Sexual Health Advice - Patient Information Leaflets
Gonorrhoea
What is gonorrhoea?
Gonorrhoea is an infection caused by a bacterium (germ) called the gonococcus. The bacterium usually lives inside the cells of the cervix (entrance to the womb), the urethra (tube where urine comes out), the rectum (the back passage), the throat and occasionally the eyes.
How do you get gonorrhoea?
Gonorrhoea can be passed on if you have vaginal, anal or oral sex with an infected person or if you share sex toys. Using a condom correctly will reduce your chance of getting and passing on gonorrhoea. It is also possible to transfer the infection from the genital areas to the eyes by fingers, and for a pregnant woman to pass the infection to her baby's eyes at birth (conjunctivitis). You cannot get gonorrhoea from kissing, hugging, sharing cups or plates, sharing towels or from swimming pools.
What are the symptoms of gonorrhoea?
About 10% of infected men and 50% of infected women will not have any symptoms at all.
Symptoms can show up 1 – 14 days after coming into contact with gonorrhoea. Sometimes it can be many months later or not until the infection spreads to other parts of the body.
If you do get symptoms, they may include:
Women
An unusual vaginal discharge – may be thin or watery, yellow or green
Pain when passing urine
Pain in lower abdomen
Men
Infection of the urethra (urethritis) causing:
discharge from the tip of the penis; white yellow or green
pain or burning when you pass urine
irritation inside the penis, or a feeling of wanting to pass urine more frequently
redness at the opening of the urethra at the end of the penis
pain or tenderness in the testicles
Infection in the rectum may not have any symptoms, but may cause irritation, itch and discharge from the anus.
Infection in the throat usually has no symptoms, but may cause a sore throat.
Infection in the eyes can cause pain, swelling, irritation and discharge (conjunctivitis).
How is gonorrhoea diagnosed?
There are different ways of testing for gonorrhoea.
Women
A doctor or nurse may use a swab to collect a sample of cells from the cervix during an internal examination, or from the vagina.
You may be asked to use a swab or a tampon yourself to collect cells from inside the vagina.
Men
You may be asked to provide a urine sample. Before having this test you may be advised not to pass urine for 1 – 2 hours.
Men and women
A doctor/nurse may use a swab to collect a sample of cells from the entrance of the urethra
If you have had anal or oral sex, the doctor or nurse may use swabs to collect cells from your rectum/throat.
If you have symptoms of conjunctivitis, swabs will also be used to collect a sample of discharge from your eyes.
It is possible to do a gonorrhoea test within a few days of having sex but sometimes you will be advised to wait up to a week after having sex. You can test for gonorrhoea even if there are no symptoms. The results of the swabs will usually be back within 5 days. The accuracy of a gonorrhoea test depends on the test used and from which part of the body the sample is collected. The accuracy of a single test from the genital area is between 75 and 95%.
What is the treatment for gonorrhoea?
The treatment for gonorrhoea is antibiotics – a single dose of antibiotic tablets or having one antibiotic injection.
If complications have occurred, other treatment may also be needed.
Some of the antibiotics that are used to treat gonorrhoea interact with the contraceptive pill. Therefore it is important you tell the doctor or nurse so they can advise you what to do
Antibiotic treatment is at least 95% effective. However some infections are resistant, particularly those caught abroad. Therefore if you or your partner could have got gonorrhoea whilst abroad, tell the doctor.
There is no evidence that complementary therapies can cure gonorrhoea.
Does my sexual partner need treatment for gonorrhoea?
Yes. They should be tested for infection, even if they do not have any symptoms. A course of antibiotics is usually advised for sexual partners, even if the tests are negative, because:
Bacteria that cause gonorrhoea are often passed on during sex. Tests for bacteria are not foolproof. A course of antibiotics helps to make sure that any possible infection is cleared.
Some women who are infected with gonorrhoea do not have symptoms. If this is left untreated, it can cause complications at a later time such as a serious infection of the uterus (‘pelvic inflammatory disease') and infertility.
It is important that you avoid vaginal, anal or oral sex until you and your partner have both finished treatment, otherwise you could be re-infected. Using a condom will reduce this risk but not guarantee it.
Can gonorrhoea go away without treatment?
The symptoms may clear over time without treatment. This can take anywhere between a couple of weeks to 6 months. However, the absence of symptoms does not mean the infection has gone. It is still possible to pass the infection on to someone else.
Without proper treatment the infection can spread to other parts of the body causing damage and serious long term complications. In women gonorrhoea can spread to other reproductive organs causing pelvic inflammatory disease (PID). This can lead to long term pelvic pain, blocked fallopian tubes, ectopic pregnancy (pregnancy outside the womb) and infertility.
In men it can lead to inflamed testicles, inflamed prostate and infertility.
How will I know how long I have had gonorrhoea infection for?
It can be impossible to know, particularly if you do not get any symptoms or they appear a long time after you have been exposed to gonorrhoea. You might never know whether you got gonorrhoea from your current partner or a previous sexual partner. These doubts can often be difficult to handle so do not be afraid to talk to the clinic staff about how you feel.
Follow up for gonorrhoea
A doctor or health care profession will often want to know that treatment has worked. It is common to be reviewed soon after you finish treatment to check that symptoms have gone. Sometimes re-testing and a second antibiotic is needed if symptoms persist.
What happens if I get gonorrhoea when I am pregnant?
Gonorrhoea can be passed to the baby during childbirth. This can cause inflammation and discharge in the baby's eyes (conjunctivitis). Gonorrhoea can be treated with antibiotics when you are pregnant or breast feeding – these will not harm the baby.
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