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If you are concerned about sexually transmitted diseases, or if you have had
sexual relations with an infected or high-risk individual, then you should see 

a medical doctor and be tested. The tests need to be ordered and interpreted by an

experienced physician only. Since the test is only a part of the diagnosis,

the actual examination is the most important factor for STD evaluation, which is why

seeing an experienced doctor is so important for you. Just a positive or negative test

 result by an online testing places - does not necessarily mean that you do or do not have STD. We

have seen many patients in our Clinic with negative Gonorrhea and Chlamydia test

results by an outside lab, who still have symptoms of urethral discomfort or tingling.

There are other bacteria transmitted through sex, so just checking Chlamydia &

Gonorrhea does not prove that that there is no other bacterial infection if you have symptom.

STD testing is not that straight-forward. For example, there are different types of Chlamydia

(LGV, Trachomatis, L, D-K ) and many different tests (blood, antibody, swab, urine,

DNA, DFA) from different sources (urethra, vaginal, urine, eye, anus, throat) that an

experienced doctor could choose depending on your history, examination and your concern.

Practice safe sex and always discuss sexual health mater with your partner.

Gonorrhea :

It is a common Sexually transmitted disease widespread around the world possibly as old as human history. The bacteria name is Neisseria Gonorrhea public commonly knows about this diagnosis and would usually blame other urethritis and similar condition to Gonorrhea. It is like many may call every brand of tissue paper as "Kleenex" or photocopy as "Xerox". Almost every patient with discharge would say "Doctor, I think I have Gonorrhea" while patient is negative for Gonorrhea and having other infectious disease. It is crucial that diagnosis of Gonorrhea being established because the treatment would be different from other Non-Gonococcal urethritis. Clinician should always get good history. I have seen many patients in the past and have complained about Gonorrhea and they received treatment by ER/ urgent care and while still having symptom. When referring to patient history then these patient just assumed they had Gonorrhea and requested and treated for that which is just wrong. Clinician must always ask good questions. If patient assume to have Gonorrhea or truly tested positive for it. Gonorrhea like to live and reproduce in moist and warm area of reproductive tract and both woman and man and also live in anus, mouth, throat and eye. The test out there is location specific means if you get tested negative in urine then it does not mean that you are negative in your throat as well.

Risk of Gonorrhea:

You could get Gonorrhea by Vaginal, anal and oral sex. Gonorrhea will infect both homosexual and heterosexual individual. Using condom is always good, but It does not provide 100% protection and you could get infected with Gonorrhea. Routine yearly testing is recommended if you are sexually active specially if you have more than one partner.

Symptom:

It is a "silent" disease and ~75% of female and ~50% of male patient have no symptom. Many patients become surprised of having positive Gonorrhea as they don't have any symptom.

Slang of symptom:

"Scratchy throat" is what Dr Arani refer to when patient having Gonorrhea in throat and have Vague sore throat.

"Creamy Discharge" is what discharge may look like thick yellow/ white and creamy

"Urethral Itching" Unpleasant feeling of itching around opening of penis and tube

"Rectal bleeding, pain" Mostly on patient in receptive of Anal sex, MSM patients

"Burning urination" some patients with Gonorrhea wrongly think they just have a simple UTI

"Abdominal, pelvic pain" Lower abdominal discomfort, sometimes lower back pain

"Testicular Pain" could be one or both testicle or around testicle

"Vaginal discharge" Some may have associated with smell or color

Gonorrhea In Throat :

Gonorrhea could infect your throat (pharynx, tonsils ..) Your doctor has to have the right information for the diagnosis of Chlamydia in throat. It could get overlook easily. If you go to your MD and complaining of sore throat you might get throat culture and get treated with certain antibiotic such as Amoxicillin. The culture might come back negative or positive of other non relevant bacteria. The main problem is regular bacterial culture will not detect Gonorrhea ! Gonorrhea has its own specific culture with specialized transport medium, so you might think your culture is negative and you might be feeling better with antibiotic while you will continue carry Gonorrhea and infect others.

Urethral Discomfort / Discharge : Variety of different type of discomfort could attributed to Gonorrhea infection such as urethral tingling, itching, burning, crawling "ant walking", stinging.

Burning upon Urination: We have seen some patients with complain of UTI and they turn out to have Gonorrhea. According to Dr. Arani it is unusual a young man having Non-STD UTI. Urethral in men is longer than women so the chance of a man gets UTI is much lower than female. If a male patients complain about burning upon urination a clinician/doctor must always ask about sexual health and keep STD in mind. In following, 3D gonorrhea anatomical diagram it would explained that the main reason that patient with gonorrhea having UTI symptom. The irritation on urethral epithelial lining causing significant pain upon urination. This lining become fragile and would put patient at risk of getting infected with other STDs such as HIV , Hepatitis C etc.

