items, for example, using a bathroom, shower, washcloth of a sick person. In fairness, it should be noted that only 1 out of 100 patients became infected in this way.

Types of gonorrhea

Gonococcal infection is divided according to the time of infection:

• Fresh - less than 2 months have passed since the estimated date of infection
• Chronic - more than 2 months

By manifestations:

• Acute - appears suddenly and has pronounced symptoms
• Symptoms develop gradually - subacute form
• Symptoms of the torpid course of the disease are hardly noticeable
• Asymptomatic latent variation is also noted

The location of the inflammation is distinguished:

• gonorrhea of \u200b\u200bthe upper part of the genitourinary system (pelvic organs, uterine cavity, appendages and fallopian tubes);
• lower sections (cervix, vagina and urinary canal);
• other organs (eyes, mouth, lungs and joints).

Lower gonorrhea may be accompanied by inflammation of the Bartholin glands (responsible for lubrication). A painful formation appears at the entrance to the vagina, it is treated surgically.

Latent form of gonorrhea

In 75-80% of women, gonorrhea occurs in this form. There are practically no symptoms throughout the course of the disease. The woman continues to feel well, but the infection is spreading further and further. And this means that the disease promises to become chronic.

Gonococcus can become latent under the influence of drugs that are not able to eliminate it. Therefore, if you suspect any STD, you should contact a venereologist or gynecologist.

Chronic gonorrhea in women

Since in most women the symptoms of gonorrhea are unclear, they are more likely than men to trigger the disease to a chronic state. Chronic gonorrhea may be suspected of:

• Frequent ailments (within a month)
• Persistent vaginal discharge (not necessarily pus-like)
• Bloody discharge outside of your period
• Many become constipated
• Fatigue, irritability, sleep disturbances

More than half of patients with a latent form received it as a result of incomplete treatment. That is, after the treatment of acute gonorrhea, they did not pass the control test or, when they felt better, they stopped taking antibiotics.

Treatment of chronic gonorrhea has its own specifics:

1. To aggravate the course of the disease, you will be prescribed a special drug that will increase the activity of bacteria.
2. After passing the tests, the doctor will identify the pathogen and test its sensitivity to antibiotics.
3. Then you will be prescribed exactly the drug that will suppress your gonococcal strain.

Signs of gonorrhea in women

The first symptoms of gonorrhea in women are too similar to the signs of other diseases, therefore many do not go to the gynecologist in time. The statistics are sad: 8 out of 10 women who fell ill were not aware of their illness until the gonorrhea turned into an acute form.

Symptoms of incipient gonorrhea:

• Unpleasant sensations when urinating, frequent urge to empty the bladder. Ladies often take this symptom for the onset of cystitis.
• Slight discharge is very similar to thrush.

With such symptoms, a woman can live the entire incubation period - from 2 to 10 days, rarely 1 month - only then notice a deterioration in her condition. Unfortunately, at the time of diagnosis, the woman has chronic gonorrhea.

Signs of acute vaginal gonorrhea:

• Purulent discharge - appears when bacteria begin to multiply very actively
• Severe pain when urinating
• Lower abdominal pain
• Bloody discharge during the intermenstrual period
• Swelling, irritation of the genitals
• Sometimes gonorrhea is accompanied by fever and weakness

Vaginal gonorrhea can be accompanied by lesions of gonococcal infection on other mucous membranes of the body and manifests itself as:

• conjunctivitis symptoms (with gonorrhea of \u200b\u200bthe eyes);
• odor from the mouth, pus on the walls of the throat, dry mouth, usually indicating stomatitis (gonorrhea of \u200b\u200bthe mouth);
• sore throat, headache and other symptoms of sore throat (with gonorrhea of \u200b\u200bthe throat).

Together with previous symptoms, these signs can clearly indicate the presence of a disease such as gonorrhea.

The latent form of gonorrhea, as the name implies, almost does not manifest itself in any way. With her, the gonococcus destroys the epithelial tissue of the genital organs. Instead, a scar is formed. So, without noticing it herself, a woman can remain sterile.

Rectal gonorrhea (practicing unprotected anal sex) is characterized by:

• Purulent bloody discharge from the anus
• Itching and burning at rest
• Painful bowel movements

Complications of gonorrhea in women

Complications of this disease directly depend on the localization of the gonococcus. The overall result of delaying treatment can be sepsis, as well as infection of other organs, since the infection can spread through the bloodstream to any part of the body.

The most likely complication is infertility. The second most likely is an increase in the chances of an ectopic pregnancy due to a deterioration in the tubal patency of the uterine appendages.

Swab for gonorrhea in women

Diagnosis of gonorrhea is as follows:

• Collecting anamnesis. You need to describe the symptoms as accurately as possible and talk about all sexual intercourse.
• Delivery of analyzes. Take a sample of blood, urine, vaginal smear (possibly mouth, nasal, anus, and eyes).

Along with tests for gonococcus, tests are done for other STDs. Based on the results, the doctor will select a treatment for you for the whole bunch of diseases at the same time.

In the chronic form, diagnosis is complicated by the small number of microorganisms in the sample. Therefore, you should contact those institutions where there is a modern research laboratory.

How is gonorrhea treated in women?

Therapy for patients with gonorrhea includes:

• antibiotic treatment
• treatment with antibacterial solutions
• relief of pain symptoms
• restoration of the microflora of the affected mucosa

It should be noted that all sex partners need to undergo treatment at the same time. At the end, you need to be observed by a doctor for some time (within 2-3 months), and 10-14 days after the end of the medication, re-test for gonorrhea.

Features of the treatment of gonorrhea:

• Every year, the number of strains resistant to standard treatments increases, so the number of new drugs to fight the disease increases every year. Because of this, the treatment should be carried out under the strict supervision of a physician who will select medicines specifically for your case.
• Folk remedies will not be able to cure gonorrhea, but they can easily harm health and aggravate the situation.
• Gonorrhea, coupled with trichomoniasis (almost half of cases) requires complex treatment.
• During treatment, you should follow a diet, excluding salty, smoked, spicy, and alcoholic beverages.

What drugs are used to treat gonorrhea in women?

We clarify that this item is for informational purposes only. Do not self-medicate under any circumstances! This is fraught with serious health consequences.

Most often, the treatment of gonorrhea is complex and the doctor prescribes a number of drugs and procedures. The main drugs for the treatment of gonorrhea are:

1. Gonorrhea of \u200b\u200bthe lower part of the genitourinary system without complications - Tsifran, Orfamax, Rocefin
2. Gonorrhea of \u200b\u200bthe lower part of the genitourinary system with complications - Orfamax, Rocefin, Trobicin
3. When combined with chlamydia - Metronidazole, Tiberal, Gairo, Fazizhin, Naxogin

Prevention of gonorrhea in women

Protected intercourse is considered the main method of preventing gonorrhea. Even women who have regular partners can become a victim of this common infection, because it is not possible to give a 100% guarantee that a sexual partner will not have casual relationships.

