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Gonorrhoea

Published by Bupa's health information team, January 2010.

This factsheet is for people who have gonorrhoea, or who would like more information about it.

Gonorrhoea is a disease caused by the bacterium Neisseria gonorrhoeae. It can be transmitted by unprotected sex or passed from an infected mother to her baby during a vaginal birth.

• About gonorrhoea
• Symptoms of gonorrhoea
• Complications of gonorrhoea
• Causes of gonorrhoea
• Diagnosis of gonorrhoea
• Treatment of gonorrhoea
• Prevention of gonorrhoea
• Questions and answers
• Related topics
• Further information
• Sources

About gonorrhoea

Gonorrhoea is a common sexually transmitted infection (STI), particularly in men and women who are under 25. It's most common in men.

Gonorrhoea can easily be treated but if left untreated, it can cause health and fertility problems.

Symptoms of gonorrhoea

Around half of women and one in 10 men with gonorrhoea don't have any symptoms. You can still pass gonorrhoea onto your sexual partner(s) even if you don't have any symptoms.

If you do have symptoms, these usually start around one to 10 days after getting the infection. However, symptoms can show up many months later, or not until the infection has spread to other parts of your body.

In men, symptoms of gonorrhoea include:

• an unusual discharge from the penis which may be yellow or green
• pain when passing urine
• pain and swelling in the testicles

In women, symptoms of gonorrhoea include:

• an increased or unusual discharge from the vagina which may be yellow or green
• pain when passing urine
• pain in the lower abdomen
• bleeding from the vagina after sex or between periods
• heavier periods

Gonorrhoea infection in the back passage (rectum) may cause a discharge or bleeding from your anus, and this area may be itchy and cause you some discomfort but usually there are no symptoms.

Gonorrhoea infection in the throat is unlikely to give you any symptoms. If your eyes are infected, it can cause irritation and a discharge (conjunctivitis) from one or both of your eyes.

Complications of gonorrhoea

Not everyone who has gonorrhoea develops complications and the time it takes complications to develop will depend on the individual. However, it's possible that gonorrhoea can cause serious health and reproductive problems if it isn't treated.

In women, gonorrhoea infection can spread to the womb (uterus), ovaries and fallopian tubes and cause pelvic inflammatory disease (PID). Between one and two women in 10 with untreated gonorrhoea get PID. PID can damage the fallopian tubes and can increase the risk of being infertile. It can also increase the risk of having an ectopic pregnancy. This is when pregnancy occurs outside the womb, for example in one of the fallopian tubes.

In men, gonorrhoea infection can spread to the testicles or the prostate gland. It can also cause the tube which carries sperm from the testes (the epididymis) to become blocked. This can affect fertility.

Rarely, untreated gonorrhoea can spread through the bloodstream and infect other parts of the body, including the heart, joints and spine.

Causes of gonorrhoea

Gonorrhoea is caused by the N. gonorrhoeae bacterium which can infect the neck of the womb (cervix), the tube that carries urine from the bladder and out through the penis or vulva (urethra), the back passage, the throat and, very rarely, the eyes.

N. gonorrhoeae can be found in the semen of men and the vaginal fluids of women who have the infection. The infection can be passed on from one person to another during vaginal, anal or oral sex as well as by sharing sex toys with an infected person.

Gonorrhoea can also be passed from an infected mother to her baby during a vaginal birth.

Diagnosis of gonorrhoea

If you think you may have gonorrhoea, you can see your GP, visit a genitourinary medicine (GUM) clinic, or a sexual health clinic to be tested. You can have a test for gonorrhoea even if you don't have any symptoms.

You don't have to ask your GP to refer you to a GUM or sexual health clinic, you can make your own appointment. All visits are confidential and you don't have to give your real name. Details won't be sent to your GP without your consent.

There are different ways to test for gonorrhoea.

• You may be asked to provide a sample of urine.
• A doctor or nurse may use a swab (similar to a small round cotton bud) to take a sample of cells from the cervix or vagina (for women) or from the tip of the penis (for men). If you're female, you may have the option to collect a sample of cells from your vagina yourself using a swab or a tampon.
• If you have had anal or oral sex, a doctor or nurse may use a swab to take a sample from your back passage or throat.

The samples will be sent to a laboratory for testing, or your doctor may look for the bacterium under a microscope and give you the result immediately.

If the tests show that you have gonorrhoea, it's important to contact your previous partners who may be at risk to prevent them from spreading the infection to others. Clinics can send anonymous letters on your behalf if you're willing to provide details.

Treatment of gonorrhoea

Gonorrhoea is treated with antibiotics. These may be given to you either as a tablet or as an injection (usually as a single dose). If you are prescribed tablets, your doctor will let you know how many days you need to take them for. It's important to take the full course of antibiotics, even if the symptoms of gonorrhoea clear up before you finish the course.

Once diagnosed with gonorrhoea, it's important to wait until the doctor gives you the 'all clear' before you have vaginal, anal or oral sex again. Wait until you and your partner have both finished treatment, or you could become re-infected.

Antibiotics can interfere with some forms of oral contraception so you may need to use an alternative contraceptive, such as condoms. Ask your nurse or doctor for advice.

Special considerations

If you're pregnant

If you have gonorrhoea when you're pregnant, it may lead to complications, such as your baby being born prematurely or your waters breaking too early.

You can also pass gonorrhoea to your baby during birth. This can cause conjunctivitis in one or both of the baby's eyes, which must be treated. If not, it can lead to blindness.

If you have gonorrhoea when you're pregnant or breastfeeding, you will be given a course of antibiotics to treat the infection. It's important to tell your doctor or nurse that you're pregnant or breastfeeding so that you're prescribed a suitable antibiotic that is safe for your baby.

Prevention of gonorrhoea

There are ways to lower your risk of getting or passing on gonorrhoea.

• Use condoms when having vaginal, oral or anal sex.
• Try not to share sex toys. If you do share them, wash them or cover them with a new condom before anyone else uses them.
• Limit the number of sexual partners you have and the frequency with which you change your sexual partners. Before having sex with a new partner, you should both consider having a test for gonorrhoea and other STIs.

Related topics

• Conjunctivitis
• Contraception - non-hormonal
• Ectopic pregnancy
• Miscarriage
• Sexually transmitted infections (STIs)
• Pelvic inflammatory disease (PID)

Further information

fpa (The Family Planning Association)
0845 122 8600
www.fpa.org.uk

Terrence Higgins Trust
0845 12 21 200
www.tht.org.uk

Sources

• Gonorrhoea. Clinical Knowledge Summaries. www.cks.nhs.uk, accessed 13 November 2009
• STI annual data tables. Health Protection Agency (HPA). www.hpa.org.uk, accessed 13 November 2009
• Gonorrhoea (neisseria gonorrhoeae). Health Protection Agency (HPA). www.hpa.org.uk, accessed 13 November 2009
• Sexually transmitted infections (STIs): Gonorrhoea. fpa (The Family Planning Association). www.fpa.org.uk, accessed 13 November 2009
• Gonorrhea - CDC fact sheet. Centers for Disease Control and Prevention. www.cdc.gov, accessed 13 November 2009
• Where can I get information and advice? fpa (The Family Planning Association). www.fpa.org.uk, accessed 11 November 2009
• Gonorrhea. The National Women's Health Information Center. www.womenshealth.gov, accessed 13 November 2009

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: January 2010