Gonorrhoea

Introduction

Gonorrhoea is a sexually transmitted infection caused by bacteria called Neisseria gonorrhoeae or gonococcus. It used to be known as 'the clap'.

The bacteria are mainly found in discharge from the penis and in vaginal fluid.

Gonorrhoea is easily passed between people through:

  • Unprotected vaginal, oral, or anal sex
  • Sharing vibrators or other sex toys that haven't been washed or covered with a new condom each time they're used

The bacteria can infect the cervix (entrance to the womb), the urethra (tube through which urine passes out of the body), the rectum, and less commonly the throat or eyes.

The infection can also be passed from a pregnant woman to her baby. If you're pregnant and may have gonorrhoea, it's important to get tested and treated before your baby is born. Without treatment, gonorrhoea can cause permanent blindness in a newborn baby.

Gonorrhoea isn't spread by kissing, hugging, sharing baths or towels, swimming pools, toilet seats, or sharing cups, plates, and cutlery, because the bacteria can't survive outside the human body for long.

Signs and Symptoms

Typical symptoms of gonorrhoea include a thick green or yellow discharge from the vagina or penis, pain when urinating, and (in women) bleeding between periods.

However, around 1 in 10 infected men and almost half of infected women don't have any symptoms.

Symptoms of gonorrhoea usually develop within about two weeks of being infected, although they sometimes don't appear until many months later.

Symptoms in Women

  • A vaginal discharge (thin or watery and green or yellow in colour)
  • Pain or a burning feeling when passing urine
  • Pain or tenderness in the lower abdomen (this is less common)
  • Bleeding between periods, heavier periods, and bleeding after sex (this is less common)

Symptoms in Men

  • A discharge from the tip of the penis (white, yellow, or green)
  • Pain or a burning feeling when passing urine
  • Inflammation (swelling) of the foreskin
  • Pain or tenderness in the testicles (this is rare)

Infection in the Rectum, Throat, or Eyes

Both men and women can develop an infection in the rectum (back passage), eyes, or throat by having unprotected anal or oral sex. If infected semen or vaginal fluid comes into contact with the eyes, you can also develop an eye infection (conjunctivitis).

Infection in the rectum can cause discomfort, pain, or discharge. Infection in the eyes can cause irritation, pain, swelling, and discharge. Infection in the throat usually causes no symptoms.

Getting Medical Advice

It's important to be tested for gonorrhoea if you think there's a chance you're infected, even if you have no obvious symptoms or the symptoms have gone away on their own.

If gonorrhoea is left undiagnosed and untreated, you can continue to spread the infection and there is a risk of potentially serious problems, including infertility.

Getting Tested

Gonorrhoea can be easily diagnosed by testing a sample of discharge picked up using a swab. Testing a sample of urine can also be used to diagnose the condition in men, but a swab is better in women.

It's important to get tested as soon as possible, because gonorrhoea can lead to more serious long-term health problems if it's not treated, including Pelvic Inflammatory Disease (PID) in women, or infertility.

Treating Gonorrhoea

Gonorrhoea is usually treated with a single antibiotic injection plus a single dose of antibiotic tablets. If the injection is contra-indicated then it may be treated by 2 different types of antibiotic tablets. With effective treatment, most of your symptoms should improve within a few days.

It's usually recommended that you attend a follow-up appointment a week or two after treatment, so another test can be carried out to see if you're clear of infection.

Who Gets It?

Anyone who's sexually active can catch gonorrhoea, especially people who change partners frequently or don't use a barrier method of contraception, such as a condom, when having sex.

Gonorrhoea is the second most common bacterial STI in the UK after chlamydia. Almost 35,000 cases were reported in England during 2014, with most cases affecting young men and women under the age of 25.

Previous successful treatment for gonorrhoea doesn't make you immune to catching the infection again.

Preventing Gonorrhoea

Gonorrhoea and other STIs can be successfully prevented by using appropriate contraception and taking other precautions, such as:

  • Using male condoms or female condoms every time you have vaginal sex, or male condoms during anal sex
  • Using a condom to cover the penis, or a latex or plastic square (dam) to cover the female genitals, if you have oral sex
  • Not sharing sex toys, or washing them and covering them with a new condom before anyone else uses them