Methods for the prevention of gonorrhea:

1. Exclusion of casual sexual contacts;
2. Use a condom as a method of contraception;
3. Significantly reduces the risk of infection by treating the genitals with disinfectants (miramistin, betadine, etc.) within a couple of hours after intercourse;
4. Periodic examination by a gynecologist.

You should not wait for serious problems with women's health before contacting a specialist. Visit your gynecologist regularly, and if you experience strange symptoms, do not debug a visit to the doctor. Be healthy and let unpleasant diseases pass you by.

Video: Gonorrhea - symptoms, treatment, prevention

Gonorrhea (gonorrhea or just tripak) - This is a common sexually transmitted disease that can threaten a person with a complication, if untreated, and also be transmitted to a newborn child.

This disease was known even before the birth of Christ, it has long been identified with one of the stages of syphilis. But only in the 30s of the XIX century, in France, Dr. Philippe Ricord, working at the Midi hospital for venereal diseases, concluded that gonorrhea existed as an individual disease.

Later, towards the end of the century, in 1879, the German physician Albert Neisser discovered the gonococcus bacterium, which excites the gonorrhea.

The entire genus of these bacteria (Neisseria) was named in his honor. It was Neisser who developed methods of treating this infectious disease.

What it is?

Gonorrhea- this is infection, affecting mainly the human genitourinary system. Gonococcus bacteria colonize the mucous membranes of the genitourinary tract of men and women, as well as the rectum, nasopharynx and eyes. It all depends on the immunity and the stage at which the triper is.

Gonococci are bacteria ovallocated in the human body in pairs. The variation in their sizes is about 0.8-1.2 microns. They settle mainly in the cytoplasm of leukocytes of purulent secretions.

Chronic gonorrhea and exposure to various medications can cause a mutation of the gonococcus. The bacteria exist in capsule form and develop in a swarm-like community. In the external environment, when the temperature rises above 50 ° C, gonococci instantly die.

The bacteria are sensitive to penicillin antibiotics and streptomycins, but eventually become resistant to them.

Causes and factors for the development of the disease

The cause of the onset of the disease is sexual intercourse of various kinds with an infected partner.

The percentage of infection in men from a sick partner is about 35%, in women the probability of infection is higher - about 65%.

Since men have a longer urethra, it is more likely that bacteria will be washed off with urine, before the urethral mucosa is damaged.

There is a likelihood of infection of the child during childbirth from a sick mother and at home (use of common hygiene products - a washcloth, a towel).

This is especially true for girls.

Gonococci can penetrate to a newborn baby in case of premature damage to the fetal membrane, when the fetus passes through the birth canal (infection of the eyes or genitals of girls occurs). Often a child is born blind.

Tripper bacteria (triperok) quickly dies in the external environment, but feels great on the surface of mucous membranes and inside epithelial cells and leukocytes. Gonococcal infection is divided into several types according to the site of damage to body tissues:

• in the genitourinary system.
• in the rectum (proctitis or inflammation).
• in the knee joint (gonarthritis).
• in the eyes (purulent conjunctivitis or blenorrhea).
• inflammation in the pharynx (pharyngitis).

The incubation period, when the gonorrhea is latent, ranges from 1-2 days to a couple of weeks, sometimes up to 1 month. In men, the disease manifests itself faster.

Symptomsgonorrhea in men

Gradual suppuration of the head

Gonorrhea on the head of the penis in men (suppuration)

Gonorrhea eye

Photo of affected eyes with gonorrhea

In the first case, when the genitourinary system of a man is affected by a gonococcal bacterium, abundant purulent discharge from the urethra and painful sensations during urination in the form of a burning sensation appear.

In contrast to women, symptoms in men appear faster (on the second day, cutting pain may bother).

If triplet disease in men invades the posterior part of the urethra, the testes, epididymis, and prostate gland may be affected. In case of insufficient human immunity, the disease threatens to develop into sepsis (blood poisoning).

During the infection, acute urethrocystitis (inflammation of the mucous membranes of the urethra and bladder) can develop. In this case, the symptoms intensify, at the end of urination, blood may appear. If the patient is still affected by chlamydia, then his condition will worsen.

Tripernaya disease in men, in almost half of cases, affects the rectum. Begins inflammatory process redness, growths, rash appear in the anus. After a bowel movement, a burning sensation and slight bleeding may occur.

The disease can develop independently or together with inflammation of the urethra. This infection appears as a result of oral-genital contacts of partners. In addition to affecting the pharynx, the tonsils and the entire oral cavity can be infected.

Inflammatory symptoms of the mucous membrane

Replenishment and pus in the throat

The symptoms of pharyngitis are not very pronounced. Sometimes dry mouth, pain and perspiration during swallowing are troubling.

When examined by a doctor, there may be swelling, grayish plaque in some areas of the oral cavity, swollen lymph nodes in the neck.

Gonococcal arthritis

Gonococcal arthritis usually affects those who have proctitis. The main signs of the disease are redness and swelling of the joints of the fingers, ankles, and wrists.

The disease is detected when taking blood and joint fluid tests.

Signs and complications of chronic disease in men

At the stage of chronic gonorrhea, inflammatory processes are expressed on the following male organs:

• the skin of the head of the penis and the inside of the foreskin (see photo above);
• cooper iron;
• prostate;
• seminal vesicles;
• epididymis;

Signs of a chronic course of the disease are gluing of the lips of the urethra in the morning, small discharge and changes in the epithelium of the urethra. Among the complications, prostatitis can also be noted.

Symptomsgonorrheathe female half

In women, as in men, the tripak acts on various organs and is invisible at the initial stage. The first signs of the disease in women may appear only after 1-2 weeks. Tripper disease in its classic form provokes the following symptoms in women:

• small purulent whitish or grayish discharge from the vagina;
• painful urination (there is burning, itching, sometimes pain);
• redness, swelling, ulceration of mucous areas;
• painful sensations in the lower abdomen;
• bleeding during the absence of menstruation.

Symptoms of inflammation of the cervix and urethra

1. With the spread of gonorrhea in the cervix, a woman has frequent purulent discharge with an unpleasant odor.
2. During sexual activity, pain and slight bleeding appear.

The defeat of the bacteria in the urethra is accompanied by the same discharge and pain during urination. Both organs can be infected at the same time.

When the pelvic organs are infected, the body temperature may rise, nausea and vomiting may appear, and sexual intercourse may be painful.

Symptoms in women are the same as in men.

Complications during the course of the disease in women

In women, with inflammation of the ovaries and fallopian tubes, subsequently, an ectopic pregnancy, obstruction of the tubes and infertility may occur.

A newborn child, due to the defeat of gonorrheal conjunctivitis, may remain blind forever.

Diagnostics

To detect the disease, it is enough to take a swab in the rectum, cervix (women), urethra (men) or throat.

Most often, gonorrhea is determined by bacteriological diagnostics, which gives the correct research result by 90%. There is a polymerase chain reaction method - this is an experimental method, it is more sensitive.

Treating an infection

Nowadays, triper is an infection that increasingly resists penicillin antibiotics, often affecting the body along with chlamydia.