Rectal/ Anal Gonorrhea: Patient may Gonorrhea that they have anal itching, discharge, feeling wet, bleeding. In many cases we have seen patients self treated for hemorrhoid. Many over the counter hemorrhoid cream has hydrocortisone in them. Hydrocortisone is corticosteroid, it will slow and stop immunological reaction in anal mucosa membrane. According to Dr. Arani this will create "Party Time" for Gonorrhea. When you get infection your body will try to fight against it by inflammatory response. By using corticosteroid anti-inflamatory you will risk the uncontrolled infection would worsen or get disseminated.

Testicular pain: Untreated Gonorrhea might give you testicular pain and redness and swelling of skin of scrotum overlying the effected testicle.

Vaginal Discharge: As cervix is not mature enough in young female then they have higher risk of infection.

Vaginal discharge needs to be evaluated. This is a sensitive area of practicing medicine. If patient have vaginal discharge and just get tested and treated for Gonorrhea then we will never know if she was infected with other organism or not. Please refer to our Bacterial Vaginosis page link:

Nausea / fever: Mostly accompanied with Chlamydia pelvic infection.

If untreated:

PID could cause irreversible damage to pelvic tissue such as uterus, tubes , etc. which could lead to infertility, chronic abdominal pain. 40% of untreated patient with Gonorrhea develop PID

HIV infection risk might rise up to 5 times

Epididymitis is inflammation and infection of tube carries sperm from testicles

Arthritis is rare but possible complication of untreated Gonorrhea

Conjunctivitis is eye inflammation could be as result of untreated Gonorrhea

Testing: We have Many testing technique to assist us to diagnose Gonorrhea such as Culture, DNA testing, discharge analysis, swab/ urine. We will choose the technique based on your symptom your history and concern.

Treatment:

Treatment is usually involve of getting antibiotics by intramuscular injection and pills,

We give same day treatment of Gonorrhea in our institution. We could also provide partner deliver therapy for your partner(s) for your convenience. We usually choose easier medicine for partner to increase compliance.

Partner Positive:

If your partner is positive with Gonorrhea you should usually get treated regardless of testing or not. To my experience empirical treatment in these population is very important because of following 2 reasons:

1) Partner might have the Gonorrhea in throat , anus or genital and just check for one of these location will miss the diagnosis of other area

2) Partner might get false negative result due to various reasons, such as poor quality sample or technical lab issues.

in conclusion, it seems very logical to treat the partner of you are positive for gonorrhea

Test of Cure: It is available to our patients for their assurance of successfully treatment. Test of the cure means clinician test the patient after treatment for gonorrhea to make sure the infections has been resolved.

COMPARE US

TEL 323-231-6000 or 818-897-8000

Safe Sex
Although condom use is a must, you may still get STD even when using

a protective condom. Bacteria and specially viruses are so small, they could

easily slip through the condom ring around the penile shaft or when the

condom is removed or infect area which does not have coverage, however,

use protection for vaginal, oral or anal sex is highly recommended. Protection

against different STD varies with condom. For example it may decrease the

chance of NGU transmission but not much of help for molluscum or genital wart

on base of penile and pubic area.

The only way to prevent STDs is by not having sex at all. If you do have sex, you can

 lower your risk by only having sex with (1) someone who doesn't have an STD and

(2) isn't having sex with anyone else. Be careful of using your partner and always

use protection. PUBLIC HEALTH, CA link

Use Protection or Say No To Your Partner! 

We are open Monday to Friday 9:00 AM to 5:30 PM & This Saturday 9 AM to 3:30 PM

                   For your convenience we have extended our phone lines
                (323) 231-6000 -[ 714 ] 313-8011OC with Appointment   

My visit to your office in March 2009 was everything I expected and more. Yourself and your staff were very professional, friendly, and answered all my questions and concerns completely which made my travel from New York

Nic, Los Angeles CA 11/18/2008

".... I had over 50 warts :-/ ..After a few treatments, I've finally gained my self confidence back. It's a pretty embarrassing thing to have, but I'll have to say that Dr. Arani made me feel very comfortable in office from day 1. The removal of the warts healed quickly and after a few months could not even tell that I had even had them. Just ask to see his before and after photos. I would not hesitate to recommend him to my friends (although this ailment is not something I'm vocal about) so instead I'm happy to let others know on here that he is a great doctor, will make you feel very comfortable and help get things back to normal for you. My advice would be to see him at the first sign of anything such as these warts. I would have saved a lot of $$ & time had I gone in after the 1st wart showed." 

"Thank you for giving me all of the test and explanations ....I looked on the internet for other centers. There are labs, but none had a doctor." T. Braz California

"I came to Dr. Arani,...he was the only person diagnose my condition"

E. Briceno  Panorama City, California  

"It was amazing that they tested me for both HIV 1 and HIV 2 without needle with negative result in few minutes. "   Pacoima, California

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