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Gonorrhoea

Gonorrhoea is a sexually transmitted infection (STI) caused by a bacteria. It is the second most common bacterial STI in the UK after chlamydia and can lead to infertility in men and women. 

Here are some key facts:

  • 1 in 10 men and half of women with gonorrhoea experience no signs or symptoms 
  • Symptoms can include yellow or green discharge, a burning feeling when peeing and pain or tenderness in the tummy
  • It can affect anyone who has ever had unprotected sex
  • Tests usually involve taking a swab of discharge or giving a urine sample
  • If left untreated can affect fertility in men and women
  • It is a bacterial infection 
  • It is passed on through unprotected vaginal, anal or oral sex, sharing sex toys or genital-to-genital contact
  • The only way to protect yourself is to use condoms every time you have sex
  • It is treated with antibiotics
  • Most of the 25,000 cases reported in the UK in 2012 were in under 25s

You can read about gonorrhoea in more detail below.

Signs and symptoms of gonorrhoea

Symptoms of gonorrhoea usually develop within a couple of weeks after exposure to the infection but for some people, it can be months later.

If you have symptoms, you might notice: 

  • Unusual green or yellow discharge from the vagina  
  • Unusual green, yellow or white discharge from the tip of the penis 
  • A burning feeling when peeing 
  • Pain or tenderness in the lower abdomen (tummy)
  • Heavy periods or bleeding between periods (this is rare)
  • Painful swelling of the foreskin
  • Pain or tenderness in the testicles (this is rare)

Gonorrhoea can also infect the rectum or throat if you have unprotected anal or oral sex. In the throat, gonorrhoea usually causes no symptoms but can cause discomfort, pain or discharge in the rectum. If infected semen or vaginal fluid comes into contact with your eyes, this can cause conjunctivitis.

Half of women with gonorrhoea and 1 in 10 men don’t have any obvious signs or symptoms at all, so even if you don’t have any symptoms, it’s really important you go to be tested for STIs if you’ve had unprotected sex.

You also need to consider emergency contraception if you’ve had unprotected sex. 

The causes and spread of gonorrhoea

Gonorrhoea is caused by bacteria called Neisseria gonorrhoeae or gonococcus found in the semen of men and vaginal fluids of women who have the infection. This bacteria can live in the cells of the cervix, the urethra, the rectum and the throat and is passed from one person to another through:

  • Unprotected vaginal sex
  • Unprotected anal sex 
  • Unprotected oral sex 
  • Sharing sex toys without washing them or covering them with a condom with each use

Fluid from the penis or vagina can pass gonorrhoea from one person to another even without penetration, orgasm or ejaculation. It is not clear if gonorrhoea can be passed on by transferring fluids on the fingers or by rubbing the female genitals together.

You don’t need to have had lots of partners and your partner doesn’t need to have experienced symptoms to pass it on to you.

You cannot get gonorrhoea from kissing, hugging, sharing baths or towels, swimming pools, toilet seats or from sharing cups, plates or cutlery.

Gonorrhoea can also be passed from mother to baby during birth but can be treated during pregnancy with antibiotics.

Testing for gonorrhoea

Testing for gonorrhoea is done with either a urine test or a swab test. The swab looks like a small cotton bud and is used to collect a sample of the discharge from inside the vagina or from the tip of the penis. Very often you can take the swab from inside the vagina yourself. A doctor or nurse may take the swab from the tip of the penis or from inside the vagina. If you have had oral or anal sex then a swab may be taken from either your throat or rectum. 

Taking the swabs may be slightly uncomfortable but should not be painful. Men may be asked to provide a urine sample – the clinic will advise you.

If there is a high chance that you have gonorrhoea (for example if your partner has tested positive), you may be given treatment before the results are back.

Gonorrhoea testing is free and you can get one at Brook servicesGUM or sexual health clinics or at some GP surgeriesCervical smear tests and routine blood tests will not detect gonorrhoea.

It is possible to buy gonorrhoea self-tests to do at home but the accuracy of these tests can vary. Some are very accurate if you carefully follow the instructions. Others are less reliable. Get advice from your nearest Brook clinic, GUM or sexual health clinic, GP or pharmacy if you’re unsure.

If you’ve had unprotected sex, don’t wait and hope for the best, have a test as soon as you can. It’s the only way you can be sure that you have gonorrhoea or not and left untreated, it can cause real damage to your body.

Treatment of gonorrhoea

Treatment usually involves having an antibiotic injection and a single dose of antibiotic tablets. Treatment for gonorrhoea does not make you immune from getting it again. 

If you leave gonorrhoea untreated it can spread to other parts of your body and can cause infertility in men and women.

You will be advised to return for a repeat test two – four weeks later to ensure you are clear of gonorrhoea.

If you had symptoms, you should notice improvements quite quickly. You should go back to where you had your test if:

  • The symptoms don’t improve within a week
  • You have unprotected sex again
  • You had unprotected sex with your partner before the treatment was finished
  • You did not follow the instructions or complete the treatment
  • The test was negative but you develop signs and symptoms of gonorrhoea

You should also avoid having sex until you have been given the all-clear, to prevent you being re-infected or passing the infection on.

It is important that you tell your current and any recent sexual partners that you are being treated for gonorrhoea, so that they go for treatment too. In the UK it is recommended you tell any sexual partners you have had over the last six months.

The staff at Brook or sexual health clinics can help if you find it hard to talk to them about gonorrhoea.

Some clinics may also offer to contact your partner using what’s called a ‘contact slip’. This is to warn them they may have been exposed and to recommend they get tested and it doesn’t mention your name.

As with any medication it is always really important to tell the clinic that is prescribing the treatment of any other medication that you may take or any other health problems that you may have. This will help the doctor or nurse to ensure that you are given the most effective treatment. You should also tell the doctor or nurse if you are pregnant or think you may be or if you are breastfeeding.

Is there a super strain of gonorrhoea?

There have been recent reports of a 'super-strain' of gonorrhoea, and the Chief Medical Officer warned that this could lead to gonorrhoea becoming untreatable. This is due to the infection becoming resistant to certain antibiotics, and all GPs and pharmacies have now been advised about the strain of gonorrhoea to ensure the correct antibiotics are being prescribed. If you are worried you should speak to your doctor or nurse.

To protect yourself from gonorrhoea and other STIs you should use a condom every time you have sex, and if you have had unprotected sexual contact get tested for STIs.

Page last reviewed: August 2015
Next review due: August 2017