Gonorrhoea

Infectious Disease

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Gonorrhoea is an infection caused by the bacterium Neisseria gonorrhoeae that spreads through having sex with someone who has the infection. It is passed on through vaginal, oral, and anal sex, and anyone can catch it. However, infection can be prevented through the correct use of condoms.

The symptoms experienced differ by the site of the body that gets infected, and typical symptoms include yellow discharge from the penis or vagina and pain or burning when urinating. Gonorrhoea can be asymptomatic, meaning that no symptoms at all are experienced.

Gonorrhoea is treated with a one-dose antibiotic injection. Once treated, it is important to continue practising safe sex as previous gonorrhoea infection doesn’t offer immunity, and so the risk of catching gonorrhoea again does not decrease.

Cases of gonorrhoea are increasing year on year. In England, cases rose from 49,393 in 2021, to 85,370 in 2023, marking a record high since records began in 1918.

The diagnosis of STI’s continues to be greatest in younger people, and gay, bisexual, and other men who have sex with men. Antimicrobial resistance in gonorrhoea, where antibiotics stop working, has increased rapidly in recent years and has reduced the options for treatment.

 

Gonorrhoea symptoms can be in the genital area, anus, or throat. Men and women might experience different symptoms that usually appear within a week after sexual contact with an infected person but can take longer.

For men, typical symptoms are:

  • Pain or burning during urination (weeing)
  • A discharge from the penis that may be white, yellow, or green
  • Painful or swollen testicles

For women, symptoms might include:

  • Pain or burning during urination (weeing)
  • Vaginal discharge
  • Vaginal bleeding between periods or after sex

Anal infections in both men and women can cause:

  • Discharge
  • Bleeding
  • Itching
  • Soreness
  • Pain during bowel movements

Throat infections from gonorrhoea often do not show symptoms. However, symptoms may include a sore throat, pain, and redness.

If gonorrhoea is not treated, it can cause serious health problems. In women, it can lead to pelvic inflammatory disease (PID), abscesses around the liver, and complications in pregnancy. In the longer term pelvic inflammatory disease can be associated with ectopic pregnancy and infertility.

In men, untreated gonorrhoea can cause scrotal swelling, a narrowing of the urethra, infection of the prostate gland and infertility.  The infection can occasionally spread throughout the body, causing a joint infection or fever and affecting the skin and several joints.

Rarely it can affect the heart and the lining of the brain and spinal cord. In even rarer cases, widespread gonorrhoea can cause severe infection and death. It can also increase the risk of HIV transmission.

Gonorrhoea can also cause complications in pregnancy, including low birth weight and pre-term delivery. Babies born to mothers with gonorrhoea can develop eye infections, which can cause redness, pain, soreness, discharge, and tearing. This can be treated with antibiotic medication for newborns, but left untreated, eye infections from gonorrhoea can cause blindness.

 

Gonorrhoea is spread through unprotected vaginal, anal, or oral sex.  It can also spread through infected fluids getting into the eyes.

It can be passed from mother to baby during childbirth, potentially causing blindness in newborns if untreated.

The bacteria mainly infect the reproductive tract (cervix, urethra), the rectum, and sometimes the throat or eyes. It's important for sexually active people, including those who are pregnant, to get tested and treated.

Gonorrhoea cannot be spread through casual contact like hugging, swimming pools, or sharing towels and utensils.

 

Gonorrhoea can be prevented by using condoms correctly during all types of sex. People with gonorrhoea should inform their current and recent sexual partners to help stop the spread of the infection – this can often be done on your behalf by sexual health clinics in the UK.

There are no specific vaccines for gonorrhoea, however, data from various studies indicate that the 4CMenB meningitis vaccine Bexsero would also likely be effective against gonorrhoea. Meningococcal bacteria (Neisseria meningitidis) and gonorrhoea (Neisseria gonorrhoeae) are closely genetically related, with evidence showing that the 4CMenB vaccine provides some cross-protection against gonorrhoea (between 32.7% to 42%).

The Joint Committee on Vaccination and Immunisation (JCVI) advises the UK government on vaccination and immunisation matters, and advised this vaccine to be used in a routine targeted programme.  It was announced on the 21st May 2025 that this programme will be rolled out within the UK, starting in August 2025, marking the first vaccination programme of its kind. 

 

Gonorrhoea is usually treated with a one-dose antibiotic injection of ceftriaxone into the bum or thigh. Azithromycin is sometimes given orally with another antibiotic, cefixime but only when ceftriaxone is not feasible.

Once treated, it is important to continue practising safe sex as previous gonorrhoea infection doesn’t offer immunity, and so the risk of catching gonorrhoea again does not decrease.

 

Multi-drug resistant gonorrhoea

Antimicrobial resistance (AMR) happens when bacteria, viruses, fungi, and parasites evolve to resist medications, making infections more difficult to treat and raising the risk of disease spread, severe illness, and death.

AMR in gonorrhoea has increased rapidly in recent years and has reduced the options for treatment. Resistance to antibiotics like cefixime and ceftriaxone has led to the rise of "super gonorrhoea," which is very difficult to treat. Resistant gonorrhoea is especially challenging because many cases show no symptoms and are difficult to cure, with treatment failures reported worldwide particularly affecting gonorrhoea in the throat which can be more difficult to treat.

In response, the World Health Organization (WHO) has created a plan to tackle this problem. Their strategies include better prevention and control, stricter drug regulations, and improved tracking of infections, particularly in countries with many cases.  The WHO also stresses the importance of developing new vaccines and treatments.

 

Page last updated Friday 20th June 2025