For pregnant women, the doctor will select an individual treatment ( Spectinomycin or other similar drugs).

In case of complications or chronic course of the disease, the patient requires hospitalization. Here are a few of them:

• the disease has affected various human organs;
• the infection has spread through the blood throughout the body (sepsis);
• the patient shied away from treatment;
• unexpected relapses of the course of gonorrhea.

During treatment, the patient is prohibited from having sexual intercourse, it is required to exclude bad habits, lead a calm lifestyle and not overcool. To increase immunity, the doctor prescribes various vitamin preparations.

All efforts for treatment, in combination, will give a positive result.

Important: Never self-medicate, contact the clinic. The necessary drugs and their dosages can only be determined by a specialist.

Gonorrhea in women - symptoms and treatment, drugs, prevention

Despite the fact that in recent years medicine has made a big step forward, such a sexually transmitted disease in women, such as gonorrhea, remains relevant and continues to spread. This ailment does not always cause acute symptoms, usually it runs latently, as a result of which it often has complications.

Gonorrhea is a sexually transmitted infection. The causative agent of the infection is Neisseria gonorrhoeae (gonococcus), named after the researcher Neisser. From the Greek language, the word "gonorrhea" is translated as "outflow of semen."

Every year, WHO registers about 62 million people infected with gonorrhea.

• Most often, gonorrhea is sexually transmitted, and infection is possible through any type of sexual contact (both traditional and anal, oral and even petting).
• Household transmission is acceptable, but rare. Infection is possible in case of non-compliance with the rules of hygiene, as well as the rules for the use of personal items (if shared towels, other people's linen, shared bed of the child and parents, etc.).
• It is also possible to infect a newborn during the passage of the natural genital tract. In the external environment, gonococci are unstable, therefore they die under the wiggle of ultraviolet radiation and at temperatures above 55 degrees.

The pathogen is contagious (highly contagious), so the risks of getting gonorrhea infection with a single sexual contact are about 70%. At the same time, gonorrhea is rarely the only disease; in 7-8 out of 10 cases, this ailment is accompanied by chlamydia and / or trichomonas.

See also: How to speed up labor at 38, 39, 40 weeks at home, how to prepare the cervix

Risk group:

• promiscuous women;
• women under 25;
• the presence of an STI;
• history of sexually transmitted diseases;
• neglect of condoms;
• pregnant women.

Types of gonorrhea:

• fresh gonorrhea - time of infection - no more than 2 months (subacute, acute);
• chronic gonorrhea - the duration of infection is more than 2 months (subacute, latent or latent and asymptomatic).

Gonococci have a tendency to spread, so that they secrete fresh, chronic ascending gonorrhea (inflammation of the ovaries, endometrium of the uterus, pelvic peritoneum, fallopian tubes).

Symptoms

The incubation period ranges from 3 days - weeks to 2-3 weeks. And, accordingly, the appearance of the first signs of the disease should be expected in 5 days. The lengthening or shortening of the incubation period depends on the body's defenses.

With a weakened immune system, the first symptoms will appear within 1-2 days. (steroid treatment, recent infectious disease, chemotherapy, etc.).

The late appearance of gonorrhea is explained by good immunity or taking antibiotics after infection due to other infections or self-medication.

With gonorrhea, the disease manifests itself on the organs affected by the pathogen. And since during sex gonococci get from the urethra into the genital tract, the cervix is \u200b\u200bfirst of all attacked.

In the future, with the development of infection, the appendages (tubes, ovaries), the uterine mucosa and sometimes the peritoneum are involved. Also, the process involves the mucous membrane of the urethra and rectum.

The occurrence of gonorrheal pharyngitis (with oral contact) is possible.

After infection, discharge appears - this is the very first and classic symptom of the disease. As a rule, these are thick, white or yellow leucorrhoea with an unpleasant odor. Often women take this for a manifestation of nonspecific colpitis or thrush and begin to self-medicate, which erases the clinical picture.

Also, gonorrhea has the following manifestations:

1. Cervicitis - in addition to discharge, the patient is worried about burning, itching, or a tickling sensation in the perineum and in the vagina. On a gynecological examination, swelling of the cervix is \u200b\u200bnoticeable, it acquires a bright scarlet hue. From the cervical canal leucorrhoea stand out with a yellow tape. These signs are evidence of gonorrheal cervicitis.
2. Inflammation of the uterus and appendages - when the infection spreads above, the appendages and endometrium are affected. There are pains in the lower abdomen of a pulling or acute nature, purulent discharge with blood (damage to the uterine mucosa), an increase in body temperature to 38-39 degrees is observed, intoxication occurs (malaise, weakness, loss of appetite, nausea, vomiting). In this case, salpingo-oophoritis and gonorrheal endometritis occur. With the involvement of the small pelvis and endocervicitis, the woman feels dyspareunia (pain during intercourse).
3. Urethritis, pyelonephritis, cystitis - infection of the urethra causes gonorrheal urethritis when women complain of painful and frequent urination. The urethra is hyperemic, edematous, its palpation is painful, there is a false urge to urinate. When the infection ascends, the kidneys and bladder are involved in the process.
4. Proctitis. The manifestations of gonorrheal proctitis are burning and itching in the anus, false desires (tenesmus) and painful bowel movements. There is also a yellow discharge from the rectum, often with bloody streaks. Examination reveals pus in the folds of the anus and redness of the anus.
5. Pharyngitis - proceeds under the guise of an ordinary sore throat. It manifests itself as painful sensations in the throat and when swallowing, an increase in the submandibular lymph nodes, an increase in temperature. However, most often, gonorrheal pharyngitis is accompanied by mild symptoms (hoarseness, perspiration) or is asymptomatic. There are hyperemic, edematous palatine tonsils with a yellowish-gray coating.

Chronic gonorrhea

Gonorrhea in this form proceeds with erased, mild or completely invisible symptoms. Among the symptoms, only discharge can be noted, periodic pains in the leg in the lumbar region, aching pains in the lower abdomen.

Chronic inflammation of the uterus is characterized by menstrual irregularities. Intermenstrual bleeding is observed, and menstruation becomes more abundant and longer. Menstruation can provoke an exacerbation of infection (endometritis, cervicitis, adnexitis, urethritis).

Since gonococci prefer columnar epithelium, they practically do not affect the vaginal mucosa, represented by squamous epithelium. The only exceptions are girls and pregnant women with vulvovaginitis.

Complications

Gonorrhea is unpleasant both in its manifestations and in the high risk of complications:

• infertility in women (defective endometrium, obstruction of the tubes);
• bartholinitis (defeat of the Bartholin glands);
• decreased libido;
• complication of pregnancy, the postpartum period (intrauterine growth retardation, spontaneous abortion, high risk ectopic pregnancy, early childbirth, premature rupture of amniotic fluid, postpartum septic diseases, antenatal death of a child, death of a child within 24 hours after childbirth, chorionamnionitis);
• infection of a child (blennorrhea, otitis media, gonococcal sepsis, infection of the genital tract);
• disseminated gonorrhea - getting into the blood of the pathogen and its dispersion throughout the body (skin hemorrhages, damage to the joints, brain, kidneys, liver, heart);
• gonorrheal conjunctivitis (in case of lack of hygiene).

