Gonorrhoea

Overview

Gonorrhoea is a common sexually transmitted infection (STI) caused by bacteria that can infect the urethra, cervix, rectum, throat, and eyes.

Yes. Gonorrhoea is the second most common bacterial STI in the UK, with around 80,000 cases reported each year.

It affects anyone who is sexually active, regardless of gender. Young people aged 15–24 and men who have sex with men are the most affected.

Symptoms

Common symptoms

• Pain or burning when urinating
• Unusual discharge from the penis or vagina
• Bleeding between periods in women
• Pain or swelling in the testicles
• Sore throat if infected through oral sex
• Pain or discharge from the rectum if infected through anal sex

Symptoms in children

• Gonorrhoea in children is very rare. If it does occur, it may cause vaginal or penile discharge, soreness, or pain. In a child, it can be a sign of sexual abuse, and this must be investigated carefully by a specialist team.

Symptoms in older adults

• Anyone who is sexually active can get gonorrhoea at any age. Symptoms in older adults are the same as in younger people, but they are sometimes mistaken for bladder or urinary tract infections. As with young people, it can also be symptom-free.

Causes

Main causes

• Infection with the bacterium Neisseria gonorrhoeae
• Spread through unprotected vaginal, anal, or oral sex
• Sharing sex toys without washing or covering them with a new condom
• From an infected mother to her baby during childbirth

Risk factors

• Having a new sex partner or multiple partners
• Not using condoms consistently
• Having sex while under the influence of drugs or alcohol
• Being a man who has sex with men
• Previously testing positive for another STI

When to see a doctor

See a doctor urgently if:

• You have symptoms like discharge, burning, or pelvic pain
• A sexual partner has been diagnosed with gonorrhoea
• You are pregnant and think you may have been exposed

Book a routine appointment if:

• You have a new partner and want an STI check-up
• You answered yes to any risk factor and want peace of mind
• You are due for a routine sexual health screen

Diagnosis

A doctor or nurse will ask about your symptoms and sexual history, and may take a swab or a urine sample to test for the bacteria. The test is quick and usually painless.

Tests that may be done

• Urine sample (you may be asked not to urinate for 1–2 hours beforehand)
• A gentle swab of the affected area (penis, vagina, cervix, rectum, or throat)
• Sometimes a blood test if the infection has spread

What to expect at your appointment

Your test will be sent to a lab and results usually come back within a few days. If you have symptoms or a partner with confirmed gonorrhoea, you may be offered treatment immediately while waiting for results. You might also be offered a test of cure after treatment.

Treatment

Gonorrhoea is treated with antibiotics, usually given as an injection plus a course of tablets. It is very effective and cures the infection in more than 95% of cases. You will be asked to avoid all sexual contact for at least a week after treatment and until your partner has also finished treatment.

Self-care at home

• Take the full course of antibiotics exactly as prescribed, even if you feel better
• Avoid all sexual contact (including oral and anal sex) until you and your partner have finished treatment and have been cleared
• Drink plenty of fluids and rest to help your body recover
• Tell any recent sexual partners so they can be tested and treated – this is important to stop the infection spreading
• Attend any follow-up test to make sure the infection has gone

Medical treatments

The standard treatment is antibiotic therapy. Your doctor will prescribe a single antibiotic injection or a short course of oral antibiotics, sometimes in combination, to reduce the risk of antibiotic resistance. Never share your antibiotics with anyone, and do not save leftover antibiotics for future use. Your doctor will tell you the exact medication and dose based on your situation.

When is surgery considered?

Surgery is not usually needed for gonorrhoea. In rare cases, a complication like an abscess (a pocket of pus) or severe pelvic inflammatory disease may need surgical drainage or a procedure to remove damaged tissue. This is rare and would be discussed with you by a specialist team.

Living with this condition

After starting treatment, symptoms like discharge or burning usually improve within a few days. Complete the full antibiotic course and attend a follow-up test if offered. It is normal to feel anxious or embarrassed, but remember that gonorrhoea is easily curable and you have taken a responsible step by getting treated.

Lifestyle tips

• Use condoms with all new partners until you have been given the all-clear
• Consider telling your current or recent partner(s) so they can also get tested
• Avoid alcohol while taking antibiotics, if advised by your doctor
• Get tested for other STIs, including HIV, as they can occur together

Diet and exercise

There is no special diet or exercise needed for gonorrhoea. Eating nutritious meals and staying hydrated supports your immune system. If you have pelvic pain or feel unwell, rest as needed and avoid strenuous exercise until your symptoms improve.

Mental health and emotional wellbeing

A gonorrhoea diagnosis can trigger shame, fear, or stress. These feelings are natural, but try to remember that it is a common, treatable infection. Talking to a counsellor, a trusted friend, or a sexual health nurse can reduce anxiety and help you move forward.

Prevention

Yes, gonorrhoea can be prevented by using condoms consistently and correctly during vaginal, anal, and oral sex. Wash sex toys before and after use, or put a new condom on them. Being in a mutually monogamous relationship with a tested partner also reduces your risk.

Complications

If left untreated

• In women: pelvic inflammatory disease (PID), which can cause chronic pelvic pain, ectopic pregnancy, and infertility
• In men: epididymitis (painful swelling of the tube that carries sperm), which can reduce fertility
• Spread to the blood stream (disseminated gonococcal infection) causing fever, joint pain, and skin rash
• Increased risk of getting or passing on HIV
• In newborns: eye infection (ophthalmia neonatorum) which can damage eyesight if not treated quickly

Long-term outlook

With prompt treatment, gonorrhoea is completely curable and most people recover with no lasting problems. Even if complications have already started, treatment can stop them from getting worse and often preserves fertility. It is never too late to get tested—seeking help today gives you the best chance of a full recovery.

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