Gonorrhoea

Gonorrhoea is a common bacterial infection that can affect the genitals, throat, eyes, or rectum (bum). It is one of the most common STIs in Aotearoa New Zealand. Many people do not notice any symptoms.

Gonorrhoea is easy to treat, but if it is not treated it can sometimes lead to longer-term health problems.

If gonorrhoea is not treated, it can:

• Lead to pelvic inflammatory disease (PID) in people with a vagina, an infection and inflammation of the upper reproductive organs, including the uterus (womb), fallopian tubes, and ovaries. This can cause scarring and may affect fertility
• Lead to epididymitis or epididymo-orchitis in people with a penis, which is painful swelling affecting the tubes that carry sperm. This can cause scarring and may affect fertility
• Increase the risk of getting or passing on HIV
• In rare cases, spread to other parts of the body and cause skin or joint infection
• Be passed to a baby during birth and cause a serious eye infection.

Gonorrhoea is usually spread through sex or sexual contact with someone that has the infection.

You can get gonorrhoea from:

• Genital contact, vaginal, anal, or oral sex without a condom
• Sharing sex toys that have not been cleaned between uses or covered with a new condom
• Infected fluid getting into the eye.

Gonorrhoea cannot be caught by kissing, hugging, sharing baths or towels, using swimming pools or from toilet seats.

Some people with gonorrhoea do not notice any symptoms. That is why testing is so important.

Symptoms by location may include:

• Eyes: Redness, irritation, or discharge
• Throat: Usually no symptoms, but it can sometimes cause discomfort
• Rectum (bum): Discharge, discomfort, or bleeding if the rectum is infected
• Vagina: Unusual discharge, pain when peeing, bleeding between periods or after sex, low tummy pain with sex
• Penis: Soreness, itching, or unusual discharge from the opening of the penis, pain when peeing, sore or swollen testicles.

Gonorrhoea can lead to serious health problems if left untreated, including infertility.

In people with a vagina

If left untreated, gonorrhoea can lead to pelvic inflammatory disease (PID) which can cause long-term damage to the reproductive system (where babies develop). If the inflammation continues for a long time, it can cause scarring and block the fallopian tubes (tubes that carry the eggs to the uterus where the baby grows), meaning the sperm may not get to an egg, and the person could become infertile (not being able to have babies).

Mothers should take care at childbirth as gonorrhoea can be passed to their baby at birth and may result in an eye infection in the baby.

In people with a penis

Untreated gonorrhoea can lead to a lower sperm count and negatively impact the quality of the sperm. It also increases risk of an inflammation called epididymitis (which affects the tube that carries sperm). This can lead to scarring and eventually lead to infertility.

Testing is simple!

If you have a vagina: A vaginal swab is used - you can usually do it yourself.

If you have a penis: A urine sample (pee in a pot) is usually taken.

Other swabs (throat, anus) might be done depending on the type of sex you've had.

If you have symptoms, a doctor or nurse may also recommend an examination to check for other possible causes.

It is possible that if you test for gonorrhoea soon after being infected, your test may not find the infection. For this reason you may be advised to repeat the test two weeks after the time when you were at risk of catching it.

Gonorrhoea is treated with antibiotics. Drug-resistant gonorrhoea is becoming more common, so some people may need further treatment or follow-up.

It is important to:

• Take all the medication exactly as prescribed
• Avoid unprotected sex, including oral sex, for 1 week from the start of treatment and until 1 week after the current sexual partner(s) have been treated.

You can reduce your risk of getting or passing on gonorrhoea by:

• Using condoms or dental dams from start to finish every time you have vaginal, anal, or oral sex
• Not sharing sex toys, or cleaning them between uses and covering them with a new condom each time
• Having regular STI checks, especially if you have new or multiple partners.

If you have been treated for gonorrhoea:

• Make sure your current sexual partner or partners are tested and treated
• Avoid sex, or use condoms, until everyone has been treated as advised
• Get retested 3 months later to check for reinfection.

If you are diagnosed with gonorrhoea, it is important to tell anyone you have had the sex within the last 3 months. Partner notification helps prevent reinfection and reduces transmission.

Where the sexual contact was within two weeks or the person is symptomatic, they should have treatment even if tests are normal. Otherwise, they should be treated if their results are positive.

Telling partners is important to stop the infection being passed on and to reduce the risk of you getting it again. Your doctor, nurse, or sexual health clinic can help you with this.