Gonorrhoea

Gonorrhoea is a sexually transmissible infection (STI) caused by the bacterium Neisseria gonorrhoeae.

Gonorrhoea can cause infection of the urethra (tube that connects the bladder to the outside of the body), cervix (the lower part of the womb), anus, throat and less commonly, the eyes.

If left untreated, gonorrhoea can lead to serious conditions, including infertility.

Symptoms

Gonorrhoea can affect all people and the symptoms depend on the body part that’s infected. Often there are no symptoms at all particularly in the cervix, throat, and anus. Even without symptoms, gonorrhoea can still be passed on through unprotected sexual contact. If symptoms do occur, they usually develop 1-14 days after contact with an infected person.

If you have symptoms, they may include:

• pain, stinging or burning when passing urine
• pain during or after sex
• unusual vaginal discharge
• irregular vaginal bleeding
• yellow or white discharge from the penis
• redness around the opening of the penis
• painful or swollen testicles
• anal discharge and discomfort
• sore, dry throat.

Long-term problems

Everyone can experience long-term conditions if their gonorrhoea infection is left untreated. These long-term conditions may develop even if a person did not have any other symptoms.

Untreated gonorrhoea can cause Pelvic Inflammatory Disease (PID). This condition may lead to complications, including infertility, chronic pelvic pain and ectopic (tubal) pregnancy. The risk of infertility increases with each bout of inflammation, especially if left untreated for long periods.

Untreated gonorrhoea can cause long-lasting irritation in the penis or pain in the testicles, as well as damage to the tubes that transport sperm, which may lead to reduced fertility.

In all people, untreated gonorrhoea may spread via the blood stream to cause severe joint pain and other internal infections. Having gonorrhoea can make it easier for a person to become infected with HIV or to pass HIV on to someone else.

Babies who have had contact with the mother’s infected birth canal during childbirth can develop an eye infection (gonococcal conjunctivitis) which may cause vision loss if not rapidly and adequately treated. Newborns may also develop severe systemic infections such as sepsis (blood poisoning) and meningitis.

How gonorrhoea is spread

Gonorrhoea is spread by:

• having unprotected (sex without a condom) vaginal, oral, or anal sex with someone who is infected with gonorrhoea
• kissing a person with a throat infection
• sharing personal items such as sex toys.

Gonorrhoea can also be passed to a baby during childbirth from contact with the mother’s infected birth canal.

Having gonorrhoea once does not protect you from getting it again. Even after you’ve been successfully treated, you can still be reinfected.

Diagnosis

Diagnosis of gonorrhoea is based on laboratory testing which involves collecting a urine specimen or swab (a sample of secretions) from the relevant body site, often the cervix, vagina, urethra, anus, or throat.

The bacteria in the sample are grown in the laboratory to determine which antibiotics will be most successful in treating the gonorrhoea.

Treatment

Treatment is usually one antibiotic injection in the buttock together with oral antibiotic tablets. To prevent the spread of the infection or complications, it is important you are treated, even if you have no symptoms.

Sexual partners

You should tell anyone you have had vaginal, oral, or anal sex with in the last two months so they can also be tested.

The Let Them Know website provides advice about how to personally or anonymously inform your partner or partners.

When you can have sex again

You should not have vaginal, oral, or anal sex (not even with a condom) for seven days after your treatment has finished, as you could still pass the infection to a partner.

Further tests after you have been treated

Repeat testing is done to check the treatment has been successful and that you haven’t been re-infected. The length of time you need to wait before the repeat test depends on the site of infection. Your healthcare provider will discuss this with you.

Prevention

You should:

• make sure your current partner or partners are tested and treated
• always use a condom for both anal and vaginal sex and consider one for oral sex too
• ask new partners to get an STI check before you decide to stop using condoms
• have regular sexual health screens.

More information

For more information about gonorrhoea, contact:

• your General Practitioner
• Canberra Sexual Health Centre on (02) 5124 2184
• call the Health Protection Service, Communicable Disease Control Information Line during business hours on (02) 5124 9213.

Acknowledgements

• Heymann DL. Control of Communicable Diseases Manual. 20th edn. Washington: American Public Health Association, USA; 2015.
• Canberra Sexual Health Centre (2021), Gonorrhoea Fact Sheet.