Gonorrhoea

What is gonorrhoea?

Gonorrhoea is a sexually transmitted infection (STI) caused by bacteria called Neisseria gonorrhoeae. It's passed on through unprotected vaginal, anal or oral sex, and is treated with antibiotics.

What are the symptoms of gonorrhoea?

Not everyone with gonorrhoea gets symptoms, so it's important to get tested if you think you might have it. If symptoms do appear, this is usually within 1–14 days of infection, though it can sometimes take months.

Symptoms affecting anyone with a vagina

• a yellow or greenish discharge from your vagina
• burning pain when you pee
• pain in your lower abdomen
• bleeding between your periods, though this is rare.

Symptoms affecting anyone with a penis

• burning pain when you pee
• fluid or discharge from your penis
• sore or swollen testicles.

If gonorrhoea affects your anus, throat or eyes

Gonorrhoea can also affect other parts of your body that come into contact with infected fluid.

• pain, itching and discharge from your anus
• a sore throat, sometimes with no symptoms at all
• eye redness, pain and discharge.

What are the causes of gonorrhoea and who is at risk?

Gonorrhoea is caused by the bacterium Neisseria gonorrhoeae. It spreads through vaginal, anal or oral sex without a condom, and can also be passed on by sharing sex toys that haven't been washed or covered with a new condom.

A mother with gonorrhoea can also pass it to her baby during childbirth. Having had gonorrhoea before doesn't protect you from getting it again, and you can pass on the infection to others even if you have no symptoms yourself.

Your risk is higher if you have a new sexual partner, more than one sexual partner, or a partner who has other partners. Sexually active people under 25, and men who have sex with men, are also at increased risk. Using condoms consistently and correctly for vaginal, anal and oral sex is the most effective way to reduce your risk.

Are there different types of gonorrhoea?

Most cases of gonorrhoea are still cured with standard antibiotics. However, some strains have become resistant to the antibiotics normally used to treat them, meaning the infection doesn't always clear up with standard treatment.

Cases of drug-resistant gonorrhoea have been identified in the UK, generally linked to travel to or from parts of Asia where resistance is more common, though a small number have been acquired within the UK. If your infection doesn't respond to standard treatment, you may be offered a different antibiotic or referred for further tests.

How is gonorrhoea diagnosed?

Gonorrhoea is diagnosed with a simple, reliable test that checks a sample of fluid from the affected area. You can be tested even if you don't have symptoms, and you may be able to take the sample yourself.

A doctor or nurse may use a swab, like a large cotton bud, to take fluid from your penis or vagina, and you might also be asked for a urine sample. If you've had anal or oral sex, you may also have a swab taken from your anus or throat.

You can also get a self-test kit, sometimes for free from a sexual health clinic or pharmacy, which you send to a lab yourself. Results can take up to 2 weeks, though some clinics offer rapid tests with same-day results.

How is gonorrhoea treated?

Gonorrhoea is treated with antibiotics, usually as a single dose given by injection, tablets, or both, and you can often start treatment before your test results come back if there's a high chance you're infected. Ceftriaxone, given by injection, is the preferred antibiotic, though cefixime tablets may be used instead if this isn't suitable, sometimes alongside azithromycin.

You'll need to go back about a week after treatment to be tested again and confirm the infection has cleared. Your current and recent sexual partners will also need testing, and a sexual health clinic can contact them for you without naming you, if you'd prefer.

Don't have vaginal, anal or oral sex until you and your partner have finished treatment and been confirmed clear. If your infection doesn't clear up, this may be because the bacteria are resistant to the antibiotic used, in which case you may be tested again and given a different antibiotic.

When should I see a doctor?

Go to a sexual health clinic or see a GP if you or a sexual partner think you might have gonorrhoea, if you've had sex without a condom, or if you're pregnant or planning to be and think you might have it.

Get urgent advice from a GP or NHS 111 if you have gonorrhoea, or think you might, and:

• your eyes are red, itchy or painful, or you have pus sticking to your eyelashes
• you have a high temperature
• you have joint pain or swelling
• you have a bumpy, spotty or blotchy rash.

These can be signs of a more serious infection that needs to be treated quickly.