Gonorrhoea

What is gonorrhoea?
Gonorrhoea is a curable sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. The numbers affected are likely to be underestimated as up to 86% of women and 55% of men have no symptoms. Clinical signs of infection include mucosal inflammation of the urogenital tract, throat and rectum in males and females, and eye infections in babies born to infected mothers. Serious complications can occasionally occur if infections are not treated.

How do people get gonorrhoea?
Gonorrhoea can be transmitted during unprotected vaginal, anal or oral sex with an infected person. It can also be transmitted from an infected mother to her baby during vaginal childbirth. In such instances the baby may develop blindness, joint infection or a life-threatening blood infection.

What are the symptoms of gonorrhoea?
Symptoms may be mild or absent in up to 86% of women and 55% of men. Even if a person is asymptomatic they can still transmit the infection to a sexual partner. If present, symptoms in women include; yellow or bloody vaginal discharge, bleeding associated with vaginal sex, bleeding between periods and a burning sensation during urination. Men may experience a white, yellow or green discharge from the penis, a burning sensation when passing urine and occasionally, painful or swollen testicles. If the infection is transmitted via anal sex, it can cause anal itching, soreness, discharge, pain during anal sex, bleeding or painful bowel movements. Gonorrhoea transmitted during oral sex is usually asymptomatic but may cause a sore throat. If symptoms do occur, they usually appear within 2-10 days of infection. They can persist or they may only last for a few days. A small number of people may be infected for over 30 days before they experience symptoms.

What complications can result if gonorrhoea is not treated?
In women, if gonorrhoea is not treated it can spread from the vagina and cervix into the uterus or fallopian tubes and cause pelvic inflammatory disease (PID). This may be asymptomatic or symptoms may include abdominal pain, bleeding between periods, vomiting and/or fever. PID can cause permanent damage and lead to ectopic pregnancy, chronic pelvic pain and tubal-factor infertility. In men, untreated gonorrhoea infection can cause epididymitis, an inflammation of the male reproductive tubes, which can occasionally lead to sterility. Gonorrhoea is also a common cause of urethritis (inflammation of urethra). Rarely, untreated gonorrhoea can spread to the blood or the joints and can be life threatening.

How is gonorrhoea diagnosed?
Gonorrhoea can usually be diagnosed from a swab taken from the penis, cervix or other affected area or from a urine sample. One or a combination of the following laboratory techniques are used for diagnosis; gram staining (pus from the swab is stained and examined under a microscope), cell culture (bacteria from the swab are grown in a special culture medium) and/(or) molecular techniques (bacterial genes are detected from a swab or urine sample). Testing is most commonly done at STI clinics. However, some GPs, family planning clinics, antenatal clinics and health centres also offer testing.

How is gonorrhoea treated?
Gonorrhoea can be usually be treated and cured with one of several antibiotics. However, strains of gonorrhoea that are resistant to commonly used antibiotics have been increasingly seen in South East Asia, Australia, Europe and the US and this makes treatment more difficult. Sex should be avoided until treatment is completed and recent sexual contacts (within the last three months) of an infected person should also be tested regardless of whether they are symptomatic. Antibiotics will not repair any permanent damage already done by the disease and further sexual contact with an infected person can result in reinfection.

How do you protect yourself against gonorrhoea?

  • Abstinence.
  • Mutually monogamous relationship with an uninfected person.
  • Correct use of male latex condoms can reduce the risk of transmission of gonorrhoea.
  • Reducing the numbers of sexual partners and the frequency of new partners will reduce the risk of infection.
  • Regular testing is recommended for individuals who are sexually active and have risk factors for gonorrhoea (multiple partners, unprotected sex with new partners).

Last updated: 20 April 2009