The Independent Pharmacy

Gonorrhoea

The most obvious symptom of gonorrhoea is a thick, green or yellow discharge from the vagina or penis. It can also cause pain when urinating, and women may find they bleed unexpectedly between periods. We know that catching a sexually transmitted infection like gonorrhoea can leave you feeling anxious and maybe a little self-conscious. But try not to worry, once you’ve done a test to confirm the infection, a course of antibiotics should help to get gonorrhoea cleared up fast. If you want to learn more about sexual health and safe sex, we’re here to help.

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Advice for Gonorrhoea

What is Gonorrhoea?

Gonorrhoea (also known as ‘the clap’) is the second most common sexually transmitted Infection (STI) in the UK after chlamydia. The infection is most common amongst those under the age of 25, although it can be contracted at any age if they are sexually active. Gonorrhoea is caused by bacteria called Neisseria Gonorrhoeae and can be passed from one person to another through the sexual fluid produced by the penis and vagina. This means it’s possible for the infection to be transmitted without penetration or ejaculation. Gonorrhoea can be contracted in a variety of ways, including:

  • Unprotected sex (this can be vaginal, anal or oral)
  • Sharing sex toys that haven’t been washed between users
  • Your genitals coming into contact with another person’s genitals

Gonorrhoea isn’t something that can be caught through casual contact, such as holding hands or kissing, nor can it be transmitted by sharing household items like, towels, baths or cutlery.

Gonorrhoea can infect the cervix, the urethra, the rectum, and also the throat and eyes in rare cases.

How is Gonorrhoea diagnosed?

Gonorrhoea is diagnosed by taking an STI test. You can be tested within a few days of suspected infection but you may have to wait up to 2 weeks to ensure the test results are accurate.

When you do not need to be tested for gonorrhoea before treatment:

  • You have already had a positive test result for gonorrhoea
  • There is a high chance you have gonorrhoea and you cannot wait for a test result
  • A sexual partner has tested positive for gonorrhoea

When you should be tested for gonorrhoea before treatment:

  • You think you or your partner have symptoms of gonorrhoea
  • You test positive for a different STI such as chlamydia
  • There is a chance you have gonorrhoea and you are pregnant
  • You have had unprotected sex with a new partner
  • Your partner has had unprotected sex with a different partner

It can take up to two weeks to receive the results of a gonorrhoea test.

If you require a gonorrhoea test, you can purchase a home test from our Online Pharmacy that can be carried out at home and sent directly to a lab for analysis.

Gonorrhoea test for women

The test for gonorrhoea in women usually involves a doctor or nurse taking a swab from the vagina or cervix. If infection is suspected in the urethra, a swab can also be taken from here. In some cases, women can take a sample herself using a swab or a tampon. Women do not normally need to give a urine sample to test for gonorrhoea as the results are less accurate than a vaginal swab.

Gonorrhoea test for men

In men, a urine sample is the most common way to diagnose gonorrhoea, although a swab may also be used to take a sample of any discharge coming from the penis.

You should not urinate for at least two hours before providing a urine sample as this can dislodge and wash away bacteria giving the chance of a false negative result.

What are the symptoms of Gonorrhoea?

The symptoms of gonorrhoea usually develop with 10 days of being infected, however they can take months in certain cases. In around 10% of men and up to 50% of women, gonorrhoea will have no obvious symptoms meaning you may have had the condition for some time without knowing or seeking treatment.

In women who display the symptoms of gonorrhoea, they may include:

  • Thick, green or yellow vaginal discharge
  • Pain or burning when urinating
  • Lower abdominal pain or tenderness
  • Bleeding in between periods or after sex
  • Heavier periods

In men who display the symptoms of gonorrhoea, they may include:

  • White, yellow, or green discharge from the tip of the penis
  • Pain or burning when urinating
  • Inflammation of the foreskin
  • Sore or tender testicles

Gonorrhoea infection of the eyes or rectum will cause discomfort, pain and discharge in the affected area. Gonorrhoea of the throat normally shows no symptoms.

How is Gonorrhoea treated?

First-line gonorrhoea treatment consists of a strong antibiotic injection, alongside antibiotic tablets, administered by a doctor or nurse at your GP surgery or local sexual health clinic.

Chlamydia can often occur at the same time as Gonorrhoea. Treatment for gonorrhoea will treat both gonorrhoea and chlamydia infections.

Gonorrhoea treatment is a one-off combination of antibiotic tablets, Azithromycin 500mg and an antibiotic injection. You should notice that the gonorrhoea treatment helps to clear your symptoms within 3 days. Any pain or tenderness present may take up to two weeks to clear; this is not a sign of failed treatment. Women who experienced abnormal bleeding should notice that this clears up by the time they get their next period.

You and your partner should not have sex until you have been successfully treated to prevent you re-infecting each other or passing the infection on to others.

If you wish to take an STI test to confirm your gonorrhoea treatment was successful, you should wait at least a week. This will allow time for your treatment to be effective and any remaining bacteria to leave your system meaning your test results will be as accurate as possible.

Can you prevent Gonorrhoea?

There are measures you can take which will help guard against gonorrhoea and other sexually transmitted diseases. These include:

  • Using a condom during penetrative sex. This applies to both vaginal and anal intercourse
  • During oral sex use a condom to cover the penis
  • If using sex toys, don’t share them with others without first washing the toy or covering it with a fresh condom
  • If performing oral sex on the female genitals, or when rubbing female genitals together, make use of a device called a dental dam. A dental dam is a thin piece of latex or plastic used to cover the female genitals

Alternatives

There are currently no non-prescription alternatives for the treatment of Gonorrhoea.

