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Gonorrhoea

Gonorrhoea is a sexually transmitted infection (STI) – it’s the second most common STI in the UK. It’s more common in people under 25, in men who have sex with men, and among people who live in large cities. It can potentially be passed on to babies during childbirth. Gonorrhoea can be treated with antibiotics.

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Details

  • Symptoms Symptoms of gonorrhoea

    You might not get any symptoms of gonorrhoea – around half of women and one in 10 men don’t get any. If you do get symptoms, they usually begin in men within the first two to five days of infection, and for women within 10 days.

    In men, symptoms of gonorrhoea include:

    • an unusual discharge from your penis that’s sometimes a yellow colour
    • pain when you wee, or finding it difficult to go
    • itching around the tip of your penis
    • pain and swelling in your testicles, but this doesn’t happen often

    In women, symptoms of gonorrhoea include:

    • more discharge from your vagina or an unusual discharge that’s a yellow colour
    • a fever
    • pain when you wee, or finding it difficult to go
    • pain in your tummy (abdomen) or pelvis
    • pain when you have sex
    • bleeding between your periods, or when you have sex
    • heavy periods

    If you have a gonorrhoea infection in your rectum (back passage), it can give you some pain and discomfort. This can happen to both men and women. You can also get a discharge from your anus.

    If you get an infection in your eyes, you might get conjunctivitis. A gonorrhoea infection in your throat will rarely give you any symptoms but you can still pass on the infection to others through oral sex.

    If you have any of these symptoms or think you could be at risk, visit a sexual health clinic or see your GP. Some family planning clinics also provide testing and treatment.

  • Diagnosis Diagnosis of gonorrhoea

    If you go and see your GP, they’ll usually refer you to a sexual health clinic to be tested and to get treatment. You can also make your own appointment. All visits are confidential and your details won’t be sent to your GP without your consent.

    You can have a test for gonorrhoea even if you don’t have any symptoms. There are different ways to take samples to test for the infection.

    • A urine sample. This is normally just used in men. You may be asked not to go to the toilet for at least an hour before this test.
    • A swab (similar to a small, round cotton bud). Your doctor or nurse will take the sample from your urethra, cervix or vagina (in women) or from the tip of the penis (in men). If you’ve had anal or oral sex, a doctor or nurse may use a swab to take a sample from your rectum or throat.

    Your samples may be sent to a laboratory to be tested, or will be tested in the sexual health clinic. The results of some tests might be available immediately, others may take up to 10 working days.

    If the tests show that you have gonorrhoea, it’s important to contact anybody you’ve had sex with recently (in the last three months). They may be at risk of having the infection. If they are informed, it will help to prevent them from spreading it to others. Sexual health clinics can support you with this.

    Taking a sample at home

    In women, it’s sometimes possible for you to collect a sample of cells from your vagina yourself using a swab. You can then post this, following your health clinic’s instructions.

  • Treatment Treatment of gonorrhoea

    You’ll be prescribed a combination of two antibiotics to treat gonorrhoea. You usually take a single-dose tablet and have an injection. Your doctor or nurse may offer you treatment for chlamydia at the same time because people often get the two infections together.

    Once you’re 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 you start taking antibiotics.

    Your doctor or nurse may offer to test you again a week later to check if the treatment has worked or not. Wait until you get the ‘all clear’ before you have sex again.

    If you’re pregnant or breastfeeding

    Tell your doctor or nurse if you’re pregnant or breastfeeding. They’ll choose an antibiotic that’s safest for your baby.

    If you don’t get treatment for gonorrhoea, it can cause complications if you become pregnant. These include your baby being born prematurely or your waters breaking too early. It’s also possible to pass on gonorrhoea to your baby when you give birth. This can cause severe conjunctivitis in babies, which must be treated to prevent the possibility of your baby going blind.

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  • Causes Causes of gonorrhoea

    Gonorrhoea is caused by bacteria called Neisseria gonorrhoeae. These bacteria can infect:

    • in women, the neck of your womb (cervix)
    • your urethra (the tube that carries urine from your bladder and out of your body)
    • your rectum
    • your throat
    • your eyes

    N. gonorrhoeae is found in semen in 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.

    A mother can also pass on gonorrhoea to her baby when she gives birth.

  • Complications Complications of gonorrhoea

    If you get treatment for gonorrhoea early, it’s less likely to cause you any further problems. If you don’t get treatment, there’s a risk the infection might spread to other parts of your body and cause complications. Not everyone who gets gonorrhoea will have complications, but the more times you have the infection, the greater your chance of becoming infertile, for example.

