Page modified at: 21/02/2010
Gonorrhoea is a sexually transmitted bacterial infection and both men and women can become infected.
Gonorrhoea is caused by Neisseria gonorrhoeae, an exclusively human pathogen that is exquisitely sensitive to drying.
During sexual intercourse with an infected partner, males have a 1:5 chance and females have a 1:2 chance of themselves becoming infected. Of the women infected by Neisseria gonorrhoeae, approximately half are asymptomatic. These women act as a reservoir of infection, perpetuating the disease. Infected men are very rarely asymptomatic, but they are unlikely to develop complications from their infections.
Among the infections associated with gonococcal infections are septic monoarthritis and pelvic inflammatory disease, a condition that can lead to infertility or ectopic pregnancy. Babies born to infected mothers may develop an eye infection, ophthalmia neonatorum. Genital infections are the most common, but current sexual practices also lead to infections of the pharynx or rectum as well. Urethral strictures may complicate untreated urethritis.
Gonorrhoea in Wales
Since the peak observed in 2004 a decrease in diagnoses was observed. During 2004, diagnostic rates in the United Kingdom were highest in 20 to 24 year old males (229/100 000) and 16 to 19 year old females (168/100 000).
In 2006, there were 507 episodes of uncomplicated gonorrhoea diagnosed in GUM clinics in Wales (17 new cases per 100,000 population) and 209 epidemiological treatments of suspected gonorrhoea. This compares to 34 per 100,000 in England (86 per 100,000 for London).
The number of episodes of uncomplicated gonorrhoea reported by GUM clinics in Wales in 2006 was lower than for the previous year (533) and represents a decrease of 5%.
In Wales in 2006, the highest rates of uncomplicated gonorrhoea are among 20-24 year old males (131/100,000) and 16-19 year old females (73/100,000 population).
81 of the 362 episodes (22%) of uncomplicated gonorrhoea reported in males in 2006 were in men who have sex with men.
Young people are an important risk group for acquiring an STI. Research shows that young people are more likely to have higher numbers of sexual partners, use barrier contraception inconsistently and are more likely to become reinfected after being diagnosed with and treated for an initial STI.Click on the graph below to link to the National Public Health Service for Wales website for further information
How is Gonorrhea spread?
Gonorrhoea is usually passed from one person to another during vaginal, oral or anal sex, or by sharing sex toys. It can live inside cells of the cervix, urethra, rectum and sometimes in the throat and eyes. Gonorrhea can also be passed from a pregnant woman to her baby during a vaginal birth.
How do I reduce the risk of catching Gonorrhea?
- Male and female condoms, when used correctly, can help protect against STIs
- Before you have sex, talk to your partner about using condoms
- Use condoms every time you have vaginal or anal sex
- If you have oral sex, use a dam
What are the Symptoms of Gonorrhoea?
It's possible to have gonorrhoea and not have any symptoms. When symptoms do occur, men are more likely to notice them than women.
The symptoms depend on the site of the infection, as gonorrhoea can infect the cervix, urethra, rectum, anus and throat.
Men may experience:
* Nothing – many are silent
* a yellow or white discharge from the penis
* irritation and/or discharge from the anus
* inflammation of the testicles and prostate gland
* pain passing urine due to urethritis
Women may experience:
* Nothing – many are silent
* a change in vaginal discharge - it may increase in amount, change colour to yellow/green and have a strong smell
* irritation and/or discharge from the anus may also occur
What happens if Gonorrhoea isn't treated?
Without treatment, the infection can spread to other parts of the body causing damage and long-term health problems, including infertility
In women, gonorrhoea can cause pelvic inflammatory disease. This can lead to:
* Ectopic pregnancy (when a pregnancy develops outside the womb, usually in the fallopian tube)
* Blocked fallopian tubes (the tubes that carry the egg from ovary to womb) - causing infetrtility
* Long-term pelvic pain
In men, gonorrhoea can lead to painful infection in the testicles and prostate gland, urethral stricutres and possibly reduced fertility.
In babies, Gonorrhoea can cause eye infections in babies if it's passed on during birth.
How can I reduce the risk of catching gonorrhoea?
Practising safer sex reduces the risk of infection with gonorrhoea. The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
Avoiding alcohol and drug use may also help prevent transmission of gonorrhea because these activities may lead to risky sexual behavior. It is important that sex partners talk to each other about their HIV status and history of other STDs so that preventive action can be taken.
Transmission of an STD, including syphilis cannot be prevented by washing the genitals, urinating, and/or douching after sex. Any unusual discharge, sore, or rash, particularly in the groin area, should be a signal to refrain from having sex and to see a doctor immediately.
How do I reduce the risk of passing gonorrhoea on to others?
Testing and treating (if appropriate) all sexual contacts helps to prevent the infection being passed on to others.
How do I get testing or treatment for Gonorrhoea?
NHS:Testing is free on the NHS from genitourinary medicine clinics, sexual health clinics, many contraception clinics, your GP and pharmacies. You can find an clinic to help with Gonorrhoea by phoning directory enquiries and asking for genitourinary medicine, sexually transmitted disease or venereal disease or locate one using our NHS Genitourinary Medicine Clinic page in the Sexual Health Section of our website.
PRIVATE:Alternatively you can have confidential private testing based on an internet ordered urine home sample kit. Telephone 0345 2303386 or use the Confidential Text Service 07786202070
How is Gonorrhoea treated?
Gonorrhoea is easy to treat with antibiotics.
Recommended Regimens Ceftriaxone 125 mg IM in a single dose OR Cefixime400 mg orally in a single dose OR Ciprofloxacin 500 mg orally in a single dose* OR Ofloxacin 400 mg orally in a single dose* OR Levofloxacin250 mg orally in a single dose*
YOU WILL ALSO NEED TREATMENT FOR CHLAMYDIA IF CHLAMYDIAL INFECTION IS NOT RULED OUT
Gonococcal infections of the pharynx are more difficult to eradicate than infections at urogenital and anorectal sites. Few antimicrobial regimens can reliably cure >90% of gonococcal pharyngeal infections. Although chlamydial coinfection of the pharynx is unusual, coinfection at genital sites sometimes occurs.