Diagnostics

The diagnosis is confirmed after laboratory tests:

• rapid tests (home diagnostics);
• microscopy of smears taken from the vagina, cervical canal, rectum and urethra;
• cultural method (sowing on a nutrient medium of discharge from the cervix and urethra);
• REEF - the reaction of immune fluorescence (staining of the smear with dyes);
• ELISA - enzyme immunoassay (study of urine);
• RSK - compliment binding reaction (serological method, venous blood is studied, the method is very useful in diagnosing chronic gonorrhea);
• PCR - polymerase chain reaction (urine and smears are examined).

Methods of provocation are used in the diagnosis of latent and chronic gonorrhea, when the pathogen is not detected in routine tests. Methods of provocation:

• chemical (the urethra is lubricated with a 1-2% solution of silver nitrate, the cervical canal is lubricated with a 2-5% solution);
• alimentary (eating spicy, salty food or alcohol);
• thermal (for 3 days, diathermy is carried out - smears are taken three times, one hour after the physiotherapy);
• biological (pyrogenal and / or gonococcal vaccine is injected into the muscle);
• physiological (smears are analyzed during menstruation).

Usually at least 2 methods are combined. Swabs are taken at 24, 48 and 72 hours.

Gonorrhea during pregnancy

The course of the disease during pregnancy largely depends on the timing of the infection. If the infection occurred before pregnancy, the disease in most patients is erased, and only a third of sick pregnant women complain. The presence of chronic gonorrhea increases the risk of infertility and ectopic pregnancy.

For pregnant women, the disease is characterized by inflammation of the vagina, which is not typical without pregnancy. This is due to hormonal changes in the vaginal mucosa. Usually, patients have complaints of profuse discharge, burning, itching. The symptoms are very similar to those of thrush, but remedies for thrush are completely ineffective.

• Gonococcus itself does not cause the development of fetal malformations, but its presence simultaneously with pregnancy is dangerous. If the infection occurs in the first half of pregnancy, inflammation of the uterine lining is observed, which may lead to a miscarriage.
• When infected in the second half, gonococci are not able to enter the uterus, it is protected by the membranes of the fetal bladder, so that abortion, as a rule, does not occur, however, placental insufficiency may develop, which can lead to a lack of nutrients and oxygen.

Intrauterine infection is also possible, manifested by chorioamnionitis and nococcal sepsis. Chorioamnionitis is accompanied by an increased heart rate, fever, a change general analysis blood. There may be no other signs. In the case of chorioamnionitis, premature labor often occurs, which begins with the passage of water.

Infection of a child is possible during childbirth, which can cause damage to his eyes. Girls may develop genital gonorrhea.

In Russia, for prophylaxis, all children immediately after birth wipe their eyes with sterile cotton wool, and also instill a 20% solution of sodium sulfacil; after two hours, this procedure is repeated. In addition, girls' genitals are treated in the same way.

In women affected by gonorrhea, after childbirth, inflammation of the uterus occurs.

Treatment

Treatment of gonorrhea in women consists in a course of antibiotic therapy. Such treatment is necessary for both sexual partners; during the period of treatment, they are prescribed abstinence from sexual intercourse and a ban on alcohol consumption. Of antibiotics, preference is given to drugs of the cephalosporin, penicillin, fluorochnilon series.

The easiest way to treat fresh gonorrhea of \u200b\u200bthe lower genital area. The course of therapy is limited to a single injection or intake of an antibiotic:

• Sumamed 2 g (its analogues Azitrox, Zi-factor, Hemomycin, Ecomed, Azicid);
• Cefixime 0.4 g or Ciprofloxacin 0.5 g - taken orally;
• Ceftriaxone 0.25 g or Gentamicin 2.0 g - intramuscularly.

Acute ascending gonorrhea is treated with the following drugs:

• Ceftriaxone 1 g intramuscularly - once a day, course duration - one week, Ciprofloxacin 500 mg intravenously - twice a day, course duration - one week, Ofloxacin 0.4 g - twice a day, course duration - one week.
• It is possible to use other antibiotics (Clindamycin, Tetracycline, Rifampicin, Josamycin, Bicillin, Ofloxacin, etc.).
• Treatment of the chronic form of gonorrhea is supplemented with a gonococcal vaccine (Levamisole, Pyrogenal, Methyluracil, Prodigiosan) and immunity stimulants.
• Autohemotherapy effectively activates the body's defense.

See also: Panadol suppositories for children: instructions for the use of rectal suppositories

Since gonorrhea is often accompanied by chlamydia and / or trichomoniasis, Doxycycline (for the duration of the course - 10 days) and Metronidazole (duration of the course - 5-7 days) are included in the course of treatment. Local treatment - washing the urethra with a 0.5% solution of silver nitrate, as well as douching the vagina with a decoction of chamomile, solutions of manganese, Protargol, Miramistin, Chlorhexidine.

In recent years, the number of cases of the development of immunity of the pathogen to certain antibiotics has been increasing. For example, Sally Davis, chief expert of the UK health system, said that back in 2013, in 80% of clinical cases, the pathogen was resistant to tetracyclines.

For this reason, experts suggest using new treatment methods, applying two drug - Gentamicin (injections) + Azithromycin (inside) or another combination of drugs - Azithromycin + Hemifloxacin - orally.

If complications arise, surgery is required.

Acute bartholinitis is opened, and the wound is washed and drained.

In the case of acute pelvioperitonitis, as well as the absence of positive dynamics, a laparotomy is performed during the day, the appendages are removed, and the abdominal cavity is washed.

Prophylaxis

In the case of unprotected intercourse, the likelihood of infection decreases after taking the following measures:

• immediately after sex, you should urinate, preferably several times (as a result, urine will flush pathogenic bacteria from the urethra);
• the genitals and thighs should be washed with soap;
• within 2 hours after intercourse, 1-2 ml should be injected into the urethra, up to 5 ml of Betadine or Miramistin solution into the vagina;
• the surfaces of the thighs and the skin of the perineum are treated with an antiseptic - a weak solution of potassium permanganate, Miramistin or a solution of Chlorhexidine. If there is no Betadine or Miramistin, you can sprinkle with potassium permanganate (weakly diluted).

Miramistin reduces the risk of contracting trichomoniasis, gonorrhea, syphilis and genital herpes by 90%.

No later than 2 days after unprotected sex, you should consult a specialist (the doctor will prescribe a scheme for the prevention of sexually transmitted diseases). After 2 weeks, it is recommended to take a smear for gonorrhea and other urogenital infections by PCR method.

It should also be noted that an effective scheme has been developed that allows you to fight the spread of the disease.

