Gonorrhoea

Gonorrhoea is a sexually transmitted infection (STI) that is very common in people aged less than 30 years. It affects both men and women and is easily treated with antibiotics.

Key points

  1. Gonorrhoea is a bacterial infection that you get by having sexual contact with another person who has it. Some people with gonorrhoea don’t notice symptoms.
  2. To test for gonorrhoea, women need a swab from your vagina and men need a urine test. Everyone needs an anal swab if you have had anal sex or anal sex play.
  3. If you have gonorrhoea, you need to tell anyone you have had sex with in the last 3 months to get tested and treated.
  4. You should use condoms or avoid sex for 7 days after you and your partner(s) have been treated so you don’t get infected or pass the infection on to someone else.
  5. If you use a condom every time you have sex you are much less likely to get gonorrhoea.

How is gonorrhoea spread?

Gonorrhoea is caused by the bacteria Neisseria gonorrhoeae. In nearly all cases gonorrhoea is transmitted through sexual contact.

  • You can get gonorrhoea by having unprotected vaginal, anal or oral sex with someone who has gonorrhoea.
  • Gonorrhoea can also be spread through other sexual practices such as mutual masturbation or fingering.
  • Gonorrhoea may be transmitted from mother to baby during birth. The baby may develop eye or joint infections as a result.
  • If you use a condom every time you have sex you are much less likely to get gonorrhoea.

What are the symptoms of gonorrhoea?

Some people with gonorrhoea don’t notice symptoms. Around 1 in 10 infected men and almost half of infected women don't experience any symptoms.

Women Men
Most women do not have any signs or symptoms. If you do, these can include: 
  • unusual vaginal discharge
  • irregular bleeding
  • discomfort when passing urine (peeing)
  • pelvic pain (especially during intercourse).
Men are more likely to have symptoms and these usually occur within 2 to 10 days after infection. Symptoms may include:
  • urethral discharge from your penis (thick yellow or white discharge)
  • pain or discomfort when passing urine (peeing)
  • redness around the opening of your penis
  • pain and swelling in your testicles.

Both men and women can have infection with gonorrhea in the rectum (bottom) if they have anal sex. This may cause rectal discharge or discomfort, but often there are no symptoms.

How is gonorrhoea diagnosed?

The best way to find out if you have gonorrhoea is to have a sexual health check-up.

  • Women will need a swab test from your vagina.
  • Men will need a urine (pee) test and sometimes a swab test from the urethra (the opening in your penis). Throat and anal swabs might be needed if you have sex with males.
  • Anyone who has had anal sex or anal sex play will need a swab from your anus.

How is gonorrhoea treated?

Gonorrhoea is treated with antibiotics. In most cases a single dose of an injection called ceftriaxone and a single dose of tablets called azithromycin usually cures gonorrhoea. 

  • If the infection is more serious, you may need to take tablets for up to 2 weeks.
  • Often chlamydia and gonorrhoea occur together, so you may be given treatment for both infections.

Carefully follow your doctor's advice about medication. Even if you feel better, finish all the antibiotics. Symptoms may improve in a few days but the bacteria may still be in your body.

Use of condoms during the treatment period

  • If you receive single-dose treatment, you should avoid sex without a condom for 7 days after treatment and until 7 days after your partner has been treated. This is to prevent getting reinfected or passing the infection on to someone else.
  • If you are using a combined oral contraceptive pill may need to use an additional method of contraception. Ask your doctor, pharmacist or nurse if you are unsure.

Follow-up appointment

After completing the treatment, go back to your healthcare professional after 3 months for a final check-up to make sure the infection is completely cleared and that you haven't been re-infected. If your symptoms don’t go away with treatment go back to your healthcare professional for review. 

Do sexual partners need treatment?

If you have had sex without a condom with your sexual partner(s) it is very likely they are infected with gonorrhoea. It is important they have a sexual health check and treatment for gonorrhoea, even if they have no symptoms and even if they have a negative gonorrhoea test.

If you are diagnosed with gonorrhoea, it is important to tell anyone you have had sex with within the last 3 months to get tested and treated.

Why is treatment of gonorrhoea important?

Left untreated, gonorrhea can cause serious and permanent damage.

  • In women, gonorrhoea can spread to your uterus and tubes and cause pelvic inflammatory disease (PID), which can cause infertility or ectopic pregnancies (where the pregnancy develops in your fallopian tubes instead of your uterus). It can also lead to chronic pelvic pain.
  • In men, gonorrhea can cause a painful condition in the tubes attached to your testicles (balls). In rare cases, this may cause you to be sterile and prevent you from being able to father a child.
  • Rarely, gonorrhoea may spread via your bloodstream to cause severe joint pain and infect other internal organs and skin.

How can I prevent getting 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 your 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.

Learn more

The following links provide further information on gonorrhoea. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.

Gonorrhoea Sexual Health Society, NZ
Gonorrhoea Ministry of Health, NZ
Gonorrhoea Family Planning, NZ
Gonorrhoea NHS, UK

References

  1. Gonorrhoea guideline Sexual Health Society, NZ, 2015
  2. Treatment of sexually transmitted and other genital infections BPAC, NZ

Reviewed by

Dr Veronica Playle is a clinical microbiologist and infectious diseases physician. She is currently completing her PhD at the University of Auckland and works part-time for Auckland District Health Board.
Credits: Health Navigator Editorial Team. Reviewed By: Dr Veronica Playle, Clinical microbiologist, Auckland Last reviewed: 12 Feb 2020