Updated December 2014

Definition

Gonorrhea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae.

Causes

Gonorrhea can be passed on through unprotected oral, vaginal or anal sex from a person who is infected. It can sometimes cause eye infections when hands infected with anal, penile and vaginal fluids touch the eye. An infected person can pass on the infection at any time until he or she is properly treated with antibiotics.  It can also be passed from an infected mother to her baby during birth.

Signs and Symptoms

It can take two to ten days (sometimes longer) for any symptoms to appear.

Most men who have gonorrhea will have symptoms within the first week after infection. Symptoms may include a burning sensation when urinating, a white, yellow or green discharge from the penis or itching around the urethra (opening to the penis).

Many women who have gonorrhea do not have symptoms. Women may notice pain or burning with urination, bleeding during or after sexual intercourse, abnormal spotting or bleeding between periods, a change in vaginal discharge or pain with sexual intercourse. Sometimes these symptoms may be mistaken for a bladder or vaginal infection.

Both men and women can get gonorrhea in the throat from oral sex.  Infections in the throat may cause a sore throat and swollen glands, but most often there are no symptoms. Gonorrhea in the rectum can cause discharge, bleeding, anal itching, soreness or painful bowel movements. There can also be no symptoms.

Diagnosis and Tests

A doctor or nurse can take a sample by swabbing the infected area (cervix, urethra, rectum or throat). Urine testing is also commonly used to diagnose both men and women. Samples are then sent to the laboratory for testing.

A follow-up test to make sure the infection is cured is recommended for all individuals with gonorrhea. Follow-up testing by urine should be done at least 3-4 weeks after you have completed the treatment or can be done 1 week after treatment if done by a culture (swab) test.

Complications

Untreated gonorrhea in women may lead to a condition called pelvic inflammatory disease (PID). It is a serious infection of the lining of the uterus, the fallopian tubes and the ovaries. PID can cause chronic pelvic pain. Sometimes the fallopian tubes of a woman with PID are damaged and as a result, she may not be able to get pregnant or she may be at increased risk of having an ectopic pregnancy. Ectopic pregnancy is a life-threatening condition where the fertilized egg grows outside of the uterus, usually in the fallopian tubes. She will need treatment to stop the pregnancy.

Some men may develop swelling and pain in their testicles, a condition called epididymitis. It is also possible for men with untreated gonorrhea to have blocked tubes so the sperm cannot pass, resulting in infertility.

Infants who are born to mothers with untreated gonorrhea may get the infection as they pass through the birth canal. Infants may develop serious eye infections that could lead to blindness or a life-threatening blood infection.

Treatment

Gonorrhea is treated with antibiotics. Some people may be treated with an injection and pills, while others just receive pills.  It is important to take all of the medication you are given, even if you do not have symptoms or if the symptoms have disappeared. Do not have sex while you and your partner(s) are on the medication and for 7 days after you finish, even with a condom.

Symptoms should disappear within a few days of starting treatment. If symptoms do not go away, return to your healthcare provider as the infection may require additional treatment.

It is important to be retested after treatment for gonorrhea to ensure the infection is gone.

Prevention/Self-care Tips

Here are a few important points to remember:

  • Take all medication as prescribed by your health care provider or clinic.
  • Avoid sex for 7 days after you and your sexual partner(s) have completed treatment. You can get re-infected every time you have sex with an untreated partner.
  • If you have an untreated STI like gonorrhea, it is easier to get HIV from a person who has it.
  • It is possible to have more than one infection at a time, so it is important to be tested for other STIs and HIV.
  • Use condoms correctly every time you have sex to lower your chance of getting an STI.

Information for Sexual Partners

All sexual partners within the past 60 days should be tested and treated. If you have not had sex in the past 2 months, then your last sexual partner should be tested and treated. Tell your partner(s) that having no symptoms does not mean there is not infection.

If you do not want to tell your partner(s), a public health nurse can notify them for you. Your name will be kept confidential.

More Information

Call the AIDS and Sexual Health InfoLine at 416-392-2437

SAFER SEX: To reduce your risk of getting a sexually transmitted infection (STI),
use a condom every time you have vaginal, anal or oral sex.