This prevention scheme includes the following provisions:

1. Identification of infected people for subsequent treatment, and examination of persons who are constantly in contact with patients is carried out.
2. Periodic examination and registration of patients with venereal infectious diseases.
3. Identification of sick people in risk groups, which include drug addicts, prostitutes, homosexuals, homeless people.
4. The use of conventional methods of treatment of gonorrhea in order to increase the effectiveness of stopping the disease.
5. Informing the population, as well as holding events that are aimed at promoting the refusal of promiscuous sexual contacts and compliance with sanitary and hygienic rules.

Healing control

After completing the course of therapy, it is required to perform a three-fold follow-up examination of the patient after provocation (usually this is the use of spicy foods and alcohol on the eve of taking the analysis).

Gonorrhea in women: symptoms and treatment, first signs

Gonorrhea is one of the most commonly diagnosed genital infections. A sexually active person should know how the disease is transmitted and the first signs of infection.

These will help to avoid an unpleasant illness and to consult a specialist in a timely manner in order to avoid negative consequences.

Gonorrhea: what is it?

The common name for gonorrhea among people - "gonorrhea" - the name is quite frightening. However, few people know the routes of infection and how gonorrhea manifests itself in women, exposing their sexual partners to the risk of infection.

Main target organs:

• vagina (with traditional intercourse);
• the urethra (close proximity to the genitals contributes to the spread of infection to the urethra);
• rectum (for anal sex);
• pharynx (with oral sex);
• eyes (lack of hygiene, infection of the baby during childbirth).

Gonorrhea is a sexually transmitted disease caused by a gonococcus (Neisseria gonorrhoeae). The route of infection is unprotected sexual contact with a sick partner.

However, for the development of the disease, a sufficient number of bacteria must be ingested. The risk of infection with traditional intercourse is 100% (with oral sex it is lower, due to the antibacterial properties of saliva).

Therefore, you should not try your own luck and neglect the elementary rules of protection (condoms). Also, a large number of women in prostitution suffer from asymptomatic gonococcal pharyngitis.

Do not be afraid of the everyday transmission of gonococcus: through towels, in saunas / pools, through toilet seats. The bacterium dies too quickly outside the human body and is not capable of leading to disease.

Infection with gonococcus outside intercourse is possible only in the following cases:

• infection of the newborn during childbirth (usually diagnosed with gonococcal conjunctivitis);
• if the child sleeps in the same bed with the sick parent, subject to gross non-observance of hygiene standards.

The first signs of gonorrhea in women

Symptoms of gonorrhea in women usually appear 5-10 days after infection, although the first signs are often confused with other, more innocent diseases:

• the discharge and itching that appear are referred to as candidiasis (thrush);
• for pains in the lower abdomen and during urination, increased urge to empty the bladder, frozen legs and cystitis are blamed.

This neglect of one's own body is aggravated by a characteristic feature of the course of gonorrhea in women: in most cases, the disease gives erased symptoms.

In men, on the other hand, gonococcal infection manifests itself quite rapidly. In addition, the incubation period is shortened if a woman has cervical erosion and concomitant diseases (for example, thrush), rectal cracks, damage to the oral mucosa.

Symptoms of gonorrhea in women

The symptomatology of gonorrhea differs radically depending on the place of introduction of the gonococcus.

Gonorrheal vaginitis

The classic picture of infection with gonorrhea (localization of infection is the vagina):

• discharge in gonorrhea in women is yellowish-white in color with an unpleasant odor (pus);
• burning sensation, severe cramps during urination, pus may be released from the urethra, its outer opening swells and turns red;
• pulling pain in the lower abdomen;
• extramenstrual bleeding (usually not intense, smearing).

The most pronounced symptoms are observed in pregnant women.

Gonorrheal pharyngitis and stomatitis

With the oral route of infection, gonorrheal stomatitis is formed (inflammation of the gums with the formation of purulent ulcers, with the development of the disease, an increase in the submandibular lymph nodes) and pharyngitis. The latter is almost always asymptomatic.

Sometimes sick women note:

• sore throat (rarely intense);
• increased salivation;
• swelling, redness of the tonsils and palatine arches, the appearance of purulent foci on them (sometimes confused with a common sore throat).

Gonorrheal proctitis

Gonorrheal inflammation of the rectum occurs both during anal sex and during traditional intercourse (infection of the rectum with vaginal secretions). Often, damage to the rectum is manifested only by itching in the anal region and mucopurulent discharge.

With the development of pathology, pain occurs during bowel movements, blood streaks are present in the feces, and the intestinal mucosa is covered with a purulent bloom.

Gonococcal conjunctivitis

Infection of the mucous membrane of the eyes with gonococcus (blenorrhea) provokes vivid symptoms: the edematous eyelids are literally glued together by purulent discharge, the mucous membrane of the eye is hyperemic, in advanced cases - corneal opacity and decreased vision.

Symptoms of chronic gonorrhea in women

• After 1.5 - 2 months from the onset of the disease, in the absence of appropriate therapy, chronic gonorrhea is diagnosed in women.
• Periods of "imaginary" recovery (complete absence of symptoms) are replaced by exacerbations with mild symptoms.
• The only thing that indicates the presence of a gonococcus in the body and ongoing inflammation is the “morning drop” syndrome: upon awakening, a woman may find a cloudy purulent drop at the opening of the urethra.

Diagnosis of gonorrhea

For any pathological symptoms that have arisen in the genitals, you should urgently consult a venereologist.

Tests for gonorrhea in women:

1. A usual smear from the vagina - gonorrhea is not always detected even with severe symptoms, a large number of leukocytes are usually recorded, erythrocytes are possible, fungus is often sown.
2. PCR and culture are the most informative methods for detecting gonococcus and other infectious agents.

In the chronic form, for the detection of gonorrhea, provocation with Pyrogenal is required according to a certain scheme. After the injection, the patient experiences a flu-like condition: fever, muscle pain, weakness.

Treatment of gonorrhea in women

When treating any sexually transmitted disease, including gonorrhea, the following rules should be strictly observed:

• Exclude any sexual intercourse during the treatment period.
• All sexual partners of a woman with whom she had contact during the expected period of infection and after it are subjected to treatment.
• Self-medication leads to chronic inflammation.
• An antibacterial drug, its dosage and the duration of the treatment course are determined only by a qualified venereologist, taking into account the duration of the disease and the test results (repeated courses are possible).
• Only local treatment (vaginal suppositories, ointments) does not give recovery.
• Convalescence is ascertained only after clean tests from the vagina.

Treatment regimen:

1. Antibacterial drugs (tablets) - fluoroquinolones (Ciprofloxacin, Ofloxacin) or cephalosporins (Cefixime) in several doses.
2. In the treatment of chronic gonorrhea, antibiotics that destroy gonococcus are often combined with Trichopolum. The treatment course for the chronic form will last up to 10 days.
3. With the simultaneous detection of chlamydia - tetracyclines (Doxycycline) and macrolides (Azithromycin). The reception scheme is individual.
4. Antifungal agents (Fluconazole and its analogs) on I, IV, VII days for the prevention of vaginal candidiasis.
5. Prevention of intestinal dysbiosis after antibiotic therapy - Bifiform, Enterol (at least 2 weeks, simultaneously or after antibiotic therapy).
6. Local treatment - irrigation with antiseptics (Furacilin), vaginal suppositories (Terzhinan), drugs to restore the vaginal microflora (prescribed after a course of antibiotics, good remedy - Epigen-intimate spray).

