What you need to know about gonorrhoea

Gonorrhoea is a common sexually transmitted infection (STI) that can affect individuals of any gender and sexual orientation. In this article, leading genitourinary consultant Dr Emily Lord explores the key aspects of gonorrhoea, answering frequently-asked questions about this important topic.

What is gonorrhoea?

Gonorrhoea infection is caused by a bacteria (Neisseria gonorrhoea). It is curable with antibiotics.

It tends to cause infections in the urethra (where urine is passed), the cervix (neck of womb), rectum, throat or sometimes in the eye(s).  If not picked up, it can lead to more complicated infections in the testicles or in the womb/ovaries.

How do you get gonorrhoea?

The infection is spread by:

• Direct contact of infected secretions from one person to another, e.g., if a man has gonorrhoea infection in his urethra, he can pass it on during unprotected sex. Depending on the type of sex, this can cause by infection in the throat, cervix or rectum.
• Sharing sex toys; without thoroughly washing, or using a condom.
• Rarely be transferred from one area to another (e.g., from the vagina, to the eye by the fingers).
• Pregnant women can transmit the infection to their baby during birth.

What are the symptoms of gonorrhoea?

Some people with gonorrhoea have no symptoms, so it is important to test regularly if you are not in a long-term monogamous relationship. The symptoms you may experience depend on the infection site:

For people with a vagina

• Urethral infection can cause pain passing urine or increased frequency of urination.
• Cervical infection: can lead to increased or altered vaginal discharge. Very occasionally, irregular bleeding after sex or between periods can occur.
• Uterine infection: (within the womb / ovaries) can cause pelvic pain, which can be partially bad during sex.

People with a penis

• Urethral infections can cause a discharge from the tip of the penis, and there can also be pain with urination or frequency.
• Testicular infection can cause pain and swelling in one or both testicles.

Rectal infection

• Most do not get symptoms in the rectum, but people may notice anal discharge or pain. Some women may get rectal infection, even if they do not have anal sex.

Pharyngeal (throat) infection

• Infections in the throat usually cause no symptoms.

Complicated infection:

• Most people do not get complications from gonorrhoea. However, it is important to catch the infection early. If it is not treated, infections may spread to the uterus (womb), fallopian tubes and ovaries, causing infertility. Spread through the blood can rarely cause joint problems.

How is gonorrhoea detected?

We use a very sensitive test (nucleic acid amplification test) to detect gonorrhoea. This includes taking a simple swab from the throat/rectum/vagina and/or urine specimen. If gonorrhoea is detected, we need to take another swab to check which antibiotics cure it (antimicrobial culture test). For those with vagina, this requires a speculum examination, to ensure that we take the swab directly from the cervix.

Can gonorrhoea be treated?

• Yes! But gonorrhoea is 'resistant' to many commonly used antibiotics. This means the antibiotic is no longer able to cure the infection. Specialists should therefore treat people in sexual health; to ensure the right antibiotic is chosen.
• It is important to ensure your partner(s) are tested/treated too.
• We recommend rechecking for infection two weeks after treatment.

How can gonorrhoea be prevented?

Consistent and correct condom use during sexual activity is one of the most effective ways to reduce the risk of gonorrhoea transmission. While condoms do not provide 100 per cent protection, they significantly decrease the likelihood of infection.

Further information

For further information, please see: gc_pil_mobile-pdf_02.pdf (bashhguidelines.org)

If you’d like to arrange an appointment with Dr Lord about your sexual health concerns, you can do so via her Top Doctors profile.