Gonorrhoea: symptoms, treatment and prevention

Gonorrhoea is a curable bacterial infection caused by the bacteria Neisseria gonorrhoeae. Gonorrhoea is the second most common bacterial STI in Ireland. The groups most commonly affected by gonorrhoea are those under the age of 25 and gay and bi men and men who have sex with men. 

What is gonorrhoea?

Gonorrhoea is a bacterial infection that can infect the cervix (neck of the womb), urethra (the tube through which you pass urine), the uterus (womb), fallopian tubes, ovaries, testicles, rectum (back passage), throat and sometimes the eyes.

The most common symptom of gonorrhoea is a discharge from the tip of the penis. You are less likely to have symptoms if you have a vagina.

How do you get gonorrhoea?

In most cases, gonorrhoea is passed from one person to another through:

• Unprotected sex (oral, vaginal and anal)
• Rimming (mouth-to-anus contact)
• Using unwashed sex toys
• During delivery of a baby (from parent to baby)

Gonorrhoea symptoms in men

If you have a penis and testicles you might have symptoms such as:

• Discharge or liquid from the tip of the penis
• Burning pain when passing urine

1 in 10 men and people with penises have no symptoms from gonorrhoea. Infections in the throat or rectum (back passage) usually go unnoticed. Because of this, it is important to have regular STI check-ups if you are sexually active. The symptoms of gonorrhoea usually appear between 1 to 14 days after coming into contact with the infection.

Gonorrhoea symptoms in women

If you have a vagina, you might not have symptoms at all.

Gonorrhoea rarely shows symptoms in people who have vaginas. 7 in 10 women have no symptoms. Although you may have no symptoms you can still pass gonorrhoea on to others if you have unprotected sex. Going for regular STI check-ups is the best way to protect your health and the health of those you have sex with.

How can I be tested for gonorrhoea?

To get tested for gonorrhoea you will need to book an appointment at a sexual health clinic. How you are tested will depend on what type of symptoms you are showing.

• If you have discharge from your penis, a urine sample is taken, and sometimes a swab is needed from your penis. 
• A swab can also be taken from the vagina.

Sometimes, a swab is needed from your throat or rectum (back passage). Your doctor or nurse can do this or sometimes you may be asked to take the swab yourself. Getting a swab taken may be uncomfortable but it should not be painful. If you are feeling anxious or worried about getting a swab done you can speak to your sexual health nurse or doctor about it and they will be able to talk you through the testing. 

How is gonorrhoea treated?

Gonorrhoea can be treated with antibiotics. Treatment usually consists of an injection into the bum muscle. Sometimes you will be treated straight away, without waiting for the result of a gonorrhoea test. This will happen, for example, if your partner is known to have gonorrhoea or if you have symptoms.

You will be asked to return for a repeat test to make sure the infection has gone. The repeat test is usually done two weeks after treatment.

Do I have to tell my sexual partners I have gonorrhoea?

If you have gonorrhoea, your current partner (or partners) will also be offered testing and treatment.

It is important that all of the people you have recently been in sexual contact with are given the option to be tested and treated. Your doctor or nurse will discuss this with you. Read our article on telling your partner you have an STI for more information.

When can I have sex again?

It is recommended that you don’t have sex until two weeks after you have finished the treatment and you have repeated the test to confirm that you have cleared the infection. It’s really important that you don’t have sex with your partner before they are tested and treated as you could become infected again.

What happens if my gonorrhoea is left untreated?

In people with penises:

Gonorrhoea can spread from the urethra (the tube through which you pass urine) to the testicles and cause pain (a condition called epididymo-orchitis). In some rare cases, this affects fertility.

In people with vaginas:

Gonorrhoea may spread internally from the cervix (neck of the womb) to the uterus (womb), and then up into the fallopian tubes and ovaries. This can lead to pelvic infection and pain – a condition called Pelvic Inflammatory Disease (PID).

PID can lead to scarring of the fallopian tubes and increase the risk of infertility and ectopic pregnancy (a pregnancy that occurs outside the womb, usually in one of the fallopian tubes).

Rarely, gonorrhoea can also spread to the blood (septicaemia) or joints and lead to serious infection.

Gonorrhoea in pregnancy

If you are pregnant and you have gonorrhoea, it is important that you get it treated to prevent your baby from catching the infection during childbirth. In newborn babies, gonorrhoea may cause redness of the eyes (conjunctivitis).

If you need to be treated while you’re pregnant, your doctor or nurse will make sure that the antibiotic prescribed is safe to take while you are pregnant.

If you need treatment while you’re pregnant, you will need to be re-tested after finishing your gonorrhoea treatment. This is to make sure that you have a negative gonorrhoea test before you give birth, ensuring that your baby will not be infected.

How can I protect myself against gonorrhoea?

There are many great options to help protect your sexual health, but none of them are 100% effective. Even if you use condoms every time you have penetrative sex, you are still at risk of getting genital warts and herpes, as these can be passed through skin-to-skin contact. Going for an STI check or taking a home STI testing kit with a partner before having sex, can be a great way of protecting yourself and those you have sex with against STIs and HIV. However, not all STI checks check for all STIs, so it is important to speak to your healthcare provider and ask them what are being tested for as part of your screening.

Discussing with your sexual partners the type of contraception or protection options available to you, and agreeing on a type that works for everyone involved can help to reduce the risk of pregnancy, STIs and HIV. Looking out for sores or symptoms on a partner’s genitals before having sex with them, can help to identify STIs that they may not be aware of. If you do see any signs that someone may have an STI, do not have sex with them until you know for certain it is safe to do so. Asking someone about their sexual health history is the responsible thing to do before having sex, and it should not be taken as an insult if someone asks you about yours. 

Looking after your mental health after an STI diagnosis

If you are diagnosed with an STI, you might feel a mixture of emotions. Unfortunately, there is still stigma in our society surrounding STIs that can cause some people to feel shame about having one. However, like any other healthcare diagnosis, you are not to blame for your STI and have not done anything “wrong”. Being diagnosed with an STI can have a negative impact on your mental health and wellbeing and if you don’t feel comfortable telling friends or family about it, you might feel isolated and alone. If you have found out you have an STI and you’re finding it difficult to cope, there are things you can do to support your mental health. 

• Remember that STIs are common and lots of people have one at some point in their life, even though they aren’t talked about a lot 
• Take time out to do something you enjoy and practice self-care
• Reach out for mental health support if you need it. If you don’t feel comfortable talking to a friend or family member, our 24/7 anonymous text service, 50808, can help
• Be patient with yourself and allow yourself to feel your emotions. It’s ok to be upset when you find out you need healthcare treatment. It’s important to take the time you need to adjust

Feeling overwhelmed and want to talk to someone?

• Get anonymous support 24/7 with our text message support service
• Connect with a trained volunteer who will listen to you, and help you to move forward feeling better
• Free-text SPUNOUT to 50808 to begin
• Find out more about our text message support service

If you are a customer of the 48 or An Post network or cannot get through using the ‘50808’ short code please text HELLO to 086 1800 280 (standard message rates may apply). Some smaller networks do not support short codes like ‘50808’.