    • In women, gonorrhoea can lead to pelvic inflammatory disease if the infection spreads to your womb (uterus), fallopian tubes and ovaries. Pelvic inflammatory disease can make you infertile and cause ectopic pregnancy.
    • In men, a gonorrhoea infection can spread to your testicles. This may lead to pain and inflammation (swelling) in the tubes that carry sperm. It’s possible this can make you infertile, but this is rare.

    The infection can potentially spread to other parts of your body too. You can get symptoms such as:

    • a fever
    • pain
    • tiredness
    • pain and swelling in your joints
    • a rash

    Your heart and spine can also be affected.

  • Prevention Prevention of gonorrhoea

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

    • Use condoms when you have vaginal, oral or anal sex.
    • Don’t share sex toys. If you do, wash them well or cover them with a new condom before anyone else uses them.
    • Before you have sex with a new partner, you could both consider having a test for gonorrhoea and other STIs.
  • FAQ: Getting tested How soon can I have a test for gonorrhoea?

    If you think you might have been infected with gonorrhoea, don’t delay getting tested. The sooner gonorrhoea is treated, the better your chance of making a full recovery and having fewer complications. It’s best to wait about three days after you last had sex to have your first test. Although it may take up to 10 days before gonorrhoea can be detected. Therefore, you might need to go back for further tests a week or two later before you can be sure of the result.

    You can still have a test even if you don’t have any symptoms. Around one in 10 men and half of women will have no symptoms even though they have the infection. If there’s a high chance you’ve been infected, you may be offered treatment before your results come back. This can happen if your partner has tested positive for gonorrhoea, for example.

  • FAQ: Other sexually transmitted infections (STIs) Is it likely I have another STI?

    Yes, people who have gonorrhoea often have other STIs too. It’s a good idea to be tested for other STIs when you’re being tested for gonorrhoea (if you’re offered other tests).

    Around one in three people who have gonorrhoea also have chlamydia. And research suggests that if you have gonorrhoea, you could double your risk of getting infected with HIV if you’re exposed to the virus.

  • FAQ: Re-testing After treatment, do I need another test?

    Yes, it’s a good idea to go to your sexual health clinic to be tested to ensure that the infection has gone.

    The bacteria that cause gonorrhoea are beginning to show resistance to the antibiotics used to treat the infection. This means the infection is now more difficult to treat. This is one reason why your clinic will ask you to return after you’ve finished your course of treatment. They can check that you’re no longer infected. Other reasons to go back for another test include:

    • still having symptoms that haven’t gone away
    • having the gonorrhoea infection in your throat
    • being pregnant

    It’s important to keep your appointment for the final test because you may need some more treatment. If the first treatment hasn’t worked, you risk passing on the infection to someone else, and developing complications.

  • Other helpful websites Other helpful websites

    Further information

    Sources

    • Gonorrhoea infection. BMJ Best Practice. bestpractice.bmj.com, last updated 21 September 2015
    • Health protection report: infection report. Public Health England. www.gov.uk, published 11 October 2016
    • Gonorrhoea. British Association of Sexual Health and HIV. www.bashhguidelines.org, published 2012
    • Gonorrhoea. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised September 2014
    • Gonorrhoea. PatientPlus. patient.info/patientplus, last checked 25 September 2014
    • Guidance for the detection of gonorrhoea in England. Public Health England. www.gov.uk, published August 2014
    • Find a clinic. fpa. www.fpa.org.uk, accessed 29 November 2016
    • Making it work. A guide to whole system commissioning for sexual health, reproductive health and HIV. Public Health England. www.gov.uk, revised March 2015
    • Fajardo-Bernal L, Aponte-Gonzalez J, Vigil P, et al. Home-based versus clinic-based specimen collection in the management of Chlamydia trachomatis and Neisseria gonorrhoeae infections. Cochrane Database of Systematic Reviews 2015, Issue 9. doi:10.1002/14651858.CD011317.pub2
    • 2015 BASHH CEG guidance on tests for sexually transmitted infections. British Association for Sexual Health and HIV. www.bashhguidelines.org, amended December 2015
    • Gonorrhoea. fpa. www.fpa.org.uk, published May 2016
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    Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, February 2017

    Expert reviewer Dr Adrian Raby, General Practitioner, Abingdon Medical Practice

    Next review due February 2020

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