You can find your local GUM sexual health clinic on the NHS choices website for treatment.

Gonorrhoea FAQs

  • Gonorrhea is a bacterial infection that is treated with antibiotics. The current treatment involves the combination of an antibiotic injection and an antibiotic tablet.

  • Gonorrhea will usually be completely treated by one course of antibiotics. However, this treatment will not prevent a second infection in the future, so it is essential to continue taking preventive measures.

  • You should notice that gonorrhoea treatment helps to clear your symptoms within 3 days. Any pain or tenderness present may take up to two weeks to clear; this is not a sign of failed treatment. Women who experienced abnormal bleeding should notice that this clears up by the time they get their next period.

  • Over-the-counter pain medication will not interact with the antibiotics used to treat gonorrhoea. It is fine to take any painkillers containing paracetamol, ibuprofen, aspirin or codeine.

  • If you wish to take an STI test to confirm your gonorrhoea treatment was successful, you should wait at least a week. This will allow time for your treatment to be effective and any remaining bacteria to leave your system meaning your test results will be as accurate as possible. You can purchase a gonorrhoea test from our Online Pharmacy or you can go to your GP or GUM clinic.

  • Antibiotic injections must be performed by a medical professional, and so cannot be acquired online.

  • The UK Department of Health requires all patients exhibiting signs of gonorrhea to be fist treated with an injection. As such, you will not be able to purchase tablets online.

    This change in protocol is due to an outbreak in 2015 of a strain of gonorrhea that was resistant to the active antibiotic used in these tablets (azithromycin). Though this may seem like an excessive response to the 15-20 reported cases, antibiotic resistance can lead to many complications in the treatment of infections. For example, Japan no longer use azithromycin at all because they have such widespread resistance.

  • Online services are available whereby you will receive a straightforward urine test in the post, then send the test to be analyzed in a lab. Results will be available on the same day that the lab receives your sample. This service is both discreet and confidential, and test for both gonorrhea and chlamydia.

  • After you have received the treatment, you should wait for 7 days before commencing any type of sexual activity. This will ensure you do not re-infect your self or others.

    If your partner is also being treated, it is important that all treatment is received and 7 days has elapsed for both of you before re-engaging in any sexual activity.

    If you have had Gonorrhea in the past and been treated successfully, you are just as likely to be infected again if you are exposed to it or have sexual contact with an infected person.

  • Yes, they are advised to be tested and will likely also receive the antibiotic treatment. Because the treatment does not prevent future infections, you may re-acquire gonorrhea if your partner does not receive treatment. For this reason, you should tell your partner that you might have gonorrhea as soon as possible.

  • Yes – it is a very common sexually transmitted infection. Each year, gonorrhea affects nearly 35,000 people in the UK and 700,000 in the US.

  • Gonorrhea bacteria are transmitted by direct contact with the mouth, penis, vagina or anus. Importantly, it can be spread without ejaculation. Pregnant mothers who are infected can also pass on gonorrhea to their child.

  • To lower your chances of contracting gonorrhea:

    • Ensure you use condoms correctly during sexual activity.
    • Wash/clean sex toys after use to reduce the chance of infection.
    • Avoid sharing towels as this can spread infection.
    • Ensure you and your sexual partner(s) have are regularly tested and are STI free.
  • Pain when urinating, discharge from the penis, discharge from the rectum and pain from the rectal area should all start to subside and improve within 2-3 days.

    Periods may be heavier and there may be intermittent bleeding between periods. This should improve by the time the next period is due.

    Pain in the testicles and in the pelvis will start to improve quickly but can take up to 2 weeks to clear completely.

  • No – if left untreated, gonorrhea can lead to long-term health complications for both men and women. The infection can be fatal if it spreads to the blood or joints. People who are infected with gonorrhea are more likely to contract the human immunodeficiency virus (HIV).

    Gonorrhea can lead to epididymitis in men. This is a testicular condition which is very painful and can cause infertility.

    Women with gonorrhea can develop pelvic inflammatory disease (PID), which initially causes fever and abdominal pain. If left untreated, PID can lead to long-term pain and collections of pus called internal abscesses, which are very difficult to treat. PID can also harm the fallopian tubes; this can lead both to infertility and a higher risk of a pregnancy developing outside of the uterus (ectopic pregnancy).

  • Abstinence is the only way to guarantee that you will avoid infection. You can reduce the risk by having sex with only one partner, whom you know to be uninfected.

    When used correctly, latex condoms and other barrier methods can be effective at preventing the spread of gonorrhea. The infection can be spread even without full penetration, so it is important to use condoms throughout sexual contact. For oral sex, alternatives include a non-lubricated condom for the penis, and plastic wrap or a dental dam for the vagina or anus. Your chances of spreading gonorrhea and other STIs will be minimized by washing with soap and water immediately after sex.

    Spermicides have been shown to be ineffective at stopping the spread of gonorrhea, and so are not recommended as a preventive method.

Donald Grant

Authored by

Dr Donald Grant
Donald Grant
MB ChB DRCOG MRCGP Dip.orth.med
3058367
GP & Clinical Advisor

Dr Don Grant is The Independent Pharmacy's original online prescriber and has advanced in his role to become the Clinical Advisor, using his wealth of experience to advise on our clinical polices and prescribing guidelines.

Daniel Hurley

Reviewed by

Daniel Hurley
Daniel Hurley
MPharm IP
2078790
Pharmacist Independent Prescriber

Dan is an experienced pharmacist having spent time working in both primary and secondary care. He currently supports our clinical team by providing robust clinical governance review of our internal processes and information.