Despite the fact that medicine today is on the highest level, has stepped far forward, still gonorrhea does not lose its relevance. Unfortunately, with gonorrhea, the symptoms in women may not be acute, in most cases it is erased, therefore it is often complicated, and women become the main source of transmission. Treatment of gonorrhea is necessary for both women and men, because its main consequence is infertility.

Gonorrhea and its prevalence

Gonorrhea is an infectious disease that is primarily sexually transmitted. That is, gonorrhea is one of the sexually transmitted infections. The causative agent is gonococcus (Neisseria gonorrhoeae), named after the scientist Neisser. Translated from the Greek "gonorrhea" means the outflow of the seed. Every year, WHO registers about 62 million people infected with gonorrhea. In Russia, in 2000, 170 thousand patients were recorded.

The main route of transmission of gonorrhea is sexual, and all types of sexual contacts are possible (traditional, genital-oral, genital-anal, and even petting).

The household route of infection is allowed, but rarely occurs, if the rules of hygiene and the use of personal toilet items are not followed (wearing someone else's linen, shared towels, a shared bed for parents and a child, and others).

Infection with gonorrhea of \u200b\u200ba newborn during childbirth is possible when passing through the natural genital tract. Gonococci are unstable in the external environment, therefore they quickly die at tempera. above 55 degrees and when exposed to ultraviolet radiation.

The causative agent is highly contagious (contagious), so the chances of "catching" gonorrhea even with a single sexual contact are 70%. Gonorrhea rarely "travels" on its own, in 70 - 80% of cases, Trichomonas and / or chlamydia are also found.

Risk group for gonorrhea among women:

• prostitutes;
• women under 25;
• a history of gonorrhea;
• the presence of sexually transmitted infections;
• neglect of condoms;
• pregnant women;
• women leading an asocial lifestyle (alcoholics, drug addicts).

Classification of gonorrhea:

• fresh gonorrhea - the duration of the disease is 2 months or less (acute, subacute);
• chronic gonorrhea - more than 2 months have passed after infection (asymptomatic, latent or latent and subacute).

Gonococci are prone to "conquering" free territories, therefore, allocate fresh and chronic ascending gonorrhea (inflammation of the endometrium of the uterus, ovaries, fallopian tubes, pelvic peritoneum).

The timing of the onset of the first symptoms after infection

The incubation period of infection lasts from 3 to 7 days to 2 to 3 weeks. Accordingly, the first signs of the disease usually appear in 5 days. The shortening or lengthening of the incubation period depends on the body's defenses.

If the immune system is very weakened, then the first symptoms of the disease will appear within 24-48 hours (a severely transferred infectious disease recently, steroid treatment, chemotherapy, etc.).

Late manifestation of gonorrhea is associated either with good immunity, or with taking antibiotics after infection for other infections or with an attempt to self-medicate. With this, and not only, it is connected that the first symptoms of gonorrhea are practically invisible.

Symptoms in women

With gonorrhea, the manifestations of the disease are associated with those organs that are affected by the pathogen. So during coitus, gonococci from the urethra enter the female genital tract and primarily attack the cervix. With the further ascent of the infection, the appendages (ovaries, tubes), the mucous membrane of the uterus, and in some cases the peritoneum are involved in the inflammatory process. In addition, gonococci involve the rectal and urethral mucosa in the process (during anal-genital intercourse or when infected discharge from the vagina and urethra enters the rectal mucosa). Gonorrheal pharyngitis (oral - genital contacts) is also quite common.

After infection with gonorrhea, symptoms appear with secretions - this is the first, classic sign of the disease. Usually it is a thick, yellow or white leucorrhoea with an unpleasant odor. Often, women take this symptom for a manifestation of thrush or, and begin to treat themselves on their own, erasing the clinical picture.

Cervicitis - In addition to discharge, itching, burning or a tickling sensation in the perineum and vagina worries. During a gynecological examination with the naked eye, it can be seen that the cervix is \u200b\u200bbright scarlet, somewhat edematous, and a yellow ribbon of leucorrhoea is released from the cervical canal - a characteristic symptom of gonorrhea. All of these phenomena indicate gonorrheal cervicitis.

Inflammation of the appendages and uterus - When the infection penetrates higher, the endometrium and appendages are affected. There are pains in the lower abdomen of an acute or pulling character, purulent discharge, mixed with blood (the uterine mucosa is affected), the temperature rises to 38 - 39 degrees and signs of intoxication appear (weakness, malaise, nausea and vomiting, loss of appetite). In this case, gonorrheal endometritis and salpingo-oophoritis occurs.

And with endocervicitis, and when the pelvic organs are involved in the process, the woman feels).

Urethritis, cystitis, pyelonephritis - Infection with gonococci of the urethra leads to gonorrheal urethritis, in which patients complain of frequent and painful urination (see,). The urethra is edematous, hyperemic, its palpation is painful, false urge to urinate appears. The ascent of the infection involves the bladder and kidneys (see, pyelonephritis).

Proctitis - Gonorrheal proctitis is manifested by itching and burning in the anus, painful bowel movements and tenesmus (false desires). There is a yellow rectal discharge, usually with bloody streaks. On examination, redness of the anus is found, the folds of the anus are filled with pus. ...

Pharyngitis - Gonorrheal pharyngitis proceeds under the mask of an ordinary sore throat. There is a sore throat, soreness when swallowing, the submandibular lymph nodes increase, the temperature rises. But most often, pharyngitis occurs with mild symptoms (hoarseness of the voice) or asymptomatic. Objectively: edematous, hyperemic palatine tonsils with a yellowish-gray coating are found.

Chronic gonorrhea

Chronic gonorrhea proceeds with an erased clinic, the symptoms are mild or invisible at all. Among the symptoms characteristic of chronic gonorrhea, only vaginal discharge, periodic and aching, can be distinguished.

With chronic gonorrheal inflammation of the uterus, menstrual irregularities occur. There are intermenstrual bleeding (see), and the menses themselves become longer and more abundant. Menstruation can exacerbate the infection (cervicitis, endometritis, adnexitis, urethritis).

Since gonococci give preference to the columnar epithelium, the vaginal mucosa, which is represented by the squamous epithelium, is almost not affected. The only exceptions are girls and pregnant women with advanced vulvovaginitis.

