What Is Gonorrhoea? Symptoms and Treatment

Gonorrhoea is a widely known infection, yet there are many misconceptions about it. It can be treated when diagnosed early. However, taking medicines on your own and skipping your partner’s treatment cause the problem to drag on and come back.

What is gonorrhoea?

Gonorrhoea is a sexually transmitted infection caused by a bacterium called Neisseria gonorrhoeae. Its popular Turkish name, “bel soğukluğu” (a chill in the lower back), is misleading: it has nothing to do with getting cold.

The bacterium is transmitted through vaginal, anal and oral sex. It can affect the urinary channel (urethra), the cervix, the rectum, the throat and, rarely, the eye. It can also pass from an infected mother to her baby during birth.

What are the symptoms of gonorrhoea?

Symptoms usually appear between a few days and two weeks after contact.

In men:

• Burning and stinging when passing urine
• A thick, yellow-green, pus-like discharge from the penis
• Redness and itching at the urinary opening
• Pain and swelling in the testicles (if the infection spreads)

In women:

• Often no symptoms at all
• Increased vaginal discharge
• Burning when passing urine
• Bleeding between periods, pain in the lower abdomen

Infections of the throat and rectum also often cause no symptoms. For this reason, having no symptoms does not mean having no infection.

How can gonorrhoea be told apart from a urinary tract infection?

Both can cause burning when passing urine. In a man, however, a pus-like discharge from the penis and a history of a new sexual partner point towards a sexually transmitted infection. The definitive distinction is made through examination and tests. For information on urinary tract infections, see the urinary tract infection page.

How is gonorrhoea diagnosed?

The following methods are used for diagnosis:

• Urine test: A sample of first-catch urine is tested for the bacterium’s genetic material (molecular test, NAAT).
• Swab of the discharge: It can be examined under the microscope and cultured. Culture also shows which antibiotics the bacterium is sensitive to.
• Throat and rectal swabs: These may be needed depending on sexual history.

Because gonorrhoea is often found together with chlamydia, testing for that infection is also carried out. Tests for HIV, syphilis and hepatitis are also recommended.

How is gonorrhoea treated?

Gonorrhoea is treated with antibiotics. Over the years, however, the bacterium has developed resistance to many antibiotics. For this reason, current guidelines recommend a specific group of antibiotics, usually given as a single-dose injection. If chlamydia is also present or cannot be ruled out, treatment for it is added.

Points to bear in mind during treatment:

1. Do not try antibiotics you have at home or have used before on your own.
2. Complete the treatment prescribed by your doctor in full.
3. Do not have sex for at least 7 days after treatment and until your partner has been treated.
4. If symptoms persist despite treatment, come back; a resistant bacterium may be involved.
5. Because reinfection is common, you may be advised to have a follow-up test a few months later.

What happens if gonorrhoea is not treated?

Symptoms may ease after a while; this does not mean that the infection has gone. Untreated gonorrhoea can lead to the following problems:

• In men: Inflammation of the testicle and epididymis (epididymitis), inflammation of the prostate and, rarely, narrowing of the urethra. Over time, these problems can have a negative effect on sperm quality.
• In women: Infection spreading to the womb and fallopian tubes, chronic pelvic pain, a risk of ectopic pregnancy, and infertility.
• In both sexes: Rarely, the bacterium can enter the bloodstream and affect the joints and skin.
• In pregnancy: It can be passed to the baby during birth and cause an eye infection in the baby.

In addition, an untreated sexually transmitted infection can also increase the risk of HIV transmission. Early diagnosis and treatment are therefore important not only for the person themselves but also for their partners.

Does my partner also need treatment?

Yes, this is an essential part of treatment. Whether or not they have symptoms, sexual partners from the last few months need to be informed, tested and treated. Otherwise, the person who has been treated can catch the infection again from an untreated partner.

Talking to a partner about this can be difficult. However, gonorrhoea is a common and treatable infection; open, non-judgemental communication protects the health of both people.

How can you protect yourself against gonorrhoea?

• Use a condom from start to finish every time you have sex, including oral sex.
• The risk rises with the number of partners; talk about getting tested before starting a relationship with a new partner.
• If you are at risk, get tested at regular intervals even if you have no symptoms.
• Avoid sexual contact during treatment and until your partner has been treated.

For protection against other sexually transmitted infections, see our article on preventing genital warts and the genital warts (condyloma) page.

When should you see a urologist?

If you have burning when passing urine, a discharge from the penis, or pain or swelling in a testicle, or if your partner has been diagnosed with a sexually transmitted infection, see a urologist without delay. If you also have a fever, joint pain or a skin rash, you need to be assessed more urgently.

Op. Dr. Mücahit Kabar sees patients in Bursa (Nilüfer), Turkey, at Özel Medicabil Nilüfer Hastanesi (weekdays 08:30–12:00, +90 444 8 112) and Özel Jimer Hastanesi (weekdays 13:00–17:00, +90 444 45 67). Appointments are booked through the hospitals’ online booking pages or appointment lines. Consultations are held in English or Turkish and are confidential; the hospitals’ international patient departments can arrange interpreters for other languages. For questions or to share reports before your visit, you can send a WhatsApp message to +90 541 622 54 82. Further details are on the contact page.