Gonorrhea

What is gonorrhea?#

Gonorrhea is a sexually transmissible infection (STI) caused by the bacterium Neisseria gonorrhoeae. It usually affects the genital area, although the throat or anus (rectum) may also be involved. It affects both men and women and is easily passed on during vaginal, anal or oral sex.

A newborn can develop gonococcal conjunctivitis (red, sore eyes) after contact with an infected birth canal during childbirth. This can cause vision loss if it is not treated rapidly and adequately.

Who is at risk of gonorrhea?#

Gonorrhea is a common STI. It can affect anyone who has unprotected sex (without condoms) with someone who has the infection. People at increased risk include:

• men who have sex with men
• female partners of men who have sex with men
• heterosexual men and women, particularly those who have multiple sexual partners, who are returning from areas where gonorrhea is common, or who inject drugs
• people in some populations with higher local rates of infection
• sex workers

What are the symptoms?#

The symptoms differ slightly between men and women.

Often, women with gonorrhea have no symptoms, which means the infection can go undetected for longer if they are not tested regularly. When symptoms do occur in women, they may include:

• unusual vaginal discharge
• pain while urinating
• pain during sex

In men, gonorrhea commonly infects the inside of the penis (the urethra). Symptoms may include:

• a burning sensation while urinating
• a white or yellow pus-like discharge from the penis, which may be seen in underwear
• swelling or pain in the testicles, which can occur if the infection is left untreated

In a small percentage of men there are no symptoms at all.

In both men and women, anal gonorrhea often occurs without any signs or symptoms. Gonorrhea in the throat may cause a sore throat but usually causes no symptoms.

Complications#

If left untreated, gonorrhea can lead to pelvic inflammatory disease (PID) in women, which can cause infertility. Symptoms of PID can include:

• fever
• lower abdominal pain and tenderness
• deep pain during sexual intercourse
• heavy and painful periods

The risk of infertility increases with each bout of inflammation, especially if it is left untreated for a long time. Women who have had PID need to be especially careful about gonorrhea and chlamydia.

How often should I get checked?#

Sexual health check-ups are recommended for anyone who is sexually active. If you are sexually active, have a full sexual health check (including tests for syphilis, HIV, gonorrhea and chlamydia) at least once a year.

How often you need checks depends on your risk:

• Men who have sex with men and who have more than one partner should be checked every 3 to 6 months.
• A man who has sex with another man and has one partner should be checked once a year.
• Sexually active women with new partners, or who feel they may be at risk, should be tested regularly, because gonorrhea may not cause symptoms until PID has already developed.

How is gonorrhea diagnosed?#

A regular sexual health check-up with a doctor or sexual health clinic can detect gonorrhea. Depending on the situation, the doctor or nurse may take a swab from the urethra, cervix, anus or throat, or ask for a urine sample. Test results are normally available within about a week.

How is gonorrhea treated?#

Gonorrhea is treated effectively with antibiotics. Symptoms usually resolve quickly, often within a week. Tell your doctor or nurse if you still have symptoms after treatment.

Avoid any type of sex (even with condoms or internal protection such as dams) until treatment is finished.

Some strains of gonorrhea are now resistant to many antibiotics. Your doctor will know which antibiotic to prescribe based on current treatment guidelines. Tell your doctor if you have been traveling overseas, as many of the newer resistant strains have originated in other parts of the world.

Can you get reinfected?#

Having gonorrhea once does not protect you from getting it again. Even after successful treatment, you can be reinfected by having sex with a partner who has the infection.

It is important to let your sexual partner or partners know that you have gonorrhea. Most people appreciate being told they may have an infection, and it is an important step in preventing further spread in the community. If your partner is treated, this also helps prevent you from being reinfected.

You do not have to do this alone. Your doctor or a sexual health clinic can help you through this process and protect your privacy. Where available, confidential services can help you notify your sexual partners anonymously if you feel unable to speak to them personally.

Reducing your risk#

Ways to reduce your risk of catching gonorrhea include:

• always practising safe sex and using condoms and water-based lubricant for all types of sex
• using female (internal) condoms as an option for vaginal or anal sex
• having a full sexual health check (including tests for syphilis, HIV, gonorrhea and chlamydia) at least once a year if you are sexually active
• getting tested more often if you are at greater risk

Men who have sex with men should have a syphilis test and tests for other STIs at least once a year, and up to four times a year if they have several partners. Remember that gonorrhea can also be spread through unprotected oral sex.

Key points#

• Gonorrhea is a common STI caused by the bacterium Neisseria gonorrhoeae and can affect the genitals, throat or anus.
• Many women, and some men, have no symptoms, so regular testing is important for anyone who is sexually active.
• Left untreated, it can cause pelvic inflammatory disease and infertility, and newborns can develop a serious eye infection.
• It is treated with antibiotics, but some strains are now resistant, so treatment follows current guidelines and partners should also be tested and treated.

Where to get help#