Gonorrhoea is caused by bacteria (tiny germs) called Neisseria gonorrhoeae.

In people with gonorrhoea, the bacteria are most commonly found in the cervix (entrance to the uterus) and urethra (the tube you pee from). The bacteria can also infect the throat, the rectum (back passage), and the eyes.

Sometimes gonorrhoea can spread to other parts of the reproductive system, including the uterus (womb), fallopian tubes, ovaries, and testicles.

Anyone who’s sexually active can get and pass on gonorrhoea. You don’t need to have lots of sexual partners.

It’s usually passed on through sex or sexual contact.

Gonorrhoea is usually passed on through vaginal, anal or oral sex without a condom with someone with the infection, or by coming into contact with the semen (cum or pre- cum) or vaginal fluids of someone who has it.

Gonorrhoea:

• is most commonly spread through vaginal/ frontal or anal sex without a condom
• can be spread by sharing sex toys that aren’t washed or covered with a new condom each time they’re used
• can be spread by giving or receiving oral sex (going down, giving head) with someone who has the infection; the advice is to use a condom or a dam (a latex or plastic square that covers the anus or vulva)
• may sometimes be transferred from the genitals to the eye(s) by the fingers and cause conjunctivitis (infection or irritation of the eye); this isn’t common
• may sometimes spread to the rectum from vaginal discharge; you don’t need to have anal sex for this to happen.

If you’re pregnant it’s possible to pass gonorrhoea to the baby – also see below for What if I’m pregnant?

It’s not clear if gonorrhoea can be spread by transferring infected semen or vaginal fluid to another person’s genitals on the fingers or through rubbing vulvas (female genitals) together.

You cannot get gonorrhoea from hugging, sharing baths or towels, swimming pools, toilet seats or sharing cups, plates or cutlery.

Signs and symptoms can be similar for each infection.

Many people with gonorrhoea won’t have any obvious signs or symptoms or will have symptoms so mild they’re not noticed.

If you do get signs and symptoms, they can show up soon after coming into contact with an infection, many months later, or not until the infection spreads to other parts of your body. They most usually show up after 2 to 14 days.

If you have a vagina/front hole you may notice:

• Bleeding between periods and/or heavier periods or withdrawal bleeds
• Bleeding after sex
• Pain when you have sex
• Pelvic pain (pain low down in the tummy)
• Unusual or increased vaginal discharge that may be thin or watery, yellow or green
• Pain when passing urine (peeing)

If you have a penis you may notice:

• An unusual discharge from the tip of the penis. It may be white, yellow or green
• Pain or a burning feeling when passing urine (peeing)
• Pain in the testicles (balls)

Other parts of the body:

• Infection in the rectum (back passage) doesn’t usually have any signs or symptoms but may cause discomfort, pain or discharge
• Infection in the throat is less common than genital infection and usually has no symptomsInfection in the eyes can cause pain, swelling, irritation and/or discharge

Anyone sexually active can get gonorrhoea. You can only be certain you have gonorrhoea if you have a test.

It’s important not to delay testing so that you can start treatment and don’t pass an infection on to anyone else.

Consider doing a test if:

• you or a sexual partner have, or think you might have, symptoms
• you’ve recently had sex without a condom with a new partner
• you or a partner have had sex without a condom with other partners
• during a vaginal examination, your doctor or nurse says that the cervix is inflamed and/or there’s an unusual discharge
• a sexual partner tells you they have an STI
• you have another STI

You could have gonorrhoea even if a partner’s test is negative. The only way to make sure you don’t have gonorrhoea is to get tested yourself.

A gonorrhoea vaccine – see below – can help lower your chance of getting gonorrhoea. But you could still have gonorrhoea even if you’ve been vaccinated, so it’s important to get tested as well.

If you have one STI, you’ll be encouraged to test for others as you can have more than one STI at the same time.

If you’ve had gonorrhoea once, you won’t be immune – you can get it again.

It’s important not to delay getting a test if you think you may have gonorrhoea. The earlier gonorrhoea is treated, the less likely you are to have any complications.

A gonorrhoea test can be done straight away but you may be advised to have another test 2 weeks after having sex.

You can have a test even if you don’t have any symptoms.

If you have a vagina/front hole:

• A gonorrhoea test is usually done by gently wiping a swab around the inside of your vagina to collect a sample to test. You may be able to take the swab yourself or a doctor or nurse may do it

If you have a penis:

• You can give a urine sample to test for gonorrhoea if you have no symptoms. Before a urine test, you’re advised not to pass urine (pee) for 1 to 2 hours.
• A doctor or nurse may take a swab from the entrance of the urethra (tube you pee from) to test for gonorrhoea

Other parts of the body

• If you’ve had anal or oral sex, a doctor or nurse may swab your rectum (back passage) or throat to test for gonorrhoea or you may be asked to swab yourself. These swabs aren’t done routinely on everyone.
• If you have symptoms of conjunctivitis (an eye infection) swabs will be used to collect a sample of discharge from your eye(s) to test for gonorrhoea.

