Overview

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

Gonorrhoea can infect the cervix (neck of womb), urethra (water passage) the uterus (womb), fallopian tubes, ovaries, testicles, rectum (anus), throat and sometimes the eyes.

Men commonly notice a discharge from the tip of the penis but most women will not notice anything wrong.

 Prompt treatment is recommended to prevent more serious problems:

In women the spread of infection to the reproductive organs possibly leading to infertility

In men the spread of infection to the testicles leading to pain and swelling

Testing is available at any specialised sexual health or Genitourinary Medicine (GUM) clinic, and in some GP surgeries and contraceptive services.

Gonorrhoea is resistant to many commonly used antibiotics. You need to be tested in a specialised sexual health service to ensure you receive the correct treatment.

How gonorrhoea is spread

The bacteria that cause gonorrhoea 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 is not spread by kissing, hugging, swimming pools, toilet seats, or sharing baths, towels, cups, plates or cutlery. The bacteria cannot survive outside the human body for long.

Symptoms of gonorrhoea

Men will usually notice:

  • a discharge from the tip of the penis
  • a burning pain when passing urine Symptoms in men usually appear within 2-5 days of catching the infection

Women may not notice anything wrong but they can still pass the infection onto their partner. Infection usually starts in the cervix (neck of the womb) and can then spread internally to the uterus (womb), fallopian tubes and ovaries.

Some women may notice one or more of the following:

  • bleeding between periods or after sex
  • lower abdominal pain particularly during sex
  • ‘cystitis’ or burning pain when passing urine
  • increased vaginal discharge

Infections in the throat or rectum usually go unnoticed.

Getting tested

In women

If you have symptoms it is best if a swab is taken from the cervix (neck of the womb) by a doctor or nurse during an internal examination.

If you do not have symptoms a self-taken swab can be taken from the entrance to the vagina.

In men

If you have a discharge a doctor or nurse will take a swab from the tip of the penis.

If you do not have any symptoms a urine sample will be collected – you should not have passed urine for an hour.

Occasionally swabs may also be taken from the throat, rectum and eye

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 and a single antibiotic tablet. With effective treatment, most of your symptoms should improve within a few days.

Occasionally a second course of antibiotics is needed if your symptoms don’t go away or you are found to have a resistant strain of gonorrhoea.

The antibiotics don’t interfere with your contraception.

You must not have sex again until both you and your partner have taken your treatment (this includes oral sex and sex with condoms).

Sometimes you may be advised to have another test to check the gonorrhoea has gone away completely – in this case it is important not to have sex until you receive your final all clear

Previous successful treatment for gonorrhoea does not make you immune to catching it again.

Who's affected

Anyone who's sexually active can catch gonorrhoea, particularly 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.

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

If you're worried you may have an STI, visit your local GUM or sexual health clinic for advice.

Symptoms

Symptoms of gonorrhoea usually develop within about 2  weeks of being infected.

About 1 in 10 infected men and 5 in 10 infected women will not experience any obvious symptoms, which means the condition can go untreated for some time.

Symptoms in women

In women, symptoms of gonorrhoea can include:

  • an unusual vaginal discharge, which may be thin or watery and green or yellow in colour
  • pain or a burning sensation when passing urine
  • pain or tenderness in the lower abdominal area (this is less common)
  • bleeding between periods, heavier periods and bleeding after sex (this is less common)

Symptoms in men

In men, symptoms of gonorrhoea can include:

  • an unusual discharge from the tip of the penis, which may be white, yellow or green
  • pain or a burning sensation when urinating
  • 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, 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 conjunctivitis.

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

Seeking 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 complications, including infertility.

Gonorrhoea in babies

Gonorrhoea can be passed from a mother to her baby during childbirth.

Newborn babies normally show symptoms in their eyes during the first 2  weeks. The eyes become red and swollen, and have a thick, pus-like discharge.

Gonorrhoea can be treated with antibiotics when you're pregnant or when you're breastfeeding. The antibiotics won't harm your baby.

 

Diagnosis

The only way to find out if you have gonorrhoea is to be tested. If you suspect gonorrhoea or any other sexually transmitted infection (STI), it's important not to delay getting tested.

It's possible to be tested within a few days of having sex, but you may be advised to wait up to a week. You can be tested even if you don't have any symptoms.

Early diagnosis and treatment of gonorrhoea reduces the risk of complications developing, such as pelvic inflammatory disease (PID) or infection in the testicles. Complications that arise from long-term infection are much more difficult to treat.