Complications of gonorrhea

Gonorrhea is unpleasant not only for its manifestations, but also for a high% of complications:

• bartholinitis (infection of the Bartholin glands - large glands of the vestibule of the vagina);
• (obstruction of the tubes, defective endometrium);
• decreased sex drive (libido);
• complication of pregnancy and the postpartum period (spontaneous abortion, intrauterine fetal growth retardation, pre-term delivery, premature rupture of amniotic fluid, increased, postpartum purulent-septic diseases, death of a child on the first day after birth, antenatal fetal death, chorionamnionitis);
• (blenorrhea - gonorrheal conjunctivitis, otitis media - inflammation of the middle ear, infection of the genital tract in girls, gonococcal sepsis);
• disseminated gonorrhea - the penetration of the pathogen into the blood and its dispersion throughout the body (hemorrhages on the skin, damage to the joints, liver, kidneys, heart, brain);
• gonorrheal conjunctivitis (if hygiene is not followed).

Practical example: Untreated gonorrhea in women can lead to tubo-ovarian formation. One night a young woman was admitted to the hospital with symptoms of intoxication, intense pain in the lower abdomen, with signs of pelvioperitonitis (irritation of the peritoneum). I have never had such a neglected case again. The operation lasted more than 2 hours - they were all around, on one side the uterine appendages were not visualized (only some conglomrate from the intestines, omentum, fallopian tube and ovary), there was a massive purulent effusion in the abdominal cavity. After the operation, it turned out that it was gonorrhea. I have operated on many tubo-ovarian abscesses, but have never seen such a severe case again.

Diagnostics

The diagnosis of gonorrhea is confirmed by laboratory tests:

• microscopy of smears from the cervical canal, vagina, urethra and rectum (Gram stain and staining of smears with methylene blue or brilliant green);
• express tests (for home diagnostics);
• culture method (sowing of discharge from the urethra and cervix on a nutrient medium);
• immune fluorescence reaction - RIF (staining of a smear with fluorescent dyes);
• enzyme immunoassay - ELISA (study of urine);
• compliment binding reaction - RSK (serological method, venous blood is studied, invaluable in the diagnosis of chronic gonorrhea);
• polymerase chain reaction - PCR (smears and urine are examined).

Methods of provoking the disease are used when chronic and latent gonorrhea is suspected, when the pathogen is not identified in routine tests:

• chemical (lubrication of the urethra with 1 - 2% silver nitrate solution, and the cervical canal 2 - 5% solution);
• biological (injection of a gonococcal vaccine and / or pyrogenal into the muscle);
• alimentary (drinking alcohol, salty, spicy foods);
• thermal (carrying out diathermy for 3 days in a row - smears are taken three times an hour after the physiotherapy);
• physiological (analysis of smears during menstruation).

As a rule, they combine 2 or more methods of provocation. Swabs are taken three times after 24, 48, 72 hours.

Practical example: The story is straight Bulgakov. A well-groomed, well-dressed and confident woman came to the reception. But there is fear in the eyes. After a short questioning, it turned out that the husband admitted that, being in Moscow, he decided to "try a prostitute", and even without a condom. The result is disastrous: gonorrhea. So a woman came running to me to get tested and find out her fate. Examination and a regular Gram smear revealed nothing. I decided to take provocative smears. The results, fortunately for the woman, were negative. As a doctor, it is very pleasant for me to work with such conscientious patients, since in many cases you come across gonorrhea by accident, after the development of purulent complications (our women are very fond of doing self-diagnosis and self-medication).

How to avoid infection after unprotected intercourse

If there has been unprotected intercourse with a partner in which there is no confidence or in the event of rape, urgent measures must be taken to prevent infection with urogenital infections. The sooner measures are taken, the lower the likelihood of infection:

• Immediately after coitus, you should urinate, if possible several times (urine will flush pathogenic bacteria from the urethra).
• Wash the inner thighs and external genitals with soap.
• Introduce 1-2 ml into the urethra, and no more than 5 ml into the vagina or Betadine from a bottle with a urological nozzle, but no later than 2 hours after an unprotected p / act.
• Treat the skin of the perineum and inner thighs with an antiseptic - a solution of potassium permanganate (weak), Chlorhexidine or Miramistin. If there is no Miramistin or Betadine, you can syringe with weakly diluted potassium permanganate.

Miramistin reduces the risk of contracting gonorrhea, trichomoniasis, syphilis, genital herpes by 10 times.

No later than 48 hours after unprotected coitus, consult a doctor (he will prescribe medication prophylaxis). After two weeks, it is recommended to take smears for analysis for urogenital infections by PCR.

Treatment of gonorrhea

Treatment of gonorrhea in women is antibiotic therapy. Both sexual partners are subject to therapy, alcohol is prohibited during treatment and sexual rest is prescribed. Of the antibiotics, preference is given to drugs of the penicillin, cephalosporin, fluorochnilon series.

Therapy for fresh gonorrhea of \u200b\u200bthe lower genital area is limited to a single dose or administration of an antibiotic:

• Ceftriaxone 0.25 g or gentamicin 2.0 g IM
• Sumamed 2 g (analogues of Z-factor, Azitrox, Hemomycin, Azicid, Ecomed)
• Cefixime 0.4 g or ciprofloxacin 0.5 g orally

Acute ascending gonorrhea is treated with the following drugs6

• Ceftriaxone 1 g / m 1 time per day for a week, ciprofloxacin 500 mg / 2 times a day for 7 days, ofloxacin 0.4 g 2 times a day for a week.
• It is possible to use other antibiotics (tetracycline, clindamycin, rifampicin, bicillin, josamycin, ofloxacin, etc.)
• Treatment of chronic gonorrhea is supplemented with immunity stimulants and a gonococcal vaccine (pyrogenal, methyluracil, levamisole, prodigiosan).
• Autohemotherapy effectively activates the body's defenses.

Since gonorrhea is often combined with trichomoniasis and / or chlamydia, Doxycycline is added to therapy for 10 days and Metronidazole preparations for 5 to 7 days. Local treatment consists in washing the urethra with a 0.5% solution of silver nitrate, douching the vagina with solutions of manganese, protargol, chlorhexidine, miramistin and chamomile decoction.

In the last decade, WHO is concerned about the increase in cases of the development of resistance of the causative agent of gonorrhea to some antibiotics, for example, the chief health expert of the UK, Sally Davis, said that in 2013, in 80% of clinical cases, resistance of the causative agent of gonorrhea to tetracyclines was determined. In this regard, experts suggest using new treatment regimens in such cases, using 2 drugs - Azithromycin (inside) + Gentamicin (injections) or another combination - Hemifloxacin + Azithromycin orally.

In case of complications, they resort to surgical intervention. In acute pelvioperitonitis and the absence of positive dynamics from treatment, laparotomy is performed within 24 hours with the removal of the appendages and flushing of the abdominal cavity. Acute bartholinitis is opened, the wound is washed and drained.

Gonorrhea is a sexually transmitted disease caused by gram-negative gonococcal microorganisms. Getting on the mucous membranes of the genital organs, they penetrate inside, causing an inflammatory process. Gonorrhea in the fair sex is not as pronounced as in men, but at the same time, it is much easier for women to get the disease. Symptoms and treatment of gonorrhea are of interest to many women who are active sex life.

According to statistics, upon contact with an infected person, a woman gets the disease in 85% of cases, while a man only in 40%. If the disease lasts less than two months, an acute form is diagnosed. In the event that treatment is started at the wrong time, the symptoms of the disease gradually weaken, and it becomes chronic.

