Gonorrhoea: Symptoms, Testing, and Treatment

What is gonorrhoea?

Gonorrhoea is a common sexually transmitted infection (STI) caused by the bacteria Neisseria gonorrhoeae. This bacteria is found in semen and vaginal fluids, and it can be passed on to another person during unprotected sex. Although gonorrhoea is treatable with antibiotics, it can lead to serious health problems if left untreated.

Because gonorrhoea doesn't always cause symptoms, especially in the early stages, it's important to get tested if you think you've been at risk, even if you feel perfectly healthy. It's also often tested for alongside chlamydia, another common STI with similarly easy-to-miss symptoms.

 

How do you get gonorrhoea?

Gonorrhoea is spread through unprotected vaginal, anal, or oral sex. The infection is passed through contact with semen or vaginal fluids containing the bacteria. It's also possible to contract gonorrhoea through sharing sex toys.

Unprotected sex can allow the bacteria to enter the cervix, urethra, or rectum, and it can also affect the throat or eyes if fluids come into contact with those areas during sex.

For extra protection during oral sex, you can use condoms or dental dams — thin, flexible sheets of plastic that cover the genitals or anus.

Symptoms of gonorrhoea

Not everyone with gonorrhoea will experience symptoms. It's estimated that one in ten men and half of all women with gonorrhoea don't show symptoms, but the infection can still be passed on to others. If symptoms do appear, they often develop within two weeks of exposure (though it can take longer).

Symptoms in women:

  • Unusual vaginal discharge (thin, watery, green/yellow)
  • Pain when urinating
  • Abdominal or pelvic pain
  • Irregular bleeding, such as between periods or after sex
  • Heavier periods than usual

Symptoms in men:

  • Unusual discharge from the penis (white, yellow, or green)
  • Pain or a burning sensation when urinating
  • Swelling or pain in the foreskin
  • Pain in the testicles

Gonorrhoea can also infect the rectum, causing pain and discharge, or the eyes, leading to conjunctivitis (redness, pain, and discharge).

Person lying curled up on a sofa in pain, holding their stomach

What happens if gonorrhoea is left untreated?

Because gonorrhoea can be symptomless, it's possible to have it without realising for some time. If left untreated, it can potentially lead to:

  • In women: pelvic inflammatory disease (PID), which can cause chronic pelvic pain and, in some cases, difficulty getting pregnant.
  • In men: epididymitis, a painful swelling of the tubes that carry sperm, which can occasionally affect fertility.
  • In rare cases: the infection can spread to the blood or joints, causing joint pain, skin rashes, or fever — known as disseminated gonococcal infection.
  • In pregnancy: a risk of passing the infection to the baby during birth.

These complications are uncommon when gonorrhoea is diagnosed and treated promptly, which is why testing matters even without symptoms.

Testing for gonorrhoea

If you think you may have been exposed to gonorrhoea, it's important to get tested. Generally, you should wait about two weeks after potential exposure before testing for gonorrhoea. Testing is simple and involves providing a urine sample or having a swab taken from the affected area.

You can get tested for free at NHS clinics or, if you prefer privacy, you can order a home test kit. Simply send off your sample to a lab for results.

Treatment for gonorrhoea

Typically gonorrhoea is treated with antibiotics which are given as an injection or tablets. Often a swab is taken to test the strain of gonorrhoea and which antibiotics are effective to treat this. After treatment a repeat gonorrhoea test is done to check that the treatment has effectively cleared the infection.

Reducing your risk

  • Use condoms or dental dams consistently during vaginal, anal, and oral sex to reduce the risk of transmission.
  • Test regularly, especially if you're sexually active with new or multiple partners.
  • Avoid sharing sex toys, or wash and cover them between uses.
  • Talk to partners. If you test positive, current partners and anyone you've had sex with recently should also be tested and treated to avoid reinfection.
Hand picking up a blister pack of the morning-after pill from a table

Frequently asked questions

No, gonorrhoea needs antibiotic treatment to clear. Left untreated, it can persist and potentially lead to complications, even without symptoms.

No, they're caused by different bacteria, though they're often tested for together, as both are common STIs that can have similar symptoms or none at all.

It's generally recommended to wait around a week after potential exposure before testing, to allow the infection to be reliably detected.

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