Gonorrhoea

Gonorrhoea is a bacterial sexually transmitted infection (STI) that is very common in people aged less than 25 years. It affects both men and women and is easily treated with antibiotics.

Key points

  1. Gonorrhoea is a common sexually transmitted infection (STI) that is easy to treat with antibiotics.
  2. Some people with gonorrhoea don’t notice symptoms.
  3. You get gonorrhoea by having sexual contact with another person who has gonorrhoea.
  4. To test for the presence of gonorrhoea, females will need a swab from the vagina and males need a urine test and a swab. Males and females will need an anal swab if you have had anal sex or anal sex play.
  5. You need to tell anyone you have had sex with with in the last 2 months to get tested and treated for gonorrhoea.
  6. You should use condoms or avoid sex for 7 days after you and your partner(s) have been treated so you don’t pass the infection on to someone else.

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.

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 they do, these can include: 
  • unusual vaginal discharge
  • irregular bleeding
  • discomfort when passing urine
  • 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 the penis (thick yellow or white discharge)
  • pain or discomfort when passing urine
  • redness around the opening of the penis
  • pain and swelling in the 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 the vagina.
  • Men will need a swab test from the urethra (opening in the penis).

If you have had anal sex or anal sex play you will need a swab from the anus (males and females).

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.
  • If you are using a combined oral contraceptive pill you will need to use a condom for 14 days when having sex as antibiotics can affect the reliability of the contraceptive pill. Ask your doctor 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.

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 2 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 the uterus and tubes causing pelvic inflammatory disease (PID), a condition that may cause infertility or ectopic pregnancies (where the pregnancy develops in the fallopian tubes instead of the uterus). This can lead to chronic pelvic pain.
  • In men, gonorrhea can cause a painful condition in the tubes attached to the testicles. In rare cases, this may cause a man to be sterile, and prevent him from being able to father a child.
  • Rarely, gonorrhoea may spread via the 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 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.

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 Choices (UK)

References

  1. Gonorrhoea guideline Sexual Health Society (NZ) 2015
  2. Treatment of sexually transmitted and other genital infections BPAC (NZ)
Credits: Editorial team.