Gonorrhoea 

Gonorrhoea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. It can infect both men and women and primarily affects the genital tract, but it can also infect the rectum, throat, and eyes.

Symptoms

For women and people with a uterus‍

Many people with gonorrhoea have no symptoms, especially in the early stages. When symptoms do occur, they might include:

• Unusual vaginal discharge (which may be yellow or green)
• Painful urination
• Lower abdominal or pelvic pain
• Pain during intercourse
• Bleeding between periods or heavier periods

Other symptoms:

• Rectal infections: Discharge, anal itching, soreness, bleeding, or painful bowel movements.
• Throat infections: Usually asymptomatic but may cause sore throat.
• Eye infections: Pain, redness, discharge if infected through contact.

Risk factors

• Sexual activity: Having unprotected sex, including vaginal, anal, or oral, with an infected partner.
• Multiple partners: Having multiple sexual partners increases the risk.
• STI history: Previous or concurrent STI infections.
• Age: Younger adults and teenagers are at higher risk.
• Partner’s STI history: If your partner has an STI, your risk increases.

Complications

If left untreated, gonorrhoea can lead to serious health issues, such as:

• Pelvic Inflammatory Disease (PID): May cause chronic pelvic pain, ectopic pregnancy, or infertility.
• Pregnancy complications: Can lead to miscarriages, preterm birth, or infect the baby during childbirth.
• Disseminated Gonococcal Infection (DGI): Infection spreads to the bloodstream, causing arthritis, tenosynovitis, or dermatitis.

Diagnosis

Gonorrhoea can be diagnosed through:

• Nucleic Acid Amplification Tests (NAATs): Swabs from the affected site (cervix, rectum, throat) or urine samples.
• Culture tests: Less commonly used but may be done in special cases.

Treatments

Medical treatment:

• Antibiotics: Gonorrhoea is typically treated with a combination of antibiotics.
  • Common regimen: An injection of ceftriaxone and oral azithromycin.
• Often chlamydia and gonorrhoea occur together, so you may be given treatment for both infections.
• Follow-up: Re-testing may be suggested to ensure the infection is cleared.

Treatment and protection of partners: 

If you have had sex without a condom with your sexual partner(s) it is very likely they are infected with gonorrhoea. It is important they have a sexual health check and treatment for gonorrhoea, even if they have no symptoms and even if they have a negative gonorrhoea test. Sexual partners should also be treated to prevent reinfection.

Condoms should be used throughout the treatment period. If you receive single-dose treatment, you should avoid sex without a condom for 7 days after treatment and until 7 days after your partner has been treated. This is to prevent getting reinfected or passing the infection on to someone else.

If you are using a combined oral contraceptive pill may need to use an additional method of contraception. Ask your doctor, pharmacist or nurse if you are unsure.

Self-care and prevention:

Gonorrhoea and other STIs can be successfully prevented by using appropriate contraception and taking other precautions, such as:

• Protection: using male condoms or female condoms every time you have vaginal sex, using male condoms during anal sex, using a condom to cover your penis, or a latex or plastic square (dam) to cover the female genitals, if you have oral sex
• Hygiene: not sharing sex toys, or washing them and covering them with a new condom before anyone else uses them.
• Regular screening: Regular STI check-ups for sexually active individuals.
• Communication: Discuss STIs and testing with your sexual partners.

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