About gonorrhea

What is it?

Gonorrhea is a sexually transmitted infection (STI) caused by the bacteria Neisseria gonorrhoeae. It is the second most common bacterial STI after chlamydia. Those most often affected are young men and women under the age of 25.

It’s caused by bacteria (germs) that can live in and around the genitals, urethra (wee tube) and rectum (butt) and sometimes in the throat and eyes. The bacteria can be found in semen (cum) and vaginal fluid. 

Many people with gonorrhea don’t have any symptoms, so getting tested is the only way to know if you have it. It’s usually easy to cure with antibiotics.

If you are under 25 and sexually active, it is recommended that you have a test for gonorrhea once a year, and when you have sex with new or casual partners.

How is it spread?

Gonorrhea is usually passed from person to person through unprotected (without a condom) vaginal (frontal), oral or anal (butt) sex. It can be transmitted after contact with your partner’s genitals, even if there is no ejaculation (/cum/ orgasm).

Rarely it can be transmitted by infected semen or vaginal fluid coming into contact with your eye and sometimes from sharing sex toys.

Additionally, pregnant mothers can pass the infection to their babies.

Gonorrhea isn't spread by kissing, hugging, sharing baths or towels, swimming pools, toilet seats, or sharing crockery and cutlery, because the bacteria can't survive outside the human body for long. You cannot get it from masturbating by yourself.

The bacteria can infect the cervix (entrance to the womb), the urethra (tube through which urine passes out of the body), the rectum (bottom), and less commonly the throat or eyes.

Symptoms

Around 1 in 10 infected men with urethral gonorrhea, and approximately half of infected women with vaginal gonorrhea don't experience any symptoms. Individuals with gonorrhea in the throat and rectum have even fewer symptoms and are largely symptom free. In people that develop symptoms these usually appear within about two weeks of being infected, although sometimes they don't appear until many months later.

Any symptoms usually start a few days or weeks after you get gonorrhea but may sometimes appear months later. 

Sometimes symptoms go away on their own, but this does not mean the gonorrhea has gone. 

You can still pass on gonorrhea when you don’t have symptoms and it may cause you long-term problems if it’s not treated. 

In women

For women, symptoms of gonorrhea include:

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

In men

For men, symptoms of urethral gonorrhea include:

• a white, yellow, or green discharge from the penis tip
• pain in the urethra (wee tube) or a burning sensation when urinating
• inflammation (swelling) of the foreskin/head of penis
• pain or tenderness in the testicles

Gonorrhea in other parts of the body

Gonorrhea in the rectum does not usually have symptoms, but may cause anal (butt) discomfort, pain, or discharge.

Gonorrhea in the throat usually has no symptoms but may cause a sore throat.

Gonorrhea in the eye may cause irritation, pain, redness, swelling and/or discharge (conjunctivitis) in and around the eyes.

How does it affect you?

If it’s treated early, gonorrhea won’t usually cause any serious problems. 

If it’s not treated, it can spread to other parts of the body and may cause serious long-term health problems. 

In women, gonorrhea can cause an infection called pelvic inflammatory disease (PID). If PID isn’t treated and cured it can cause pain, ectopic pregnancy and can eventually cause infertility. 

During pregnancy gonorrhea can be associated with miscarriage, premature labor, and the baby being born with conjunctivitis (inflammation of the eye) which can lead to permanent vision damage.

In men, gonorrhea can spread to the testicles causing pain and swelling called epididymo-orchitis. Very rarely, there is a possibility it could affect your fertility. 

Left untreated, gonorrhea can lead to pelvic inflammatory disease (PID) (10-20% cases), ectopic pregnancy in women, reduced fertility, and testicular swelling/pain in men. Rarely, it results in arthritis (inflammation of the joints) or septicemia (infection in the bloodstream).

Diagnosis (testing)

The only way to find out if you have gonorrhea is to get tested. 

For women, gonorrhea is diagnosed by testing a vaginal swab sample.

For men, gonorrhea is diagnosed by testing a urine sample.

Diagnosis for gonorrhea in the throat and anus is made from a throat and anal swab (don’t worry, we’ll send two separate swabs).

When should I take a test?

It’s a good idea to get tested if you or a sexual partner: 

• Have sex without a condom with a new partner. 
• Have any symptoms of gonorrhea. 
• Have another STI.
• Want to stop using condoms with a partner.
• A sexual partner informs you that they have, or have recently had, gonorrhea.

