Gonorrhoea in Women

In women, gonorrhoea is most likely to infect the urethra and the canal of the neck (or cervix) of the womb. The outer parts, or vulva, also become irritated by the discharge which subsequently appears.

Symptoms

In the early stage there is some scalding during the passage of urine, with soreness, discomfort, and a sense of weight in the pelvis. In some cases the vulva becomes greatly inflamed with profuse discharge, but generally the symptoms are less severe and the discharge is not regarded as being very abnormal.

Complications in the Female

Bartholiivian Abscess

Bartholin's glands in the vagina become inflamed and abscesses form. The fluid may be withdrawn by an aspirator and a penicillin solution injected. Chronic infection may necessitate surgical removal of the gland.

Cervical Erosion

Gonococcal infection sometimes causes acute erosion of the cervix which heals rapidly if treated with anti-biotics but chronic erosions require cautery or excision.

Salpingitis

In neglected gonorrhoeal conditions, the sudden onset of acute abdominal pain usually indicates that the disease has spread up to the Fallopian tubes at the sides of the womb, causing fever and abdominal pain. The first attack may settle down in a few days, or it may develop into peritonitis, with suppuration or abscess formation in one or both tubes. Many cases of sterility in women are due to gonorrhaeal infection of the Fallopian tubes. which causes subsequent blockage so that the eggs cannot become fertilised or pass down from the ovaries into the womb.

It will therefore be seen that promiscuous intercourse holds very grave danger for women who, if they become infected with gonorrhoea, may be deprived of the ability to bear children and of family happiness.

Pain in acute salpingitis is relieved by aspirin or other analgesics; morphine is sometimes required. The patient is nursed in a semi-recumbent position and antibiotics administered until the fever has gone. In severe chronic conditions hysterectomy may be necessary.

Proctitis

Rectal infection occurs in many cases in both men and women. Treatment is by penicillin injections plus proflavine suppositories.

Treatment

The treatment is in general the same as for men. A woman with recent gonorrhoeal infection should not take vigorous exercise, especially during the first menstrual period after infection. A penicillin or other antibiotic is given by a doctor, and the patient does not generally require to be kept in bed unless the disease extends to the Fallopian tubes and pelvis.

A surgical operation is sometimes necessary for the removal of the infected tubes, but this is not generally undertaken during the acute stage of inflammation.

Inflammation of the Vagina and Vulva in Girls

Gonorrhoeal infection of the vagina in young girls up to the age of puberty is often difficult to cure, and is liable to relapse. It is usually caught by direct contact such as may occur in sleeping with a grown-up person with gonorrhoea, or from infected discharge on the fingers of an adult. Such cases in children must be treated with great care, and the child should be isolated and kept away from school and from other children.

Penicillin is the usual antibiotic used, and hot alkaline sitz baths twice daily are advised. Bismuth subgallate may be used as an external dusting-powder after bathing with dilute solution of potassium permanganate (1 in 10,000 parts). Tests must be made before the child can be considered to be cured, or before she may be allowed to mix with other girls.

Ophthalmia Neonatorum

Any infant showing purulent or thick discharge from the eyes within three weeks after birth is notifiable by law. The case must be fully and promptly investigated since it may be due to, gonorrhoea which-is responsible for a high percentage of all cases of blindness. This blinding condition may be prevented if the mother receives proper treatment during pregnancy.

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