Quick answer
What is gonorrhoea?
Gonorrhoea is a bacterial STI that can infect the genitals, rectum, and throat — often without symptoms but can cause discharge and pain urinating. Untreated gonorrhoea causes pelvic inflammatory disease and infertility. Diagnosed by swab or urine test; treated with antibiotics — usually an injection plus tablets. Free confidential testing at sexual health clinics. Partners must be treated to prevent reinfection.
Gonorrhoea — “the clap”
Gonorrhoea is a bacterial sexually transmitted infection caused by Neisseria gonorrhoeae — the second most common bacterial STI in England after chlamydia. It infects the cervix, urethra, rectum, throat, and eyes.
Like chlamydia, it is often silent — yet causes infertility, chronic pain, and antibiotic resistance problems if ignored.
Symptoms
Men (more often symptomatic):
- green or yellow discharge from penis
- pain or burning urinating
- testicular pain — epididymitis
Women (often asymptomatic):
- increased vaginal discharge
- pain urinating
- bleeding between periods or after sex
- pelvic pain — PID if ascends
Extragenital:
- rectal — discharge, discomfort — often silent
- pharyngeal — usually no symptoms — important reservoir
Disseminated gonorrhoea (rare):
- joint pain and swelling (septic arthritis)
- skin lesions
- fever
Complications
| Site | Complication |
|---|---|
| Women | PID, infertility, ectopic pregnancy, chronic pelvic pain |
| Men | Epididymo-orchitis, urethral stricture (rare) |
| Pregnancy | Neonatal eye infection — prevented by screening/treatment |
| All | Resistance makes treatment harder |
Testing
Sexual health clinic — gold standard:
- first-catch urine (men and women)
- self-taken vaginal swab
- rectal and throat swabs — request if exposure — not always routine unless declared
NAAT (nucleic acid test) — highly sensitive.
Test with chlamydia always — co-infection common.
Treatment
National guidelines evolve with resistance — current typical first-line (BASHH):
- Ceftriaxone 500mg to 1g intramuscular injection (single dose)
- plus doxycycline 100mg twice daily for 7 days ( chlamydia co-cover)
Test-of-cure:
- repeat swab 2 weeks post-treatment in some guidelines — especially throat infection or treatment failure concern
Resistance:
- Multi-drug resistant gonorrhoea reported globally — UK surveillance active
- never share antibiotics or incomplete courses — drives resistance
Partner notification — essential — anonymous contact tracing available.
Gonorrhoea vs chlamydia
| Gonorrhoea | Chlamydia | |
|---|---|---|
| Discharge | Often purulent, green/yellow | Often mucoid |
| Symptoms in women | Frequently silent | Frequently silent |
| Treatment | Injection + oral combo typical | Oral doxycycline |
Clinic manages both simultaneously.
Prevention
- condoms — reduce risk
- regular screening with new partners
- complete treatment and partner treatment
Pregnancy
Screen and treat — ophthalmia neonatorum preventable with treated mother and prophylactic eye care for newborn per protocol.
Gonorrhoea is curable with correct antibiotics today — but resistance is a real threat. Test, treat, trace partners, and retest as advised.
Common questions
- What are the symptoms of gonorrhoea?
- Men — green or yellow penile discharge, pain urinating, testicular pain. Women — often no symptoms; possible increased discharge, pain urinating, bleeding between periods, pelvic pain. Throat and rectal infection often silent — swab if relevant exposure.
- How is gonorrhoea treated in the UK?
- Current BASHH guidance typically uses ceftriaxone 500mg to 1g IM injection plus doxycycline tablets for 7 days ( chlamydia cover). Regimens change with resistance — sexual health clinics follow latest national guidance. Test-of-cure swab 2 weeks after treatment in some cases.
- Can gonorrhoea go away without treatment?
- No — spontaneous clearance is unreliable and complications develop. Untreated gonorrhoea causes PID, infertility, epididymitis, and rarely disseminated infection affecting joints or heart valves.
- How long after treatment can I have sex?
- Avoid all sex including oral and anal for 7 days after you and partner(s) complete treatment, or until any symptoms resolve — prevents reinfection. Use condoms with new partners.
- Is gonorrhoea the same as chlamydia?
- Both are bacterial STIs with overlapping symptoms — but different bacteria, different antibiotics historically. Clinics test for both together. Co-infection is frequent — dual treatment standard.
- Can oral sex transmit gonorrhoea?
- Yes — pharyngeal gonorrhoea often has no symptoms but can transmit and contribute to resistance spread. Throat swabs needed for complete screening if oral sex occurred.