Gonorrhea In Males

Humans are the only host for Neisseria gonorrhoeae. It is spread from person to person through sexual contact. It can spread through vaginal, anal, or oral sex. The bacteria can also be transmitted on contaminated fingers or sex toys. The infection can affect any mucus membrane, but it is most common in the following locations:

• the rectum
• the throat
• the urethra

Gonorrhea in males may spread to the testicles or the epididymis, which produces sperm. Sometimes the bacteria can spread through the bloodstream to other areas of the body, such as the abdomen, heart, joints, spinal cord, brain, and liver.

About half of men with gonorrhea have no symptoms. Those who have symptoms may notice the following:

• discharge of pus from the penis
• eye pain and discharge
• frequent or painful urination
• pus-filled discharge from the penis
• rectal discomfort
• sore throat

Gonorrhea that has spread to other parts of the body may cause a rash and fever. The person may have painful, swollen joints. Other symptoms are specific to the body part that is infected. An infection in the heart, for example, may cause heart valve problems and impaired blood flow.

Gonorrhea is caused by Neisseria gonorrhoeae bacteria. It is spread through sexual contact or during childbirth. Reported infection rates are more common in blacks and in those of lower socioeconomic status; however, this is partly because the public clinics who see these patients are more likely to report to the public health authorities than private healthcare professionals are.

The teenage and young adult years are the highest risk period for infection.

Risk factors for gonococcal infections include the following:

• child abuse
• multiple sexual partners
• unprotected sexual contact

Safer sex practices can reduce, but not eliminate, the risk for gonorrhea. Prompt treatment of the infected person and any sexual partners will prevent further spread.

Diagnosis of a gonococcal infection starts with a medical history and physical exam. The Neisseria gonorrhoeae bacteria can be cultured from infected body sites. Testing for HIV and syphilis should also be offered to those diagnosed with gonorrhea. These sexually transmitted infections (STIs) are more common in people with gonococcal infections.

Gonorrhea can cause serious long-term effects if it is not treated effectively. These effects include the following:

• congestive heart failure, a condition in which a weakened heart cannot pump blood effectively
• death from overwhelming sepsis or bloodstream infection
• endocarditis, which is an infection involving the heart
• infertility
• meningitis, or infection of the brain and spinal cord
• septic arthritis, with infection of one or more joints
• visual impairment, including blindness
• perihepatitis, which is inflammation of the lining of the liver
• stricture disease, or scar tissue within the urethra, the urinary drainage tube of the penis

Gonorrhea is very contagious. It is spread from person to person during sexual contact.

The Centers for Disease Control and Prevention (CDC) recommend that uncomplicated gonorrhea in the genital tract be treated with ceftriaxone (i.e., Rocephin), ciprofloxacin (i.e., Cipro, Proquin SR), levofloxacin (i.e., Levaquin), ofloxacin (i.e., Floxin) or cefixime (i.e, Suprax).

Azithromycin (i.e., Zithromax, Z-max) or doxycycline (i.e., Adoxa, Doryx, Oracea, Periostat, Vibramycin) should be added to treat Chlamydia trachomatis, a disease which commonly occurs along with gonorrhea. Pain medications can be used as needed. Infected individuals should avoid sexual contact until the infection is completely gone. Gonococcal infections that involve other body organs will also need treatment.

Antibiotics may cause rash, stomach upset, and allergic reactions.

The discharge and discomfort of gonorrhea may take a while to stop, even with treatment. A man can quickly be reinfected if he engages in sex with an infected partner. Sexual partners should be tested and treated as needed.

Any new or worsening symptoms should be reported to the healthcare professional.