Gonorrhoea is a sexually transmitted infection caused by bacteria called gonococcus (neisseria gonorrhoeae). The bacteria are found mainly in vaginal fluid and discharge from the penis; they can live inside the cells of the cervix, urethra, rectum, throat and rarely the eyes. Gonorrhoea is easily passed between people through unprotected vaginal, oral or anal sex and sharing sex aids.
Around one in ten infected men and almost 50% of infected women are symptom free. An early diagnosis and prompt treatment will reduce the risk of any further more serious complications. In women this can be pelvic inflammatory disease (which can lead to longer-term pelvic pain, ectopic pregnancy and potential infertility) or male testicular infection (which may also lead to a reduction in fertility). These complications that may appear from longer term infection are more challenging to treat. Gonorrhoea can also be passed from a pregnant woman to her baby during childbirth and cause conjunctivitis or even blindness if treatment is not administered.
Symptoms of gonorrhoea in women may include a "thicker" discharge from the vagina which may be yellow or green in colour, pain on urination and less often tenderness or pain in the lower abdomen and heavier periods or spotting between periods.
The majority of men who contract gonorrhoea experience symptoms after they are infected, which can include discharge from the penis, which may be white, yellow or green, pain or a burning feeling on urination, inflammation of the foreskin and less frequently pain or tenderness in the testicles or prostate gland.
Both women and men can also catch gonorrhoea at other sites of the body. These include infection in the rectum, throat and eyes.
If gonorrhoea or any other sexually transmitted infection is suspected it is important not to delay getting tested - even without symptoms. A self-administered swab (like a cotton bud) is commonly used in women and a urine sample is taken for men, an examination is not always required.
Gonorrhoea is treated with a single dose of antibiotics, usually a 500mg injection of ceftriaxone or 400mg oral cefixime. One gram oral azithromycin is usually provided at the same time and this will also deal with Chlamydia in the case of a co-infection. Other antibiotics can be used particularly for more complicated or throat/eye infections. Hence, sexual intercourse and intimate contact should be avoided until both partners have finished the course of treatment and for a further seven days to prevent reinfection, reduce the need for further treatment and prevent further dissemination of the infection. It is important that sexual partners are tested and treated (both current and recent).
Treatment is at least 95% effective. If the antibiotics have been effective, there should be an improvement in symptoms however it is common to be asked to take a follow up test to be sure. Gonorrhoea can be treated with antibiotics when pregnant or breastfeeding but this requires a face to face consultation.