Who should get tested

It's recommended you get tested if:

  • you or your partner think you have symptoms of gonorrhoea
  • you've had unprotected sex with a new partner
  • you or your partner have had unprotected sex with other people
  • you have another STI
  • a sexual partner tells you they have an STI
  • during a vaginal examination, your nurse or doctor tells you the cells of your cervix are inflamed or there's discharge
  • you're pregnant or planning a pregnancy

Where to get tested

There are several different places you can go to be tested for gonorrhoea:

It's possible to buy a gonorrhoea test from a pharmacy to do yourself at home. However, these tests vary in accuracy, so it's recommended that you go to your local sexual health service.

All tests are free through the NHS, but you'll have to pay if you go to a private clinic.

If you go to your GP practice, you may have to pay a prescription charge for any treatment.

Testing for gonorrhoea

There are a number of different ways to test for gonorrhoea. In many cases, a swab will be used to remove a sample for testing, although men may only be asked to provide a urine sample.

A swab looks a bit like a cotton bud, but it's smaller and rounded. It's wiped over parts of the body that may be infected to pick up samples of discharge. This only takes a few seconds and isn't painful, although it may be a little uncomfortable.

Testing women

If you have symptoms it is best if a swab is taken from the cervix (neck of the womb) by a doctor or nurse during an internal examination.

If you do not have symptoms a self-taken swab can be taken from the entrance to the vagina.

Women are not usually asked to provide a urine sample to check for gonorrhoea because this is a less accurate test for women.

Testing men

If you have a discharge a doctor or nurse will take a swab from the tip of the penis.

If you do not have any symptoms a urine sample will be collected – you should not have passed urine for an hour.

Infections of the rectum, throat and eyes

If there's a possibility that your rectum or throat is infected, the doctor or nurse may need to use a swab to collect a sample from these areas.

If you have symptoms of conjunctivitis, such as red, inflamed eyes with discharge, a sample of the discharge may be collected from your eye.

Getting the results

Some clinics may be able to carry out rapid tests, when the doctor can view the sample through a microscope and give you your test results straight away.

Otherwise, you'll have to wait up to 2 weeks to get the results.

Young people and sexual health clinics

You can attend a sexual health clinic at any age and all results will be treated confidentially.

If you're 13 to 16 years old, nobody in your household will be contacted without your permission. However, you may be encouraged to talk to your parents, guardian or another trusted adult.

The situation is different for people under 13, because the law says that people of this age cannot consent (say yes) to sexual activity.

Treatment

Gonorrhoea is usually treated with a short course of antibiotics.

Gonorrhoea can be easily treated with a single dose combination of antibiotics – one is usually given by injection.

 Occasionally a second course of antibiotics is needed if your symptoms don’t go away or you are found to have a resistant strain of gonorrhoea.

The antibiotics don’t interfere with your contraception.

You should avoid having sex until you, and your partner, have been treated and given the all-clear, to prevent re-infection or passing the infection on to anyone else.

If your symptoms do not improve after treatment or you think you've been infected again, see your doctor or nurse. You may need repeat treatment or further tests to check for other problems.

Sexual partners

Gonorrhoea is easily passed on through intimate sexual contact. If you're diagnosed with it, anyone you've recently had sex with may have it too.

It's important that your current partner and any other recent sexual partners are tested and treated.

Your local sexual health clinic may be able to help by notifying any of your previous partners on your behalf.

Treating babies with gonorrhoea

Babies with signs of a gonorrhoea infection at birth, or who have an increased risk of infection because their mother has gonorrhoea, will usually be given antibiotics immediately after they're born.

This doesn't harm the baby, and helps prevent blindness and other complications of gonorrhoea.

Complications

If treated early, gonorrhoea is unlikely to lead to any complications or long-term problems. However, without treatment, it can spread to other parts of your body and cause serious problems.

In women, gonorrhoea can spread to the reproductive organs and cause pelvic inflammatory disease (PID). This is estimated to occur in 10 to 20% cases of untreated gonorrhoea. PID can lead to long-term pelvic pain, ectopic pregnancy and infertility.

During pregnancy, gonorrhoea can cause:

  • miscarriage
  • premature labour
  • the baby being born with conjunctivitis

If the baby is not promptly treated with antibiotics, there's a risk of progressive and permanent vision damage.

In men, gonorrhoea can cause painful infection in the testicles and prostate gland, which may lead to reduced fertility in a small number of cases.

In rare cases, when gonorrhoea has been left untreated, it can spread through the bloodstream and cause life-threatening infections in other parts of the body (sepsis).



The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website nhs.uk
Last Updated: 06/04/2022 15:14:41