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Gonorrhoea


Expert reviewer, Dr Adrian Raby, General Practitioner
Next review due July 2022

Gonorrhoea is one of the most common sexually transmitted infections (STIs) in the UK. The number of people getting the infection has increased in recent years. It’s most common in people under 25, although if you’re sexually active, you can get it at any age.

Gonorrhoea can usually be easily treated with antibiotics. But if you don’t get appropriate treatment, it can lead to complications.

A woman is walking walking on the street

About gonorrhoea

Gonorrhoea is caused by a type of bacteria called Neisseria gonorrhoeae. The bacteria can infect the tube that carries urine out of your body (the urethra), your back passage, throat or eyes. In women, it can also infect your cervix (entrance to your womb). You can catch it through having unprotected vaginal, anal or oral sex with an infected person, as well as by sharing sex toys.

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

Symptoms of gonorrhoea

You might not get any symptoms of gonorrhoea — around half of women and one in 10 men don’t. 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 — this could be white, yellow or green
  • pain when you pee or finding it difficult to go
  • pain and swelling in your testicles — but this doesn’t happen often

In women, symptoms of gonorrhoea include:

  • an increase or change in the normal discharge from your vagina — it may be yellow or green in colour
  • pain in your lower abdomen
  • pain when you pee or finding it difficult to go
  • pain when you have sex
  • more rarely, heavier periods, or bleeding between your periods or when you have sex

If you have a gonorrhoea infection in your rectum (back passage), you may have some pain, discomfort, itching and a discharge with mucus or bleeding from your anus.

If you get an infection in your eyes (conjunctivitis), you may have pain, swelling and discharge from your eyes. A gonorrhoea infection in your throat will rarely give you any symptoms but occasionally may cause a sore throat or tonsillitis.

If you have any of these symptoms or you think you could be at risk, you should arrange to get tested. Find out more about who should get tested and where to go for a test in our section: Diagnosis of gonorrhoea below.

Diagnosis of gonorrhoea

Who should have a test?

The only way to know for sure if you have gonorrhoea is to have a test. If there’s any chance you may have the infection, it’s important to get tested and treated as soon as possible. This will reduce the risk of passing on the infection to anyone else. You should have a test if:

  • you or your partner has any of the symptoms listed in the section above
  • you’ve recently had unprotected sex (sex without a condom) with a new partner
  • your partner has had unprotected sex with another partner
  • a current or recent partner tells you they have a sexually transmitted infection

Where to get tested

There are a number of services where you can get tested for gonorrhoea and other STIs. These include genitourinary medicine (GUM) and sexual health clinics, your GP surgery, contraception clinics and some antenatal services. You can also pay to go to a private clinic.

If you see your GP, they may give you an initial assessment, but they’ll usually refer you to a GUM or sexual health clinic if you need any further tests and treatment. You can also make your own appointment directly with a GUM or sexual health clinic without seeing your GP. All visits are confidential, your details won’t be sent to your GP without your consent.

In some areas, sexual health services may provide sample kits that you use yourself at home and then send to be tested. It’s also possible to buy kits to test yourself at home but these aren’t always very accurate. It’s best to go to a clinic to get tested if you can.

How is the test done?

There are different ways to take samples to test for the infection.

  • If you’re a man, you’ll usually be asked to give a urine sample. The doctor or nurse may also take a sample of any discharge from the tip of your penis, using a swab (a small, round cotton bud).
  • If you’re a woman, you’ll usually need to have a swab from your vagina tested. You may be asked to take the swab yourself or your doctor or nurse may take it for you as part of an examination.
  • If you’ve had anal or oral sex, you may need to have a swab from your back passage or throat.

Getting your results

Sometimes, the doctor or nurse doing your test may be able to tell you the result there and then. But other times, your samples may need to be sent to a laboratory to be tested, and it might take up to two weeks to get your result.

If the tests show that you have gonorrhoea, it’s important to inform anybody you’ve had sex with recently. This can mean in the last three months, although your doctor will advise you. They may be at risk of having the infection, so it’s important that they’re tested too. Sexual health clinics can support you with this.

Treatment of gonorrhoea

Gonorrhoea is treated with antibiotics. You may be offered treatment before your test results are back if your partner has a confirmed diagnosis of gonorrhoea. You’ll be given either a single-dose tablet or an antibiotic injection, depending on whether or not your doctor has your test results before starting treatment.

