It's hard to defecate and urinate, isn't it, brother? It can't be gonorrhea!

So one Monday, my clinic was very busy. That's when I first met Ryan. Ryan is a 26-year-old software developer. He was a little shy. His face was a little strange. When he came and sat down, I realized that there was something else wrong, not just this disease.

" Dr. Priya , this is a little hard to say," Ryan began, his voice trembling a little. "For the past few days, I've been having difficulty urinating , and it feels like it's burning. On top of that, I've also started to have this... white discharge. It's been like this for a few days."

I smiled and calmed him down a bit. "It's okay, Ryan, if there's something like that, it's best to talk. Let's see what's wrong."

What is gonorrhea?

After listening to Ryan's description and looking at his history, I thought it might be gonorrhea. Gonorrhea is a sexually transmitted disease. It is caused by a bacteria called Neisseria gonorrhoeae. It is also called "the clap." In men, gonorrhea usually occurs in the urethra. However, it can also occur in the throat, anus, or other areas of the genitals . It depends on the sexual activity.

"Gonorrhea is a more common disease than people think," I told Ryan. "But it can be cured. But it's important to get treatment quickly. Otherwise, it can lead to other problems."

According to the World Health Organization (WHO), more than 8.2 million people worldwide develop gonorrhea each year. This means that it is one of the most common sexually transmitted diseases caused by bacteria .

What happens when you get gonorrhea?

The pain Ryan was having was similar to what men feel when they get gonorrhea.

For men:

• Burning when urinating: Ryan said it felt like a burning sensation, like being cut by a razor blade.
• A white or yellow discharge: It just looks like pus .
• You may feel a slight pain: sometimes it can be a little deep, like a testicle .

Some men don't show any symptoms of the disease. In that case, it's too late to take the medicine. I told Ryan that if he doesn't take the medicine, it can lead to prostate infections or even infertility.

For women (just for information):

Even though Ryan's illness was a man's, I also told him how gonorrhea can affect women. Because most of the time, women don't show any symptoms of the disease. If you show that,

• Pain when urinating
• White, yellow vaginal discharge
• Pelvic or abdominal pain: This can often be a sign of pelvic inflammatory disease (PID).

Studies show that 50%-70% of women with gonorrhea do not show any symptoms, so it is best to get tested regularly.

How is gonorrhea transmitted?

"It's spread through unprotected sex with someone who has gonorrhea, meaning without a condom," I explained. "This bacteria really likes warm, moist places in the reproductive system, like the urethra."

Ryan nodded. But his face wasn't very good. "I'm being careful. But I had unprotected sex recently. Could that be the cause?"

"That could be it," I said slowly. "Let's do some tests to make sure."

How to diagnose the disease

To find out for sure if it's gonorrhea, I asked them to do these tests:

• Urine Test: This is very simple. It's not difficult. It can check for bacteria.
• Swab testing: This is done depending on your symptoms and sexual activity. Sometimes a swab is taken from the urethra, throat, or rectum.

I told Ryan that these tests could be done quickly and easily. "We can start the medication as soon as the test reports come back," I said.

Nucleic Acid Amplification Tests (NAATs) for gonorrhea have a greater than 95% success rate, meaning these tests can accurately determine whether or not you have the disease.

What happens if you don't take the medicine?

"Okay, Doctor. What will happen if I don't take the medicine for that?" Ryan asked, sounding a little scared.

I made him understand that if he didn't take the medicine, things would get difficult.

For men:

• Inflammation of the tubes behind the testicles (epididymitis) can cause pain and swelling.
• The urethra may become narrowed (urethral stricture), making it difficult to urinate.

For women:

• Pelvic inflammatory disease (PID) can cause frequent abdominal pain and infertility.

For both women and men:

• If the bacteria spreads to the bloodstream (disseminated gonococcal infection - DGI), symptoms such as fever, joint pain, and skin rash may occur.

According to the Centers for Disease Control and Prevention (CDC), gonorrhea is responsible for about 20% of pelvic inflammatory disease (PID) cases. Therefore, it is important to take your medication on time.

Medicines for gonorrhea

"Okay, so what are you going to do about it?" Ryan asked.

I told him that antibiotics are given for gonorrhea. The current treatments are:

• Single-Dose Injectable Ceftriaxone: This is injected into a muscle .
• Azithromycin or Doxycycline tablets: Sometimes these are also given. This is to check if there is anything else, like chlamydia, and treat that at the same time.

"If you take medicine, it will definitely get better," I reassured him. "But you also need to make sure that anyone you have sex with takes medicine. Otherwise, it could happen again."

Antibiotic-resistant gonorrhea is a big problem these days. According to the World Health Organization (WHO), antibiotic-resistant gonorrhea is on the rise worldwide. Therefore, it is essential to take the medications prescribed by your doctor correctly and on time.

What can you do to avoid getting gonorrhea?

"Okay, Doctor. What can we do to keep it from happening again?" Ryan asked.

I told him some things he could do to prevent it from happening again.

• Always use condoms: If you use condoms every time you have sex, the chances of getting the disease are greatly reduced.
• Regular testing: It is important for sexually active people, especially those with multiple partners, to get tested regularly.
• Open communication: It's important to talk about this with the people you're joining and get them tested too.
• Reducing the number of people you gather with: The fewer people you gather with, the less chance you have of spreading the disease.

A study on Sexually Transmitted Infections found that consistent condom use reduces the risk of gonorrhea transmission by about 90%.

Ryan's follow-up

About two weeks after taking the medicine, Ryan came back to check on him. His face wasn't feeling so good. "The inflammation is gone now," he said. I reminded him again to take the medicine I gave him until it was finished. He also told the others not to have sex again until they finished taking the medicine.