Gonorrhoea is a sexually transmitted infection (STI) caused by bacteria called Neisseria gonorrhoeae or gonococcus. It used to be known as “the clap”. The bacteria are mainly found in discharge from the penis and vaginal fluid from infected men and women.
Gonorrhoea is easily passed between people through:
*unprotected vaginal, oral or anal sex
*sharing vibrators or other sex toys that haven’t been washed or covered with a new condom each time they are used
The bacteria can infect the cervix (entrance to the womb), the urethra (tube that carries urine out of the body), the rectum and, less commonly, the throat or eyes. The infection can also be passed from a pregnant woman to her baby.
Gonorrhoea is not spread by kissing, hugging, sharing baths or towels, swimming pools, toilet seats, or sharing cups, plates and cutlery, because the bacteria can’t survive outside the human body for long.
If you have any of the symptoms of gonorrhoea or you are worried you may have an STI, you should visit your local genitourinary medicine (GUM) or sexual health clinic for a sexual health test.
Gonorrhoea can be easily diagnosed by testing a sample of discharge picked up using a swab. Testing a sample of urine can also be used to diagnose the condition in men.
It’s important to get tested as soon as possible because gonorrhoea can lead to more serious long-term health problems if it’s not treated, including pelvic inflammatory disease (PID) in women, or infertility.
Who is affected?
Anyone who is sexually active can catch gonorrhoea, especially people who change partners frequently or don’t use a barrier method of contraception such as a condom when having sex.
Gonorrhoea is the second most common bacterial STI in the UK after chlamydia. More than 25,000 cases were reported in England during 2012, with most cases affecting young men and women under the age of 25.
Previous successful treatment for gonorrhoea doesn’t make you immune from catching the infection again.
Symptoms of gonorrhoea usually develop within about 10 days of being infected, although they sometimes may not appear until many months later.
About 1 in 10 infected men and half of infected women will not experience any obvious symptoms, which means the condition can go untreated for some time.
Symptoms in women
In women, symptoms of gonorrhoea can include:
- an unusual vaginal discharge, which may be thick and green or yellow in colour
- pain or a burning sensation when passing urine
- pain or tenderness in the lower abdominal area (this is less common)
- bleeding between periods, heavier periods and bleeding after sex (this is less common)
Symptoms in men
In men, symptoms of gonorrhoea can include:
- an unusual discharge from the tip of the penis, which may be white, yellow or green
- pain or a burning sensation when urinating
- inflammation (swelling) of the foreskin
- pain or tenderness in the testicles (this is rare)
- Infection in the rectum, throat or eyes
Both men and women can also develop an infection in the rectum, eyes or throat by having unprotected anal or oral sex. If infected semen or vaginal fluid comes into contact with the eyes, you can also develop conjunctivitis.
Infection in the rectum can cause discomfort, pain or discharge. Infection in the eyes can cause irritation, pain, swelling and discharge. Infection in the throat usually causes no symptoms.
Seeking medical advice
It’s important to be tested for gonorrhoea if you think there is a chance you are infected, even if you have no obvious symptoms or the symptoms have gone away on their own.
If gonorrhoea is left undiagnosed and untreated, you can continue to spread the infection and there is a risk of potentially serious complications, including infertility.
Gonorrhoea is usually treated with a short course of antibiotics.
Treatment is recommended if:
- tests have shown that you have gonorrhoea (see diagnosing gonorrhoea for more information)
- there is a high chance that you have gonorrhoea, even though your test results haven’t come back yet
- your partner is found to have gonorrhoea
In most cases, treatment will involve having a single antibiotic injection (usually in the buttocks or thigh) followed by one antibiotic tablet. It is sometimes possible to have another antibiotic tablet instead of an injection if you prefer.
If you have any symptoms of gonorrhoea, these will usually improve within a few days, although it may take up to two weeks for any pain in your pelvis or testicles to go away completely. Bleeding between periods or heavy periods should improve by the time of your next period.
Attending a follow-up appointment a week or two after treatment is usually recommended so that another test can be carried out to see if you are clear of infection.
You should avoid having sex until you (and your partner) have been treated and given the all-clear to prevent re-infection or passing the infection on to anyone else.
If your symptoms do not improve after treatment or you think you have been infected again, see your doctor or nurse. Treatment may need to be repeated, or you may need further tests to check for other problems.
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.
If you are worried you may have an STI, visit your local sexual health clinic for advice. You can find yours here.