A woman infected with gonorrhea may feel no pain and notice no early symptoms. She may, however, experience pain in the lower abdomen, with or without a burning sensation during urination or a whitish discharge from the vagina. If the infection is allowed to reach other organs of her reproductive system, the ovaries and the fallopian tubes may become inflamed and sterility can result. If uncontrolled, the gonococcal infection may spread to contiguous organs, or it can become blood borne, so that sites of infection may occur in multiple and varied locations, such as the valves of the heart, meninges, joints, peritoneum, and skin. Diagnosis is confirmed by the presence of gonococci in the discharge from the penis or vagina or in fluid from any affected area.
Gonorrhea is treated aggressively with antibiotics.
Penicillin is no longer the treatment of choice because of the development of resistant organisms. The patient is usually treated for concurrent chlamydial infection with doxycycline hyclate or tetracycline. The possibility of reinfection or infection of sexual partners should be discussed with the patient, as well as the importance of identifying and treating all sexual partners. Sexual abstinence or the use of a condom should be stressed. Oral sexual activity should be avoided if there is a pharyngeal infection.