Gonorrhoea

Published by Bupa's Health Information Team, November 2011.

This factsheet is for people who have gonorrhoea, or who would like more information about it.

Gonorrhoea is a sexually transmitted infection (STI) caused by Neisseria gonorrhoeae bacteria. The infection is usually passed from person to person through unprotected sex. However, it can also be passed on from an infected mother to her baby during a vaginal birth.

About gonorrhoea

Gonorrhoea is a common STI in the UK, it was diagnosed in over 16,500 people in 2010. There are likely to be many more people who remain undiagnosed because up to half of women and one in 10 men have no symptoms of gonorrhoea so don’t seek advice from a doctor. It’s more common in men aged 20 to 24 and women aged 16 to 19 than in other age groups.

Gonorrhoea can be treated with antibiotics but, if left untreated, it can cause health and fertility problems.

Symptoms of gonorrhoea

Often, you can be infected with gonorrhoea and have no symptoms. However, there are some symptoms to look out for, which usually begin within the first 10 days of being infected.

In men, symptoms of gonorrhoea include:

• an unusual discharge from your penis, which may be yellow or green
• pain when passing urine
• pain and swelling in the testicles

In women, symptoms of gonorrhoea include:

• an increased or unusual discharge from your vagina, which may be yellow or green
• pain or difficulty passing urine
• pain in your lower abdomen (tummy)
• pain during sex
• bleeding from your vagina after sex or between periods – this is less common
• heavier periods

If you have gonorrhoea infection in your rectum (back passage), it can cause pain and discomfort and a discharge from your anus, but often you will have no symptoms. Infection in your eyes commonly causes conjunctivitis – inflammation of the transparent surface layer that covers the white of your eye (the conjunctiva). Infection in your throat rarely causes any symptoms.

Complications of gonorrhoea

If gonorrhoea is treated early, it’s less likely to cause further problems. If it’s left untreated, there is a risk of the infection spreading to other parts of your body. Not everyone who gets gonorrhoea will have complications, but the more times you have the infection, the more chance there is of complications happening.

In women, infection with gonorrhoea can lead to pelvic inflammatory disease. This is when the infection spreads to the womb (uterus), fallopian tubes and ovaries. Some women have pain and discomfort in their pelvis, but there may be no symptoms. Pelvic inflammatory disease can lead to further complications, including infertility because of blocked fallopian tubes and ectopic pregnancy (when pregnancy occurs outside the womb, for example, in one of the fallopian tubes).

In men, complications caused by gonorrhoea include infection in the prostate gland or in the testicles, which may lead to long-term pain and inflammation (swelling) in the tubes that carry sperm. These tubes can become blocked and this may lead to infertility.

The infection can spread to other parts of your body, which could give you symptoms such as fever, pain, tiredness, joint pain and swelling or a rash. Your heart, joints and spine can be affected. You would need to be treated in hospital for this.

Causes of gonorrhoea

Gonorrhoea is caused by bacteria called N. gonorrhoeae. These bacteria can infect the neck of the womb (cervix), the tube that carries urine from the bladder and out through the penis or vulva (urethra), the rectum, the throat and, very rarely, the eyes.

N. gonorrhoeae can be found in the semen of men and the vaginal fluids of women who have the infection. You can get or pass on gonorrhoea during vaginal, anal or oral sex, as well as by sharing sex toys.

Gonorrhoea can also be passed on from an infected mother to her baby during a vaginal birth.

Diagnosis of gonorrhoea

If you think you may have gonorrhoea, see your GP or go to a sexual health clinic to be tested. Your GP will most likely refer you to a sexual health clinic for testing and treatment. You can have a test for gonorrhoea even if you don't have any symptoms.

You don't have to ask your GP to refer you to a sexual health clinic - you can make your own appointment. All visits are confidential and you don't have to give your real name. Details won't be sent to your GP without your consent.

There are different ways to test for gonorrhoea.

• You may be asked to provide a sample of urine. You may be advised not to pass urine for up to two hours before this test.
• A doctor or nurse may use a swab (similar to a small round cotton bud) to take a sample of cells from the urethra, cervix or vagina (for women) or from the tip of the penis (for men). If you're female, you may have the option to collect a sample of cells from your vagina yourself using a swab or a tampon.
• If you have recently had anal or oral sex, a doctor or nurse may use a swab to take a sample from your rectum or throat.

The samples will be sent to a laboratory for testing, or the doctor may look for the bacteria under a microscope and give you the result immediately.

If the tests show that you have gonorrhoea, it's important to contact your previous partners who may be at risk to prevent them from spreading the infection to others. Clinics can send anonymous letters on your behalf if you're willing to provide details.

Treatment of gonorrhoea

You will be prescribed antibiotics to treat gonorrhoea. You will usually be given this as a single dose tablet or a single injection. You may also be treated for chlamydia at the same time because the two infections often occur together.

The antibiotics used to treat gonorrhoea can interfere with some forms of contraception such as the contraceptive pill or patch. Ask your doctor or nurse for advice on using alternative contraception during and after your treatment for gonorrhoea.

Once diagnosed with gonorrhoea, it's important to wait until you and your partner have completed your treatment before you have sex again. This will usually be seven days after taking the single dose of antibiotic. Alternatively, your doctor may offer to test you again to check whether the treatment has worked. You will be advised to wait until you are given you the 'all clear' before you have sex again.

Special considerations

If you’re pregnant or breastfeeding

Tell your doctor if you’re pregnant or breastfeeding. He or she will be able to choose an antibiotic that is safe for your baby.

There can be complications of untreated gonorrhoea when you’re pregnant. These include your baby being born prematurely or your waters breaking too early. It’s also possible for a mother to pass on gonorrhoea to her baby during a vaginal birth. This can cause conjunctivitis in babies, which must be treated. If this is left untreated, it can lead to blindness.

Prevention of gonorrhoea

There are ways to lower your risk of getting or passing on gonorrhoea.

• Use condoms when having vaginal, oral or anal sex.
• Try not to share sex toys. If you do share them, wash them or cover them with a new condom before anyone else uses them.
• Before having sex with a new partner, you could both consider having a test for gonorrhoea and other STIs.

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.