Gonorrhea: What is it, and why is it Called The Clap?

Neisseria Gonorrhoeae
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What is Gonorrhea?

The Clap. A Dose. GC. A Drip. All these phrases refer to the same thing – the sexually transmitted disease most accurately known as gonorrhea.

Gonorrhea is an extremely common sexually transmitted disease in the United States. It infects over 800,000 new people a year. It is caused by the bacterium Neisseria gonorrhoeae, and it can be spread by oral, vaginal, or anal sex. It can also be passed from a mother to her child during a vaginal delivery.

Gonorrhea is frequently asymptomatic. However, that doesn't mean it can't have serious health consequences. Left untreated, gonorrhea can cause pelvic inflammatory disease in women and epididymitis in men. Both of these conditions can eventually lead to infertility. Gonorrhea can also cause a disseminated infection. Disseminated gonorrhea happens when the bacteria get into the bloodstream and spread throughout the body. Symptoms of disseminated infection include fever, chills, skin blistering, and joint pain. These are different than the symptoms of a genital infection.

Symptoms of Gonorrhea

The symptoms of gonorrhea vary a lot from person to person and between men and women. Common symptoms include:

Genital Infections in Women:

Genital Infections in Men:

  • yellow, white, or green urethral discharge
  • burning on urination
  • pain and swelling of the testicles
  • some cases have no symptoms, but asymptomatic cases are less common than in women.

Rectal infections (from anal sex):

  • rectal pain
  • rectal discharge
  • rectal bleeding
  • painful bowel movements

Throat infections (from oral sex)

  • sore throat

Remember, that vast majority of gonorrhea infections, particularly in in women, are asymptomatic.

In other words, most women with gonorrhea often have no idea they are infected. This is one reason why regular STD screening is so important. If people wait for symptoms to appear, the infections can be hanging around for a long period of time before detection,. That is a longer window in which they can cause long-term fertility damage or spread to others.  Asymptomatic gonorrhea infection can also occur in men as well. However, they are much less common.

The Problem of Gonorrhea Treatment

Although theoretically straightforward to treat, the growing number of cases of antibiotic-resistant gonorrhea mean that treatment is becoming more and more difficult. Using the wrong antibiotic, or the right antibiotic the wrong way, can leave someone still infected -- with bacteria that will be even harder to get rid of on the second attempt.

Some scientists believe that gonorrhea is on the brink of becoming a public health disaster. Over time, the bacteria that cause the disease have become resistant to all but one class of antibiotics. Fluoroquinolones, which had been a standard gonorrhea treatment for many years, became essentially obsolete in the early months of 2007. That is when resistant strains were found more and more often in the general public.

In early 2012, scientists started reporting that gonorrhea was now becoming resistant to cephalosporins -- the last line of defense against infection. Today, in order to address concerns about antibiotic resistant gonorrhea, doctors have been instructed to treat it with not one but two antibiotics.The hope is that by doing so they can stop the spread of resistance in the population. Unfortunately, antibiotic resistance has continued to grow and shift. 

When treating gonorrhea, it's also important to be aware that non-genital cases of gonorrhea are more difficult to treat than genital cases. Oral and rectal gonorrhea may also be more difficult to detect.

Neither oral or anal STD testing is a standard part of doctors visits,. That is why it's important to tell you doctor both if you have regular anal or oral sex and if you have any unusual rectal or oral symptoms. Without such open and honest discussion, it's easy for such infections to go undetected for very long periods of time.

Why is Gonorrhea Called The Clap?

There is a lot of folk history about why gonorrhea is called "the clap." The most common belief is that it gained the name because doctors treated it by clapping the penis hard between their hands to force out infected secretions. However, that may not be the real story. There have also been suggestions that gonorrhea is called the clap because it derives from related French words for the terms "brothel" and "sore". No one is entirely sure. One thing is certain, however, popular wisdom is wrong about the term dating back to World War II. The Oxford English Dictionary has examples of "the Clap" being used to describe genital infections since the 1500s.

... Learn more about gonorrhea testing and ​treatment

Sources:

CDC. 2015 Sexually Transmitted Diseases Treatment Guidelines . The Centers for Disease Control and Prevention. http://www.cdc.gov/std/tg2015/gonorrhea.htm. 

CDC. Fact Sheet on Gonorrhea. http://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm. 

"clap, n.2." OED Online. Oxford University Press, September 2015. Web. 5 December 2015.

Kirkcaldy, R.D. et al. (2013). Cephalosporin-Resistant Gonorrhea in North America. Journal of the American Medical Association. 309(2):185-187. 

Martin I, Sawatzky P, Liu G, Allen V, Lefebvre B, Hoang L, Drews S, Horsman G, Wylie J, Haldane D, Garceau R, Ratnam S, Wong T, Archibald C, Mulvey MR. Decline  in Decreased Cephalosporin Susceptibility and Increase in Azithromycin Resistance in Neisseria gonorrhoeae, Canada. Emerg Infect Dis. 2016 Jan;22(1):65-7. doi: 10.3201/eid2201.151247. 

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