Am I Infected with Gonorrhea? Symptoms and Treatment Options

Q: Am I Infected with Gonorrhea? Symptoms and Treatment Options

Hello： Gonorrhea is a bacterial infection, not a viral one, and can be treated with various antibiotics. <br>A two-week course of medication is recommended, but there may be antibiotic resistance. <br>If symptoms persist, a urine test should be conducted to consider changing the

Am I really infected with gonorrhea?

Hello Doctor: I would like to inquire about gonorrhea.
I had an encounter with a stranger, and six days later, I started to feel slight pain when urinating, although it was not very noticeable, and there was no discharge.
I did not see a doctor at that time.
On the seventh day, I noticed a more pronounced discharge that was white with a slight yellow tint and had an odor.
The pain during urination became more significant, and my urine was particularly dark yellow and cloudy, with frequent urination.
That evening, I experienced generalized body aches, weakness, and loss of appetite.
I went to a clinic in Taichung for a consultation.
The doctor assessed my condition and immediately diagnosed it as gonorrhea, stating it was somewhat severe.
He recommended treatment with an injection, informing me that I would likely feel better in about two days.
He also mentioned that if I preferred oral treatment, there was only a 10% chance of improvement with that option.
I was somewhat shocked that oral treatment for gonorrhea was so ineffective.
After some thought, I decided to take my chances and chose oral treatment.
The doctor prescribed a week’s worth of antibiotics and pain relievers, to be taken three times a day, without a dose before bedtime.
I was instructed to return in a week to assess my condition.
The clinic asked me to pick up my medication from their partnered pharmacy and collected a urine sample, although they did not inform me of its purpose.
The medication prescribed was cephalexin, a first-generation antibiotic at 500 mg.
After picking up the medication, I looked it up online and found that it is a first-generation drug, but I am not very familiar with medications and would like to know if this drug is effective.
Should I wait for the urine test results to determine which medications are effective against this infection? Today is the third day of taking the medication, and my urine color has returned to normal, but I still experience slight pain.
The pain is manageable with pain relievers, but it becomes quite noticeable once the medication wears off.
I have noticed some improvement in the frequency of urination, but the amount of discharge seems unchanged, and the pain persists, differing only in severity with or without medication.
What should I do? Should I wait another week for a follow-up at the same clinic, or should I see another doctor for an injection? This clinic already has my urine sample.
If I go to another clinic, will I need to provide another urine sample to get medication? If I continue taking this type of antibiotic for another week, will it delay treatment and potentially lead to other complications? Moreover, is this definitely gonorrhea and not a non-gonococcal infection? The symptoms took so long to appear, rather than showing up within two to three days, which raises some doubts for me.
I hope the doctor can clarify my current confusion, as I have been pondering this issue for quite some time.

Mr. Wu, 20~29 year old female. Ask Date: 2020/09/22

Dr. Du Shixi reply Urology

Hello: Gonorrhea is a bacterial infection, not a viral one, and can be treated with various antibiotics.
A two-week course of medication is recommended, but there may be antibiotic resistance.
If symptoms persist, a urine test should be conducted to consider changing the medication.
Most general hospitals and clinics can manage this condition, and injections are often recommended due to lower chances of resistance.
Whether to return to the same clinic is a personal decision.
There is no significant concern about delays in treatment, as medications for sexually transmitted infections (STIs) are typically administered one at a time, and if the first is ineffective, a different one can be used until the infection is resolved.
It is possible to have either gonorrhea or non-gonococcal infections; however, urethral discharge is usually treated as gonorrhea initially.
It is essential to practice safe sex, focus on treatment, and maintain a healthy lifestyle.
Follow-up testing is necessary until the infection is fully resolved and asymptomatic to ensure safety.
Common causes of urethral discharge include gonorrhea, Chlamydia, Mycoplasma, and Trichomonas.
There are various testing methods available, including urine tests, urethral swab cultures, antigen tests, serological antibody tests, and PCR for DNA detection.
For more information, you can refer to the CDC website: https://www.cdc.gov.tw/Category/QAPage/Hg_yY5n-atQnxcunf6MElA.

Reply Date: 2020/09/22

More Info

It sounds like you're experiencing a challenging situation regarding your health, particularly concerning the potential diagnosis of gonorrhea. Let's break down your symptoms, treatment options, and what you should consider moving forward.

From your description, it appears that you engaged in sexual activity and began experiencing symptoms approximately six days later. The symptoms you mentioned—pain during urination, unusual discharge, and systemic symptoms like body aches and fatigue—are indeed consistent with a gonococcal infection. Gonorrhea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae, and it can lead to various complications if not treated promptly.

Your healthcare provider's initial assessment and recommendation for treatment are crucial. Gonorrhea is typically treated with antibiotics, and the choice of treatment can depend on the severity of the infection and local antibiotic resistance patterns. The fact that your doctor suggested an injection as a first-line treatment indicates that they were concerned about the severity of your infection. Injectable antibiotics, such as ceftriaxone, are often preferred due to their effectiveness and the ability to ensure that the full dose is administered.

You mentioned that you opted for oral treatment with cephalexin, a first-generation cephalosporin. While cephalexin is an antibiotic, it is not the standard treatment for gonorrhea. The recommended treatment usually involves a combination of ceftriaxone and azithromycin to cover potential co-infections, such as chlamydia, which often accompanies gonorrhea. The concern with using cephalexin is that it may not be effective against Neisseria gonorrhoeae, especially given the rising rates of antibiotic resistance.

Given that you are already three days into your oral antibiotic treatment and still experiencing symptoms, it is essential to follow up with your healthcare provider. If your symptoms persist or worsen, it may be necessary to reconsider the treatment approach. You should not wait a week if you are still in discomfort; instead, it would be prudent to seek a follow-up consultation sooner. If you feel that your current clinic may not be providing the most effective treatment, you can consider visiting another healthcare provider for a second opinion. However, be sure to inform them about your previous treatment and any tests that have been conducted.

As for the timing of your symptoms, gonorrhea can have a variable incubation period, typically ranging from 1 to 14 days, with most individuals showing symptoms within 2 to 7 days. The delay in your symptoms does not rule out gonorrhea; it is possible to have a longer incubation period.

In summary, here are the steps you should consider taking:
1. Follow Up Promptly: If your symptoms are not improving, seek medical attention sooner rather than later. Explain your concerns and the treatment you have received.

2. Consider Testing: If you switch clinics, ensure that they are aware of your previous tests and treatments. They may want to perform additional tests to confirm the diagnosis and check for other STIs.

3. Discuss Treatment Options: If you are not responding to cephalexin, discuss the possibility of switching to the recommended injectable antibiotics with your healthcare provider.

4. Monitor Symptoms: Keep track of your symptoms, including any changes in pain, discharge, or urinary habits, and report these to your healthcare provider.

5. Avoid Sexual Activity: Until you have been treated and cleared of the infection, it is advisable to abstain from sexual activity to prevent transmission to others.

Remember, early and effective treatment is crucial in managing gonorrhea and preventing complications. Don't hesitate to advocate for your health and seek the best possible care.

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