Gonorrhoea - including symptoms, treatment and prevention

Gonorrhoea is a serious infection of the genital tract in both men and women, caused by a bacterium Neisseria gonorrhoeae, sometimes called the gonococcus.

Gonorrhoea is a notifiable condition1

How gonorrhoea is spread

Gonorrhoea is transmitted sexually, by oral, anal or genital sex.

Signs and symptoms of gonorrhoea

Both men and women may have gonorrhoea without having any symptoms and so can be infected, or spread infection, without knowing anything is wrong. Some men never develop symptoms, but most do.

Symptoms that may occur in include:

  • Throat and anal infections can occur following receptive oral and anal intercourse and infections at these sites are often without symptoms.
  • Joint pain and infection (arthritis).
  • Conjunctivitis (inflammation of the lining of the eyelids and eye) in both adults and children. Babies born to infected mothers can become infected as they pass through the infected cervix and may develop gonococcal conjunctivitis soon after birth.

Having any sexually transmitted infection (STI) increases the risk of HIV infection if you are exposed to HIV virus while the other infection is present.

Men

In addition to the above, gonorrhoea in men causes urethritis (infection of the urethra, the urinary canal leading from the bladder to exit at the tip of the penis) causing:

  • discharge of pus from the penis
  • a burning sensation in the penis when urinating.

Women

In addition to the above, gonorrhoea in women usually affects the cervix (opening of the uterus at the top of the vagina) causing:

  • vaginal discharge
  • discomfort on urination
  • bleeding between periods, often after having sex.

The infection may spread from the cervix to the Fallopian tubes (tubes leading from the ovaries to the uterus), causing pelvic inflammatory disease (PID). Pelvic inflammatory disease due to gonorrhoea is often without symptoms, but there may be:

  • fever
  • low abdominal pain
  • pain on intercourse.

If untreated, pelvic inflammatory disease may lead to scarring of the Fallopian tubes and ectopic (tubal) pregnancy or infertility.

Diagnosis of gonorrhoea

Diagnosis is made by microscopic examination and growth of bacteria from:

  • a sample of discharge from the cervix or urethra
  • a specimens from the throat, rectum, eye or joints.

Newer molecular tests such as PCR (polymerase chain reaction) tests on urine in a pathology laboratory may be used to screen people with no symptoms.

Incubation period

(time between becoming infected and developing symptoms)

1 to 10 days, sometimes longer.

Infectious period

(time during which an infected person can infect others)

Months if untreated.

Treatment for gonorrhoea

Effective antibiotic treatment is available on prescription from a doctor. After treatment, a follow-up test may be needed to see if the infection has been cured.

Treatment is simple if given soon after infection. Infections may cause lifelong complications, particularly in women, if not diagnosed and treated early.

Prevention of gonorrhoea

  • Practice safer sex.
  • No sex until antibiotic treatment is completed and your usual sexual partner has completed treatment.
  • A follow-up test must be done to make sure that treatment has cleared the infection.
  • All sexual partners need to be contacted, tested and treated, if indicated. Even if partners have no symptoms they may be able to transmit infection to other sexual partners.
  • Testing to exclude other sexually transmitted infections is advisable.

Useful links

1 - In South Australia the law requires doctors and laboratories to report some infections or diseases to SA Health. These infections or diseases are commonly referred to as 'notifiable conditions'.