Tell your doctor or nurse if you’re pregnant of breastfeeding. You’ll still be able to have antibiotic treatment, but your doctor will choose an antibiotic that’s safest for use in pregnancy or while breastfeeding.

If you also have chlamydia, you’ll be offered treatment for this at the same time. Some of the treatments for gonorrhoea also act against chlamydia.

How long does it take for gonorrhoea to go?

If you take your antibiotic treatment as directed, you should start to notice an improvement in your symptoms within a few days. You’ll usually be offered a follow-up test a week or so after having the treatment to check that the infection has gone. If you delay treatment, you risk developing more serious problems, as well as passing the infection to other people. For more information, see our section: Complications of gonorrhoea below.

You should wait for seven days after both you and your partner have completed treatment before you have sex again. If you choose to have sex before this point, using a condom will reduce your risk of passing the infection between you again.

Complications of gonorrhoea

If you get treatment for gonorrhoea early, it’s usually easy to get rid of the infection and you’re unlikely to have 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. The more times you have the infection, the more likely you are to develop complications.

  • In women, gonorrhoea can spread to your womb (uterus), fallopian tubes and ovaries, leading to pelvic inflammatory disease. Pelvic inflammatory disease can cause pain in your pelvis, and lead to infertility and ectopic pregnancy.
  • If you get gonorrhoea when you’re pregnant and you don’t get it treated, it can lead to miscarriage. It’s also possible to pass gonorrhoea to your baby when you give birth. This can cause severe conjunctivitis (infection of the eyes) in babies, which must be treated to prevent the possibility of your baby going blind.
  • 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.
  • More rarely, the infection can spread more widely around your body, causing symptoms such as pain and inflammation in your joints, and skin lesions.

Prevention of gonorrhoea

There are several things you can do to lower your risk of getting or passing on gonorrhoea and other sexually transmitted infections (STIs).

  • Use condoms when you have vaginal, oral or anal sex. You can also use latex squares that cover a woman’s genitals if you’re having oral 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 unprotected sex with a new partner, you could both consider having a test for gonorrhoea and other STIs.

Frequently asked questions

  • Yes, you’ll usually be offered an appointment for a follow-up test one to three weeks after your initial treatment, to check that your infection has gone.

    This is especially important if:

    • your symptoms haven’t gone away
    • you may have come into contact with gonorrhoea again — for instance if you had unprotected sex with a partner before you both received treatment
    • you had the gonorrhoea infection in your throat

    If the follow-up test finds that you still have gonorrhoea, this could mean either that you’ve become infected again or that your infection is resistant to the antibiotics used. If the first treatment hasn’t worked, you risk passing on the infection to someone else and developing complications. It might be that you need to try treatment with a different type of antibiotic.

  • If you think you might have been infected with gonorrhoea, don’t delay getting checked out. The sooner gonorrhoea is treated, the easier it is to treat and the less likely you are to develop complications.

    You might be advised to wait about three days after you last had sex to have your first test. And sometimes you may be asked to return for a repeat test to confirm the result. Sometimes your doctor may recommend starting treatment before your results come back. This may happen if you have symptoms and have had unprotected sex in the last two weeks with someone you know to have the infection.

    You can still have a test even if you don’t have any symptoms. Around one in 10 men and half of women have no symptoms even though they have the infection.

  • Yes, it’s common to have other STIs, especially chlamydia, at the same time as gonorrhoea. Having gonorrhoea also seems to increase your risk of getting infected with HIV, if you’re exposed to the virus. It’s recommended that you’re tested for other STIs, including HIV when you’re being tested for gonorrhoea.


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Related information

    • Sexually transmitted infections and screening for chlamydia in England, 2018. Health Protection Report. Public Health England, June 2019. gov.uk
    • Gonorrhoea infection. BMJ Best Practice. bestpractice.bmj.com, last reviewed May 2019
    • Gonorrhoea. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised March 2019
    • Gonorrhoea. Family Planning Association, May 2017. www.fpa.org.uk
    • British Association for Sexual Health and HIV national guideline for the management of infection with Neisseria gonorrhoeae. British Associaiton for Sexual Health and HIV (BASHH), 2019. www.bashhguidelines.org

  • Reviewed by Pippa Coulter, Freelance Health Editor, July 2019
    Expert reviewer, Dr Adrian Raby, General Practitioner
    Next review due July 2022



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