Patient information from BMJ

Gonorrhea

Last published:Dec 16, 2020

Gonorrhea is an infection that is passed from person to person during sex. It can cause serious health problems. But it is often easy to treat. Practising "safe sex" will help protect you from getting it.

You can use our information to talk to your doctor about what treatments are best for you.

What is gonorrhea?

Gonorrhea is an infection caused by bacteria called Neisseria gonorrhoeae. The bacteria can pass from person to person during sex.

• In women gonorrhea usually affects the neck of the womb (the cervix) or the tube that carries urine from the bladder to the outside (the urethra), or both.

• In men it most often affects the tube that carries urine out from the bladder (the urethra).

• The infection can be passed on by oral sex and anal sex as well as by vaginal sex. So it can also affect the throat and rectum as well as the genitals.

• Touching your eyes after touching infected fluid from your genitals can lead to eye infection. This is called gonococcal conjunctivitis.

Sometimes gonorrhea can spread into other parts of your body, which can cause serious complications.

Newborn babies can get eye infections if gonorrhea is passed to them during childbirth. This can cause blindness if it's not treated with antibiotics.

What are the symptoms?

Many women who get gonorrhea have no symptoms. But men usually get some signs that they have been infected.

If you're a woman you might get:

• a yellow or greenish discharge from your vagina

• burning pain when you urinate

• pain in your lower abdomen

• bleeding between your periods (this is rare).

If you're a man you might get:

• burning pain when you urinate

• a need to urinate more often than usual

• fluid or pus coming out of your penis (often leaving a yellow or yellow-green spot on your underwear)

• sore testicles

• redness or soreness at the tip of your penis.

You might get a sore throat if you have gonorrhea in your throat. And if the infection is in your rectum you might have pain, itching, or discharge there.

If you think you might have gonorrhea, or any sexually transmitted infection, you should see your doctor or go to your local sexual health clinic as soon as possible.

The doctor or nurse will examine you and take a sample of urine or a swab sample to test whether you have gonorrhea. You might get the results of tests straight away, or in a few days.

If gonorrhea spreads into your bloodstream you might get painful joints, a rash, and a fever. Tests will show if your symptoms are caused by gonorrhea.

If the test shows that you have gonorrhea, your last sex partner, and any other partners you've had within the last few months, should be tested for gonorrhea too.

This is especially important if you have had sex partners who are women, because many women have no symptoms and may not know that they could be infected.

What treatments work?

If you have gonorrhea, treatment with antibiotics should get rid of the infection. Antibiotics are medicines that kill bacteria.

You'll probably have an antibiotic shot as well as an antibiotic pill to take at the same time. This is all the treatment that most people need.

But if gonorrhea has spread to other parts of the body you will need to take antibiotics for at least a week. You might be given antibiotics through a drip (also called an intravenous infusion or IV). And you may need to stay in the hospital.

Antibiotics don't usually cause serious side effects. But some people feel sick, or get stomach pain or diarrhea.

Other things you need to know

• If you have gonorrhea you might also have chlamydia, another infection that spreads during sex. You might be tested and treated for both infections. Or you might be treated for both even if you haven't been tested.

  This is because it takes some time to get the test results. Doctors worry that some people might not come back to find out their results, so they treat them right away without doing a test. Chlamydia is also treated with antibiotics.

• You should not have sex again until you and your partner or partners have finished treatment for gonorrhea.

What will happen to me?

If you’re a woman

Gonorrhea that isn’t treated can spread to your ovaries, womb, or the tubes that lead from your ovaries to your womb (the fallopian tubes). When this happens it is called pelvic inflammatory disease (PID).

PID can lead to blocked fallopian tubes, which can make it hard for you to get pregnant. PID can also lead to an ectopic pregnancy. In an ectopic pregnancy a fertilized egg starts growing in the fallopian tube.

Ectopic pregnancies are dangerous for the mother. The egg cannot develop into a baby and usually has to be removed, either using drugs that end the pregnancy or with an operation.

PID can be treated with antibiotics. The sooner you get treatment, the easier it is to treat.

If you’re a man

It’s rare for men to get any further problems from gonorrhea. This is because most men get symptoms, so they get treatment.

But if you are not treated, gonorrhea can spread to your testicles and your prostate. This can be painful. You can also get scar tissue in your urethra, blocking the flow of urine. This can lead to further infections and possible kidney damage.

What can I do to stop getting gonorrhea again?

The best way to reduce your risk of getting infected with gonorrhea again is to always use condoms during sex.