How does infection occur

A woman becomes infected with gonorrhea in the following cases:

• With unprotected intercourse with a carrier of the disease. In 80% of cases, the disease is transmitted in this way, and it does not matter whether it was genital-oral, vaginal or anal sex. Even if a full-fledged sexual intercourse did not take place, but simply there was a contact of the mucous membranes of the genitals, infection will occur.
• In a household way. Due to the structure of the genitals, in this way the fairer sex is infected with gonorrhea much more often than men. Gonococcus is quite tenacious and does not die during the day in a humid environment at room temperature. In water, it can exist for about seven hours, and in soapy water for up to two hours. If a woman uses someone else's towels, linen, washcloth, soap and sits on a dirty surface, then the probability of infection is about 5%.
• The child becomes infected with the disease while passing through the birth canal. If a woman has a chronic infection, she received gonorrhea during pregnancy and did not undergo treatment, then during natural childbirth the baby can become infected. Most often, in this case, the eyes of the newborn are affected, less often the genitals (mainly in female infants).

Women who are promiscuous and do not use condoms are at risk of contracting gonorrhea. Also, the risk group includes the fairer sex, whose age is less than 25 years old or pregnant (due to weakened immunity). Gonorrhea is often an adjunct to other sexually transmitted diseases.

Symptoms of the disease

In 20% of women, gonorrhea proceeds without visible signs, and it can only be detected with the help of tests. The incubation period can last from 3 to 21 days, depending on how strong the immune system is. Most often, the first symptoms of the disease appear 5 to 10 days after infection.

Gonococcus can affect the mucous membranes of the uterus, appendages, urethra, causing various diseases, which are united by common features:

• In the initial period of the disease, a woman has white discharge. Then they turn yellow-green, viscous with an unpleasant odor. If the mucous membrane of the uterus is affected, an admixture of blood appears in the leucorrhoea.
• The disease may be accompanied by itching and burning in the vagina or in the external genital area.
• With gonorrhea, women experience pain and discomfort during intercourse.
• Often gonorrhea causes discomfort during urination. There is a feeling of fullness of the bladder, frequent urge, itching and burning during urine output.
• Sometimes patients experience pain in the lower abdomen, which can be given to the perineum or back.
• In the event that the gonococcus affects the uterus or appendages, a woman may develop general symptoms in the form of fever, weakness, dizziness, nausea, and lack of appetite.

If therapy was started at the wrong time, and the disease became chronic, then the patient develops other signs of gonorrhea:

• Aching pain above the pubis, which can radiate to the leg or back.
• Greenish, not too profuse, viscous discharge with an unpleasant odor.
• Menstrual problems that manifest as too long and heavy periods or bleeding during ovulation.

Why is gonorrhea dangerous?

Many women wonder how to cure gonorrhea, and what will happen if you do not see a doctor in time? The causative agent of the disease multiplies rapidly and becomes the cause of the following pathologies:

• Cervicitis.
• Endometritis.
• Bartholinita.
• Obstruction of pipes.
• Ectopic pregnancy.
• Miscarriage on early dates pregnancy.
• Premature birth.
• Intrauterine fetal death.
• Fetal developmental disorders.
• Gonorrheal conjunctivitis.
• The spread of gonococcus through the blood, as a result of which it affects the skin, joints, liver, brain.

Very often women who have been diagnosed with gonorrhea suffer from infertility. This is due to the fact that gonococci cause inflammation, which in turn becomes the cause of the adhesion process, which interferes with the patency of the tubes.

How do I diagnose gonorrhea?

In order to confirm the diagnosis, a woman needs to consult a doctor who will conduct a visual examination and take an anamnesis. The following tests can also be assigned:

• Smear microscopy. For this, material taken from the vagina is used. It is examined under a microscope, which in half of the cases makes it possible to identify gonococci.
• Bacterial culture. This is a more accurate method, in which the material is placed in a nutrient medium, where, under favorable race conditions, it begins to multiply. With bacterial culture, it is possible to determine not only the presence of a microorganism in a smear, but also its sensitivity to antibiotics.
• Polymerase chain reaction (PCR). This is the most modern and accurate method that allows you to identify the genetic material of the causative agent of the disease in the material taken from the patient.
• Linked immunosorbent assay. It makes it possible to detect antibodies to the pathogen in the patient's blood.

If there is a suspicion that the disease is latent, the doctor may prescribe a provocation in the form of lubrication of the urethra and cervical canal with a solution of silver nitrate or the use of salty foods and alcoholic beverages. It is also possible to take a smear during your period.

Treatment

When treating gonorrhea, most doctors stop at the following remedies.

Group	Name	How to apply
Cephalosporins	Ceftriaxone	The powder is dissolved with Novocaine 0.5% or sodium chloride 0.9%. The drug is administered intramuscularly at a dosage of 0.5 or 1 g. Treatment of gonorrhea in women uncomplicated by other infections requires a single injection of the drug.
	Cefixime	Tablets for gonorrhea must be taken in a dosage of 400 mg once.
	Cefotaxime	The powder is dissolved in the same way as Ceftriaxone and is injected intramuscularly, once 0.5 g of the drug.
Fluoroquinolones	Ciprofloxacin	For uncomplicated gonorrhea, 0.1 g of Ciprofloxacin is prescribed intravenously or 250 mg of the drug orally. The drug is used once.
Penicillins	Benzylpenicillin	Injected intramuscularly 1,000,000 IU of Benzylpenicillin. Treatment continues for 3 to 6 days.
	Bicillin 3	One bottle of the drug is administered intramuscularly, daily for six days.
	Bicillin 5	Used for chronic disease. Introducing one bottle once a day for 3 - 5 days.
Macrolides	Azithromycin	Take 2 g of the drug during the day. In the chronic form of the disease, 1 g of Azithromycin is prescribed on the first day, and then, within 3 days, 250 mg of the drug.

Examples of complementary medicines

Very often, gonorrhea in women is, as it were, combined with other equally serious sexually transmitted diseases. In more than 30% of cases, gonorrhea is combined with chlamydia. In order to get rid of this infection, in addition to the drugs described above, a woman can be prescribed:

• Ornidazole.
• Metronidazole.
• Tinidazole.

With a combination of gonorrhea and candidiasis, in addition to the main treatment, antifungal agents are used: Fluconazole, Ketoconazole.

If, against the background of gonorrhea, there is an exacerbation of genital herpes, then additionally may be prescribed:

• Cycloferon.
• Gerpevir.
• Acyclovir.

Apply drugs in accordance with the instructions and recommendations of the attending physician. The duration of therapy can be from 1 to 14 days, depending on the severity of the infection and the sensitivity of its pathogen.

Local treatment

In order to get rid of the disease, not only injections or pills are used. How to treat gonorrhea in women: silver nitrate solution, potassium permanganate, Miramistin solution, chlorhexidine bigluconate. The douching procedure is usually carried out once a day for 3 to 5 days.