Gonorrhea in Singapore – An Overview

Gonorrhea in Singapore is the second most common sexually transmitted infection (based on 2018 data from the Department of Sexually Transmitted Infections Control). It is caused by the bacterium Neisseria gonorrhoeae, a Gram-negative diplococcus that mainly infects the mucosal surfaces of the urethra and endocervix. Gonorrhea is also commonly known by its nickname “The Clap”. The nickname refers to a treatment that used to clear the blockage in the urethra from gonorrhea pus, where (in males) the penis would be ‘clapped’ on both sides simultaneously.

Neisseria gonorrhoeae can be found in the fluid discharges from the penis or vagina and can be spread via unprotected sexual intercourse be it – vaginal sex, anal sex, or oral sex. This bacterium is capable of living well within the mucosal surfaces of the mouth (pharynx) and rectum. It can also infect the conjunctiva of the eyes, sometimes obtained via contact with the genital secretions of an infected patient. In women, gonorrhea can travel further upwards and cause pelvic inflammatory disease (PID), a common but serious complication that can lead to female infertility. Gonorrhea can also be transmitted vertically from an infected mother to her infant during vaginal delivery.

Symptoms of Gonorrhea

Many people infected with gonorrhea may not show any symptoms. Women are more likely not to have symptoms than men. When the disease causes symptoms, they usually develop within 10 days after sexual intercourse with an infected individual.

Symptoms of Gonorrhea in Women

• An unusual vaginal discharge, which may be thin or watery and green or yellow in color;
• Pain or a burning sensation when urinating;
• Bleeding between periods, heavier periods, and bleeding after sexual intercourse;
• Pelvic pain, especially during sexual intercourse; or
• Sore, dry throat

Symptoms of Gonorrhea in Men

• An unusual discharge from the tip of the penis, which may be white, yellow or green;
• Pain or a burning sensation when urinating;
• Inflammation of the foreskin of the penis;
• Pain or tenderness in the testicles; or
• Sore, dry throat

Infection in the Rectum, Throat, or Eyes

Both men and women can develop an infection in the rectum, throat, or eyes by having unprotected anal or oral sex. If infected semen or vaginal fluid comes into contact with the eyes, gonococcal conjunctivitis (gonorrhea of the eye) may develop. Infection in the rectum can cause discomfort, pain, or discharge. Infection in the eyes can cause pain, irritation, swelling, and discharge, and infection in the throat usually causes no symptoms.

Diagnosis for Gonorrhea

Diagnosis of gonorrhea includes a medical history and a physical exam. There are discreet testing options for Gonorrhea in Singapore, for those who prefer greater privacy.

Gonorrhea Swab Test

This involves an internal examination, where the trained clinician will take a swab from the urethra in men and the cervix in women, to be tested for Neisseria gonorrhoeae.

Urine Sample Test

The patient is advised to provide a urine sample for PCR testing of gonorrhea bacteria. It is important to hold the urine for at least 2 hours beforehand, as recent urination can wash the bacteria away affecting the test results.

Treatment for Gonorrhea in Singapore

Early diagnosis and treatment of gonorrhea can reduce the risk of complications developing, such as pelvic inflammatory disease (PID) or infection in the testicles. Complications that arise from long-term infection are much more difficult to treat.

Gonorrhea is treated with a single dose of antibiotics, specifically Ceftriaxone. Other types of antibiotics may be used for patients who have an allergy to Cephalosporin or for patients with antibiotic-resistant strains of Neisseria gonorrhoeae. The patient is advised to follow up in the clinic 2 weeks after treatment with a repeat swab or urine test to ensure clearance and to abstain from sexual contact until the treatment for the infection is completed. Patient’s sexual partners are advised to get tested and treated for gonorrhea as well.

Some clinics where treatment for Gonorrhea is available include Tanjong Pagar Medical Clinic (Central) DSC Clinic (Central), Cross Street Medical Clinic (Central), Shim Clinic (East), and Dr Ben Clinic @ Jurong West (West).