If you are aged under 25 and sexually active you are advised to do a gonorrhea test once a year if not using condoms with new or casual partners.

It's possible to be tested within a few days of having sex especially if you have symptoms, but if you have no symptoms and just want a sexual health check-up, you may want to wait up to two weeks after the last sexual contact before getting a test. This is because it can take up to 2 weeks before gonorrhea shows up on a test. This is called the window period.

Testing too early after a sexual risk, during this window period, may give you false reassurance (i.e., your test result may be negative when you are actually infected).

If you test negative for gonorrhea during the window period, you may be advised to test again later, in case the first test didn’t detect it. 

You can order a home test kit for gonorrhea for free. You collect samples at home that we will test in our laboratory to provide you with results.

See our frequently asked questions for information on when you will get your test results. Frequently asked questions

Treatment

Gonorrhea is easy to treat and cure, usually with a single antibiotic injection in the thigh or buttocks. Sometimes it takes more than one type of antibiotic to cure gonorrhea. With effective treatment, any symptoms should improve within a few days. It is important to treat it early so it’s less likely to cause any health problems.

If you have been found to have gonorrhea, you will need to attend your nearest health clinic for treatment.

There is increasing bacterial resistance to gonorrhea treatment with only a few options left for eradicating the infection. This means additional swabs (cultures) may need to be taken before your treatment is given, where we grow the bacteria in a laboratory and see what drugs are effective in treating it. You are also often asked to attend a clinic for repeat gonorrhea testing 1-2 weeks after treatment to ensure the infection has cleared.

Don’t have sex with anyone until 7 days after you and any partners have finished treatment and any symptoms have gone. Ideally, wait until you have also had a test to check if the gonorrhea has gone.

Gonorrhea treatment is safe to take during pregnancy and stops you passing gonorrhea on to the baby during the birth.

Contacting partners

If you are diagnosed with penile gonorrhea you will need to inform anyone you have had sex with, within the last two weeks, or the last partner before that, if longer ago. If you have gonorrhea at any other body site or have been symptom free you will need to contact partners from within the last three months. Your sexual contacts should be advised to get tested and may be offered treatment.

After treatment

Any symptoms should improve a few days after starting treatment and be gone after 2–4 weeks.

You should not have oral, anal, or vaginal sex until 7 days after you and any partner(s) have finished treatment and the symptoms have gone. Ideally wait until you have also had a test to check if the gonorrhea has gone.

Whether or not you have symptoms, it’s important to have another test 1-2 weeks after finishing treatment to check if the gonorrhea has been cured. 

If you have been infected with gonorrhea, it is possible you may also have another STI. Therefore, it is advisable that you have a full sexual health screen for chlamydia, syphilis and HIV. To protect yourself use condoms and encourage your partner to test for STIs also.

If you are under 25 and sexually active, it's recommended that you get tested for gonorrhea every year or when you change sexual partner.

People under 25 who have gonorrhea should consider re-testing three months after being treated because young adults are found to be at increased risk of catching gonorrhea again.

Prevention

Previous successful treatment for gonorrhea doesn't make you immune to catching the infection again. In fact, you should consider having another sexual health screen three months after being treated for gonorrhea because there is a higher risk of becoming infected with it or another STI (including HIV) over the next year.

The best ways to help protect yourself from gonorrhea and other STIs are:

• Use condoms when you have vaginal or anal sex.
• Use condoms or dams for oral sex.
• Get tested for STIs when you have a new sexual partner and before you stop using condoms with a partner.
• If you share sex toys, cover them with a new condom or wash them thoroughly before each person uses them.

Antibiotic-resistant ‘super’ gonorrhea

There are different types of gonorrhea bacteria. Some types are resistant to one of the antibiotics used to treat gonorrhea. Gonorrhea that is resistant to antibiotics is often called super gonorrhea. 

Super gonorrhea is usually easy to cure with the right antibiotics, but it may sometimes need treatment with more than one antibiotic or need repeat treatment.  

If you have gonorrhea, a sexual health clinic should always check what type of gonorrhea you have so they can give you the right antibiotics. 

It’s important to take the antibiotics as instructed to help stop gonorrhea becoming resistant to any more antibiotics.

Gonorrhea: Myths vs Facts