A swab is like a long, thin cotton bud. It sometimes has a small plastic loop on the end rather than a cotton tip. It’s wiped over body parts that could be infected. This only takes a few seconds and isn’t painful, though it may be uncomfortable for a moment.

Cervical screening (smear tests) and routine blood tests don’t detect gonorrhoea.

If you’re not sure if you’ve been tested for gonorrhoea, just ask.

If you have a test at a clinic or surgery, it may be possible to look at your swab sample under a microscope straight away and give you the result before you leave. Otherwise, you’ll have to wait up to 2 weeks.

If you use an online testing service, you’ll usually get your results within 1 week from when the service receives your sample.

The accuracy of a test depends on the kind of test used, the type of sample that’s collected, and which part of your body the sample is collected from.

Gonorrhoea tests done by trained healthcare professionals or done according to instructions from an online testing service provided by your local sexual health service are usually highly accurate.

As no test is 100% accurate there’s a small chance that the test will give a negative result when you do have gonorrhoea. This is known as a false negative result. This can sometimes explain why you might get a different result from another test or why you and a partner might get a different test result.

It’s possible, but unlikely, for a gonorrhoea test to be positive if you haven’t got gonorrhoea. If there are any doubts about the result you may be offered a second test.

There are different services you can go to. Choose the one you feel most comfortable with.

A free gonorrhoea test can be done at:

• a sexual health clinic or genitourinary medicine (GUM) clinic
• some GP surgeries
• some contraception and young people’s clinics
• some pharmacies.

Abortion clinics, antenatal services and some gynaecology services may offer a test.

Free home self-sampling tests

In many areas, free home tests for gonorrhoea are available to order online from your local sexual health service. You take your own sample (self-sampling) and send it to be tested. These tests are usually only for people without symptoms. If you have symptoms, always get tested at a sexual health service.

Buying a test

It’s also possible to buy gonorrhoea tests from pharmacies and other private providers. These may be self-sampling tests or home tests that give you the result in a few minutes. The accuracy of these tests varies. If you choose to buy a testing kit, it’s a good idea to get advice from a pharmacist or your doctor. You can also choose to pay for a gonorrhoea test at a private clinic.

If a self-sampling test or home test shows that you have gonorrhoea, it’s important to seek treatment straight away. The test should have instructions explaining what to do. It’s important to get treatment for gonorrhoea from a specialist sexual health service to make sure you get the right treatment.

Buying a Self-sampling Test from the FPA

A STI Four Screen Self-Sampling Test Kit is available here – this test covers gonorrhoea, chlamydia, HIV and syphilis.

Before buying a test it’s worth checking if there are free tests available in your area first.

All tests are free through NHS services. All treatment for sexually transmitted infections from these services is also free.

If you have gonorrhoea, you’ll always need to go to a sexual health service for your treatment and any follow-up tests that are needed.

Gonorrhoea is treated with antibiotics

• You’ll usually be offered a single antibiotic injection. Gonorrhoea can be resistant to antibiotics, so a doctor or nurse should always take a swab to check which type of gonorrhoea you have and which antibiotics might work best at treating it
• If there’s a high chance you have gonorrhoea, treatment may be started before the test results are back
• You may need other treatment if complications have occurred or if the first antibiotics don’t cure the gonorrhoea
• Complementary therapies (treatments outside of mainstream healthcare) can’t cure gonorrhoea
• If you have a higher chance of getting gonorrhoea again in the future, you may be offered a gonorrhoea vaccine

Most people notice an improvement quite quickly after having treatment. It’s important to finish all your treatment, even if symptoms go away.

• Discharge or pain when you urinate (pee) should improve within about 2 to 3 days
• Bleeding between periods or heavier periods caused by gonorrhoea should improve by your next period
• Pelvic pain and pain in the testicles should start to improve quickly but may take up to 2 weeks to go away
• Discharge and discomfort in the rectum (back passage) should improve within 2 to 3 days.

If you have pelvic pain or painful sex that doesn’t improve, see your doctor or nurse. It may be necessary to have some further treatment or investigate other possible causes of the pain.

Yes. You’ll need a follow-up test 1 to 2 weeks after finishing the treatment to check it’s worked.

This is very important as gonorrhoea can be resistant to antibiotics. Your doctor or nurse may also advise other tests.

You may need a repeat test or more treatment if:

• you think you’ve come into contact with gonorrhoea, or another STI, again
• you had sex with a partner before the treatment for both of you was finished
• you didn’t complete the treatment or didn’t take it according to the instructions
• the signs and symptoms don’t go away
• your test was negative but you develop signs or symptoms
• you’re pregnant.

