Gonorrhoea

Reviewed by Dr Dan Rutherford, GP

What is gonorrhoea?

Gonorrhoea is a venereal disease caused by the bacteria Neisseria gonorrhoeae. The disease most frequently affects 15 to 25-year-olds, although the number of cases has fallen in recent years.

How do you contract gonorrhoea?

Gonorrhoea is mainly transmitted through sexual contact. However, mothers infected with gonorrhoea can also transfer the disease to their children during delivery. If untreated, such children may develop a serious inflammation of the eyes, which can result in blindness.

To prevent this, lapsis (silver nitrate) used to be applied to the baby's eyes soon after birth. The treatment was discontinued in 1985, and is only used today if an inflammation of the eyes actually develops.

What are the symptoms of gonorrhoea?

Of those infected, approximately half the women and a third of the men do not show any symptoms.

In men, the primary symptom is painful urination. Levels of pain can often be extremely severe. Discharge is also seen from the urethra (the tube through which urine passes from the body). At first, this discharge is slimy and of limited quantity but it quickly develops into a more substantial yellowish substance.

Homosexual men can develop gonorrhoea in the rectum. This varies from being symptom-free to involving the painful discharge of bloody pus from the rectum.

In women, the symptoms tend to be more limited, normally consisting of painful urination and an increasing amount of discharge from the vagina.

In both sexes, a throat infection can occur as a result of oral sex with an infected partner. In most cases there are no further symptoms but sometimes a sore throat is accompanied by fever.

Who is at risk?

People with multiple partners.

People who do not practise safe sex.

Good advice

Practise safe sex - use a condom.

If you think you may have been infected, contact your doctor who will examine you and your partner or partners and provide treatment if necessary.

Remember that assessment for a sexually transmitted disease is always available at a genitourinary medicine (GUM) clinic. The telephone number for your local clinic can be found in the telephone directory.

How does the doctor diagnose gonorrhoea?

The bacteria can be detected through obtaining a smear from the urethra, the neck of the uterus, the throat or the rectum then examining it under a microscope.

What if it is left untreated?

If gonorrhoea is left untreated it can develop into an inflammation of the sexual organs in women and an inflammation of the epididymis in men.

In women, a possible long-term consequence of gonorrhoea is closure of the Fallopian tubes. If this happens, the passage of the fertilised egg into the uterus is made difficult and the risk of sterility and ectopic pregnancy increases.

In very rare cases, gonorrhoea can spread to the whole body through the veins. This results in painful joints, rashes, high temperature, and shivering. In extreme cases, cerebrospinal meningitis and inflammation of the heart might develop.

Resistant types of gonorrhoea from certain parts of the world such as Asia and Africa can be particularly difficult to treat.

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