Gonorrhoea overview

Overview

Gonorrhoea is a bacterial infection that is passed from one person to another through sexual contact. It can infect the genitals, rectum, and throat. With proper treatment, it is curable, but if left untreated it can cause long-term health problems.

Yes, gonorrhoea is one of the most common STIs worldwide. It affects millions of people each year, particularly in younger sexually active adults.

Gonorrhoea can affect anyone who is sexually active, regardless of age, gender, or sexual orientation. The highest rates are seen in people aged 15 to 24, but it can occur at any age.

Symptoms

Common symptoms

• Pain or a burning sensation when urinating
• Unusual discharge from the penis or vagina – may be white, yellow, or green
• Pain or swelling in the testicles (in men)
• Abnormal vaginal bleeding between periods or after sex (in women)
• Itching or soreness around the genitals
• Pain during sex for women
• Sore throat if the infection is in the throat

Symptoms in children

• Gonorrhoea in children is very rare and is usually a sign of sexual abuse. Symptoms may include discharge, pain when urinating, or redness around the genitals.

Symptoms in older adults

• Older adults may have the same symptoms as younger people, but they are less likely to be tested for STIs. Symptoms may be mistaken for other conditions like a urinary tract infection.

Causes

Main causes

• Infection with the bacterium Neisseria gonorrhoeae, which is passed from one person to another through unprotected vaginal, anal, or oral sex.
• Sharing sex toys without cleaning or covering them with a new condom.
• An infected pregnant woman can pass the infection to her baby during childbirth.

Risk factors

• Having unprotected sex (without a condom) with multiple partners
• Having a new sexual partner
• Not using condoms consistently or correctly
• Having a partner who has had an STI in the past
• Being a man who has sex with men

When to see a doctor

See a doctor urgently if:

• If you have severe pelvic pain, fever, or chills, seek urgent medical care.
• If a joint becomes painful, swollen, or red, see a doctor within 24 hours.

Book a routine appointment if:

• If you have any symptoms of gonorrhoea, such as unusual discharge or pain when urinating.
• If you have had unprotected sex with someone who might have an STI.
• If you are sexually active and have multiple partners, consider regular STI testing even without symptoms.

Diagnosis

A doctor or nurse will ask about your symptoms and sexual history. They will take a sample (swab) from the affected area – usually the urethra (penis), cervix (vagina), rectum, or throat. Sometimes you may be asked to provide a urine sample.

Tests that may be done

• Urine test – you may be asked to provide a urine sample.
• Swab test – a nurse will gently wipe the inside of the urethra (for men) or cervix (for women) with a cotton swab. This can also be done for the throat or rectum if needed.
• In some clinics, a self-administered swab (you collect the sample yourself) is available.

What to expect at your appointment

The test is usually quick and not painful, though it may be slightly uncomfortable. Results are often ready within a few days. The clinic will let you know how to get your results. If you test positive, you will be offered treatment and asked to inform your recent sexual partners so they can also get tested and treated.

Treatment

Gonorrhoea is treated with antibiotics, usually a single injection or a course of tablets. Because some types of gonorrhoea are becoming resistant to certain antibiotics, the exact treatment may depend on local guidelines. It is very important to finish the entire course of any medications prescribed and to attend follow-up testing to make sure the infection is gone.

Self-care at home

• Avoid any sexual contact (vaginal, anal, or oral) for at least 7 days after finishing treatment and until you and your partner(s) have been treated and cleared.
• Inform your recent sexual partners (from the past 6 months) so they can get tested and treated – this helps reduce the spread of the infection.
• Use condoms with every new sexual partner to lower the risk of getting gonorrhoea again.

Medical treatments

Treatment usually involves a single injection of an antibiotic or a course of oral antibiotics. The specific antibiotic used will be chosen by your doctor based on current guidelines and your individual situation. It is common to receive a combination of antibiotics to reduce the risk of resistance. After treatment, you will need a follow-up test (usually after 2 weeks) to confirm the infection has cleared.

When is surgery considered?

Surgery is not usually needed for gonorrhoea. In rare cases, if a complication like an abscess (a pocket of pus) develops in the pelvis, it may need to be drained, but this is very uncommon.

Living with this condition

Once treated, gonorrhoea does not usually affect your daily life. However, it is important to practice safer sex to avoid getting it again. Tell your current and past partners so they can be treated too. This can feel awkward, but clinics often offer advice on how to do this or can do it anonymously.

Lifestyle tips

• Use condoms with every sexual encounter to reduce future risk.
• Get tested for STIs regularly if you have multiple partners or new partners.
• Limit your number of sexual partners.

Diet and exercise

There are no specific diet or exercise restrictions related to gonorrhoea. Eating a healthy, balanced diet and staying physically active can support your overall health and immunity.

Mental health and emotional wellbeing

Being diagnosed with an STI can cause feelings of shame, anxiety, or stress. These feelings are normal, but gonorrhoea is a treatable medical condition, and many people get it. Talking to a healthcare provider or a counsellor can help. Remember that you are not alone, and treatment is available.

Prevention

Yes, gonorrhoea can be prevented by using condoms every time you have vaginal, anal, or oral sex. It also helps to limit the number of sexual partners and to have open conversations with partners about STI testing. Regular STI testing is recommended for sexually active people, especially those with multiple partners.

Vaccines

There is no vaccine specifically for gonorrhoea. However, some countries have recommended the HPV or hepatitis B vaccines for other STI-related infections. Ask your healthcare provider about available vaccines.

Screening programmes

If you are sexually active, especially under 25, or have multiple partners, it is a good idea to get tested for STIs at least once a year. Some clinics offer free and confidential testing. Talk to your doctor or local sexual health service about how often you should be screened.

Complications

If left untreated

• In women, the infection can spread to the womb and fallopian tubes, causing pelvic inflammatory disease (PID), which can lead to chronic pelvic pain and infertility.
• In men, untreated gonorrhoea can cause epididymitis (inflammation of the tube that stores and carries sperm), which may lead to reduced fertility or sterility.
• Gonorrhoea can spread to the blood or joints, causing a serious condition called disseminated gonococcal infection (DGI), with fever, joint pain, and skin lesions.
• Pregnant women with untreated gonorrhoea can pass the infection to their baby during childbirth, which can cause eye infections and blindness in the newborn.

Long-term outlook

When caught early and treated properly, gonorrhoea has an excellent outlook. Almost all cases are cured with the right antibiotics. By completing treatment and informing partners, you can protect your health and prevent complications. There is hope – with prompt care, most people recover fully without long-term problems.

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