The common slang term “the clap” refers directly to the sexually transmitted infection (STI) known medically as Gonorrhea. This colloquial name has been in use for centuries, with the most popular theory suggesting it came from the French word clapier, slang for a brothel. Understanding the medical facts about Gonorrhea is the first step in addressing this common public health concern.
Gonorrhea: Identification and Medical Facts
Gonorrhea is a bacterial sexually transmitted infection caused by the organism Neisseria gonorrhoeae. This bacterium is a Gram-negative diplococcus that primarily targets the mucosal surfaces of the body, including the reproductive tract, rectum, and throat.
The infection is one of the most frequently reported bacterial STIs worldwide, with tens of millions of new cases estimated annually. Its prevalence is high among younger, sexually active individuals. While the infection is curable with antibiotics, its continued spread is complicated by the high number of cases that do not initially present with noticeable symptoms.
Recognizing Signs and How the Infection Spreads
The presence and severity of Gonorrhea symptoms differ significantly between sexes and based on the infection site. Many people, particularly women, may experience no symptoms at all, making it easier to unknowingly transmit the infection. When symptoms in women do appear, they can include increased vaginal discharge, pain or a burning sensation during urination, and bleeding between menstrual periods.
For men, symptoms tend to be more noticeable, often involving a white, yellow, or green discharge from the penis. They may also feel a burning sensation during urination or experience pain and swelling in one testicle, a condition known as epididymitis.
The infection is not limited to the genitals; it can affect the throat, causing a sore throat, or the rectum, leading to discharge, itching, or painful bowel movements.
Transmission occurs through contact with infected sexual fluids—semen, pre-ejaculate, and vaginal secretions—during vaginal, anal, or oral sex. The bacteria are efficient at adhering to mucosal tissues. Gonorrhea is not spread through casual contact like hugging, sharing utensils, or using the same toilet seat.
Diagnosis and Current Treatment Protocols
Diagnosis of Gonorrhea is typically performed using a non-invasive procedure, most commonly a nucleic acid amplification test (NAAT) on a urine sample. If the infection is suspected in the throat or rectum, a swab of the affected area is taken instead. These tests detect the genetic material of the Neisseria gonorrhoeae bacterium.
Gonorrhea is a curable infection, but treatment requires prompt medical intervention with antibiotics. The Centers for Disease Control and Prevention (CDC) currently recommends a single, high-dose injection of the antibiotic ceftriaxone as the primary first-line treatment. This injectable dose is often paired with a course of oral doxycycline if co-infection with Chlamydia is suspected.
A major public health challenge is the growing problem of antibiotic resistance in N. gonorrhoeae. The bacterium has developed resistance to nearly every class of antibiotic used to treat it over the decades. This adaptability is why treatment guidelines have changed frequently, removing previously effective drugs like oral azithromycin from the primary regimen.
Following treatment, a “test of cure” is recommended for anyone treated for pharyngeal (throat) Gonorrhea to ensure the infection has been completely eradicated, as treatment failure is more common at this site. All individuals treated for Gonorrhea are advised to be retested approximately three months later due to the high rate of reinfection. It is also necessary to notify and ensure the testing and treatment of all recent sexual partners to stop the cycle of transmission.
Preventing Transmission and Understanding Long-Term Effects
Consistent and correct use of barrier methods, such as condoms and dental dams, is the most effective way to prevent the sexual transmission of Gonorrhea. Abstinence is the only absolute way to prevent infection. Regular screening is also a powerful preventive tool, particularly for sexually active women under 25 and men who have sex with men, as early detection allows for quick treatment.
If Gonorrhea is left untreated, it can lead to severe and permanent health complications. In women, the bacteria can ascend into the upper reproductive tract, causing Pelvic Inflammatory Disease (PID). PID can result in chronic pelvic pain, tubal scarring, increased risk of ectopic pregnancy, and infertility.
In men, untreated infection can cause epididymitis, which is painful inflammation of the tubes attached to the testicles, potentially leading to infertility.
In rare cases for both sexes, the bacteria can enter the bloodstream and spread throughout the body, causing Disseminated Gonococcal Infection (DGI). DGI can lead to serious conditions like septic arthritis (joint infection) and can even affect the heart valves.