Gonorrhoea treatment recovery in older adults

Overview

Gonorrhoea (say: gon-oh-REE-uh) is a sexually transmitted infection (STI) caused by bacteria. It can infect the genitals, rectum, throat, and sometimes the eyes or joints. With proper treatment, it is curable.

Gonorrhoea is very common worldwide. While it is more often diagnosed in younger people, older adults can get it too. Rates have been rising in adults over 45 in some countries.

Any sexually active person can get gonorrhoea, regardless of age. Older adults may be at risk if they have new or multiple sexual partners and do not use condoms.

Symptoms

Common symptoms

• Pain or burning when urinating (peeing)
• Unusual discharge from the penis or vagina – may be yellow, green, or white
• Pain or swelling in the testicles (in men)
• Unusual vaginal bleeding (in women)
• Pain during sex (in women)

Symptoms in children

• Gonorrhoea can occur in children, but this is rare and usually requires a doctor's evaluation. Symptoms may include discharge or redness, but many children have no symptoms.

Symptoms in older adults

• Older adults often have no symptoms at all.
• If symptoms do appear, they may be mild and easy to ignore, such as slight burning when peeing or a small amount of discharge.
• Some older adults may have joint pain or swelling if the infection spreads (disseminated gonorrhoea).
• Rectal infections (from anal sex) may cause itching, discomfort, bleeding, or discharge from the back passage.

Causes

Main causes

• Infection with the bacterium Neisseria gonorrhoeae.
• Spread from person to person through unprotected vaginal, anal, or oral sex.
• Can be passed from a pregnant woman to her baby during childbirth.

Risk factors

• Having sex without a condom
• Having multiple sexual partners
• New sexual partner within the last 12 months
• Previous STI history
• In older adults, changes in sexual activity after a divorce, separation, or loss of a partner may increase risk if safer sex practices are not used.

When to see a doctor

See a doctor urgently if:

• If you think you have been exposed to gonorrhoea, even without symptoms
• If you have any symptoms of gonorrhoea, such as discharge, pain when peeing, or rectal discomfort
• If a sexual partner has been diagnosed with an STI

Book a routine appointment if:

• If you are sexually active with more than one partner or a new partner, consider routine testing for STIs, including gonorrhoea.

Diagnosis

A doctor or nurse will ask about your symptoms and sexual history. They will take a sample from the area that might be infected – for example, a urine sample, a swab of the penis, vagina, rectum, or throat. The sample is sent to a lab to check for the bacteria.

Tests that may be done

• Urine test
• Swab of the penis (for men) or vagina (for women) – you can often do this yourself
• Swab of the rectum or throat if those areas may be infected

What to expect at your appointment

The test does not hurt. You may feel a little discomfort from a swab. Results usually come back within a few days. If the test is positive, the doctor will prescribe antibiotics. It is important that your sexual partner(s) also get tested and treated to prevent reinfection.

Treatment

Gonorrhoea is treated with antibiotics. Because the bacteria have become resistant to some older antibiotics, a healthcare provider will prescribe a course of antibiotics that works against current strains. Usually a single injection or a combination of tablets is used. It is important to take all the medicine as directed and to avoid sex until you and your partner(s) have finished treatment and symptoms have gone.

Self-care at home

• Finish the entire course of antibiotics, even if you feel better.
• Do not have sex (vaginal, anal, or oral) for at least 7 days after finishing treatment, or until your doctor says it is safe.
• Tell your recent sexual partners (last 3 months) so they can get tested and treated.
• Drink plenty of water to flush your system.
• Avoid alcohol until you have finished antibiotics – it can affect your liver and make side effects worse.

Medical treatments

Treatment is with a course of antibiotics, usually given as an injection plus tablets. The exact choice depends on local resistance patterns. Your healthcare provider will decide what is best for you. Older adults may need monitoring for side effects, especially if they have other health conditions or take other medicines.

When is surgery considered?

Surgery is not needed for gonorrhoea itself. If complications develop, such as an abscess (collection of pus) or severe pelvic inflammatory disease, a procedure to drain fluid might be required, but this is rare.

Living with this condition

Once you have had treatment, you can return to your normal activities. You may need to take a follow-up test after treatment to make sure the infection has cleared, especially for older adults who may have weaker immune systems. Avoid sex until you get the all-clear.

Lifestyle tips

• Use condoms every time you have sex to prevent future infections.
• Limit your number of sexual partners.
• Talk openly with your partner(s) about STI testing.

Diet and exercise

Eating a healthy diet and staying active will help your body recover. No specific foods are required. If you have any side effects from antibiotics (such as diarrhoea), drink plenty of fluids and eat bland foods like rice or toast until you feel better.

Mental health and emotional wellbeing

Being diagnosed with an STI can be upsetting, worrying, or embarrassing. You might feel anxious about telling partners or about your health. These feelings are normal. Talking to a trusted friend, partner, or healthcare professional can help. Remember that gonorrhoea is common and curable – it does not mean anything bad about you as a person.

Prevention

Yes. Using condoms consistently and correctly during vaginal, anal, and oral sex greatly reduces the risk of getting or spreading gonorrhoea. Having fewer sexual partners and having open conversations about STI testing also helps.

Vaccines

There is no vaccine for gonorrhoea at this time.

Screening programmes

Regular STI screening is recommended for sexually active people with risk factors, such as having a new partner or multiple partners. Talk to your healthcare provider about how often you should get tested.

Complications

If left untreated

• In women: pelvic inflammatory disease (infection of the womb, fallopian tubes, or ovaries), which can cause long-term pelvic pain and infertility.
• In men: infection of the epididymis (tube that stores sperm), which can cause pain and rarely infertility.
• In both sexes: the infection can spread to the blood and joints, causing fever, rash, and arthritis (joint pain and swelling).
• In older adults: complications may be more serious if the immune system is weaker or if there are other health problems like diabetes or kidney disease.

Long-term outlook

With prompt antibiotic treatment, gonorrhoea is curable and complications are very rare. Most people recover fully. Even if complications have started, treatment can often stop them from getting worse. Following up after treatment is important to make sure the infection is gone. Remember, getting treated protects your health and the health of others.

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