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Gonorrhoea

gonorrhoea

If you suspect that you have gonorrhoea, see a doctor even if symptoms go without treatment. An antibiotic usually clears the infection. Your sexual partner or partners should also be tested and treated, even if they have no symptoms. You should not have sex until you have finished treatment.

What is gonorrhoea?

Gonorrhoea is an infection caused by a bacterium (germ) called the gonococcus.

How do you get gonorrhoea?

It is passed on if you have sex with an infected person. This is usually during vaginal sex. Therefore, in men, the infection usually affects the urethra (the tube between the bladder and the end of the penis).

Oral sex or anal sex can also transmit infection to the mouth or anus.

How does gonorrhoea present?

Possible symptoms in women with gonorrhoea

  • About 1 in 2 women get an increase or change in vaginal discharge.
  • About 1 in 4 women get pain in the lower part of the stomach.
  • Rarely, you may notice bleeding between periods, or heavy periods.
  • Pain when passing urine can sometimes mimic a urine infection.
  • Infection of the rectum or back of the throat (pharynx) can develop. Such infections do not usually cause symptoms, although occasionally you may notice rectal itching or a sore throat.

Possible symptoms in men with gonorrhoea

  • Infection of the urethra (urethritis) is the typical infection in men. This commonly develops 5-7 days after having sex with an affected person.

Symptoms include:

  • A discharge (fluid) from the penis. This may stain your underpants.
  • Pain or burning when you pass urine.
  • Irritation inside the penis, or a feeling of wanting to pass urine frequently.
  • Redness at the opening of the urethra at the end of the penis.
  • Gonorrhoea is believed to cause symptoms in most infected men (about 9 in 10 affected). However, about 1 in 2 women with gonorrhoea do not get any symptoms
  • The symptoms may clear over time, even without treatment. This may take up to six months but can be just a couple of weeks or so. However, without treatment, some bacteria usually remain in the urethra. It is just that the symptoms may go.

Therefore, even if symptoms go or are not present, there is a good chance that you can pass on the infection if you do not have treatment.

What tests are required?

You will normally be advised to have tests if gonorrhoea is suspected - even if symptoms go.

A urine sample and/or a swab of the discharge will be taken to try to identify the bacterium that causes gonorrhoea. In men, the swab will be taken from the urethra. In women, the swab is taken from the inside of the cervix (endocervix) and from high up in the vagina. You may also be advised to have tests for other sexually transmitted infections.

What complications are required from gonorrhoea?

In women

  • Infection can spread to the uterus (womb) to cause pelvic inflammatory disease. This can cause long-standing (chronic) pelvic pain and can lead to infertility.
  • Pregnancy can be complicated by premature labour, ectopic pregnancy or miscarriage.
  • Infection present during pregnancy can lead to infection spreading to the eyes of a newborn baby; this is called ophthalmianeonatorum.
  • Pelvic infection can spread to the liver.
  • Abscesses can develop in the Bartholin's glands on either side of the lower part of the vaginal opening.

In men

  • In a small number of cases the infection travels up the urethra to the prostate. Rarely, a stricture (narrowing) of the urethra may develop.
  • Spread in the bloodstream to other parts of the body is rare.
  • Men who have sex with men can get infections of the anus and throat.

How do you treat gonorrhoea?

The usual treatment is a single injection of an antibiotic plus a single large dose of a different antibiotic taken by mouth. However, sometimes other treatment regimes and schedules are used. For example, if you have an allergy to the usual antibiotic, or if you have another infection at the same time.

Does my sexual partner need treatment?

Yes. They should be tested for infection, even if they have no symptoms. Treatment with antibiotics is usually advised for sexual partners, even if the tests are negative, because:

  • Bacteria that cause gonorrhoea are often passed on during sex. Tests for bacteria are not foolproof. Treatment with antibiotics helps to make sure that any possible infection is cleared.
  • If a sexual partner is infected and not treated, infection can be passed back to you.
  • If you have gonorrhoea without symptoms then you may have had it for some time. In this situation any sexual partners within the previous three months should be tested and treated.

Follow-up

A doctor or healthcare professional will normally want to know that treatment has worked. It is usual to be reviewed soon after you finish treatment to check that symptoms have gone and to do a test to check that the infection has gone. Sometimes further treatment (perhaps with a different antibiotic) is needed if the infection has persisted despite treatment.
You should not have sex until both you and your sexual partner have finished treatment.

Can gonorrhoea be prevented?

Wearing a condom during sex (including anal sex and oral sex) helps to prevent the spread of sexually transmitted infections.

The risk of sexually transmitted infections increases with the number of changes of sexual partner.


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