How quickly a repeat gonorrhoea test can be done will depend on which test is being used. Your clinic, GP surgery or online provider can advise you.

Only some people who have gonorrhoea will have complications.

If it’s treated early, gonorrhoea is unlikely to cause any long-term problems.

But, without effective treatment, gonorrhoea can spread to other parts of the body and cause health complications.

The more times you have gonorrhoea, the more likely you are to get complications.

• If you have a vagina/front hole, gonorrhoea can spread to other reproductive organs causing pelvic inflammatory disease (PID). This can lead to long-term pelvic pain, blocked fallopian tubes, ectopic pregnancy (when the pregnancy develops outside the uterus), and infertility
• If you have a penis, gonorrhoea can lead to a painful infection in the testicles. If this isn’t treated, it can cause long-term pain and, very rarely, there’s a possibility it could affect your fertility
• It’s not common, but gonorrhoea can lead to inflammation (pain and swelling) of the joints and tendons, known as Sexually Acquired Reactive Arthritis (SARA). SARA may sometimes cause inflammation of the urethra (tube you pee from) or the eyes. It’s more common in people with a penis than people with a vagina/front hole
• Rarely, gonorrhoea may spread to the blood causing serious infection

Gonorrhoea may eventually go away, but it can take a long time.

If you delay seeking treatment, even if signs and symptoms go away, gonorrhoea could cause long-term damage and you may pass it on to someone else.

Don’t have any vaginal/frontal, anal or oral sex (even with condoms), or share sex toys, until 7 days after you and your partner(s) have finished the treatment and any symptoms have gone.

This helps to stop you being reinfected or passing the infection on to someone else.

A gonorrhoea test can’t tell you how long you’ve had gonorrhoea for.

If you feel upset or angry about having gonorrhoea and find it difficult to talk to a partner or friends, don’t be afraid to discuss how you feel with the staff at the clinic or GP surgery.

If you have gonorrhoea it’s very important that your current sexual partner(s) and any other recent partners are tested and treated as they may have the infection without knowing it.

This will help to stop them reinfecting you or passing the infection on to anyone else.

Gonorrhoea is just one of many factors that can affect your fertility.

Most people who’ve had gonorrhoea won’t become infertile or have an ectopic pregnancy.

If you’ve had gonorrhoea, you won’t normally be offered any routine tests to see if you’re fertile unless you or a partner are having difficulty getting pregnant. If you’re concerned, talk to your doctor or practice nurse.

Gonorrhoea can be treated with antibiotics when you’re pregnant or breastfeeding. The antibiotics won’t harm the baby but do tell the doctor or nurse that you’re pregnant or breastfeeding.

• Gonorrhoea can be passed to the baby during the birth. This can cause inflammation and discharge in the baby’s eyes (conjunctivitis).
• You’ll be advised to have a test after you complete your treatment to check the infection has gone.

No, gonorrhoea doesn’t cause cervical cancer.

If you have a higher chance of getting gonorrhoea, you may be able to get a free gonorrhoea vaccination.

Where to get it

The Bexsero 4MenCB vaccine is available from sexual health clinics in England, Scotland, Wales and Northern Ireland. It’s not yet available in the Isle of Man.

Who can get it

The vaccine may be offered to gay, bisexual and other men who have sex with men who have:

• multiple sexual partners
• had a bacterial STI in the last year, including chlamydia, gonorrhoea or syphilis

Other people with a higher chance of gonorrhoea may also be offered the vaccine.

If you think you could benefit from the vaccine, talk to your sexual health care provider.

Effectiveness

The vaccine is estimated to be around 32 to 42% effective at preventing gonorrhoea.

Getting vaccinated will lower your chance of getting gonorrhoea compared to people who haven’t been vaccinated, but some people will get gonorrhoea even after being vaccinated.

If you do get gonorrhoea after being vaccinated, any symptoms are likely to be milder than if you’d not had the vaccine. And you’re less likely to pass gonorrhoea on to sexual partners.

Because the vaccine isn’t effective at preventing gonorrhoea, it’s a good idea to use condoms as well. Also see How can I protect myself from gonorrhoea and other sexually transmitted infections?

How it’s given

The vaccine is usually given as an injection in the upper arm.

2 doses are needed. The second dose must be at least 4 weeks after the first dose but can be given later.

You’ll get the full benefit of the vaccine around 2 weeks after the second dose.

You may need to have a booster dose after a few years if you still have a higher chance of gonorrhoea.

More information

• NHS and government guide to the vaccine
• Queer Health guide to the vaccine

A gonorrhoea vaccine can help lower your chance of getting gonorrhoea. It’s available for free to people with a higher chance of gonorrhoea. The vaccine will not prevent all cases of gonorrhoea and will not help protect you from any other sexually transmitted infections (STIs).

The following measures will help protect you from getting and passing on gonorrhoea and most other STIs, such as HIV, syphilis and chlamydia.