Gonorrhoea

What is gonorrhoea?

Gonorrhoea is a common sexually transmissible infection (STI) caused by the bacterium Neisseria gonorrhoeae. It usually affects the genital area, although the throat or anus (rectum) may also be affected.

Gonorrhoea can affect men and women and is easily spread from person to person during vaginal sex, anal or oral sex.

Gonococcal conjunctivitis (red, sore eyes) can occur in babies who have had contact with the mother’s infected birth canal during childbirth. It may cause vision loss if not rapidly and adequately treated.

Who is at risk of gonorrhoea?

Gonorrhoea can affect anyone who has unprotected sex (without condoms) with someone who has the infection.

Some people who are at increased risk of gonorrhoea include:

• Men who have sex with men and their sexual partners
• people with multiple sexual partners
• sex workers
• travellers returning from countries where gonorrhoea is prevalent
• people who inject drugs
• Aboriginal and Torres Strait Islander people living in remote areas
• Gonorrhoea is also more common in people diagnosed with another STI (such as HIV, syphilis and chlamydia).

What are the symptoms of gonorrhoea?

The symptoms of gonorrhoea are slightly different in men and women.

Symptoms of gonorrhoea in women

Often, women with gonorrhoea experience no symptoms. This can lead to gonorrhoea going undetected for longer in women if they are not tested regularly.

Symptoms of gonorrhoea in women may include:

• unusual vaginal discharge
• pain while urinating
• irregular vaginal bleeding
• pain during sex.

Symptoms of gonorrhoea in men

Gonorrhoea commonly infects the inside of the penis (the urethra).

Symptoms of gonorrhoea in men may include:

• burning sensation while urinating.
• white or yellow pus-like discharge from the penis (may be observed in underwear).
• swelling and pain in the testicles – which can occur if the gonorrhoea infection goes untreated.

In a small percentage of men there are no symptoms at all.

Symptoms of oral and anal gonorrhoea

In both men and women:

• anal gonorrhoea often occurs without signs or symptoms, but in some it may cause anal pain and discharge
• gonorrhoea in the throat may cause a sore throat – however, it usually occurs without symptoms.

Gonorrhoea can cause infertility in women

If left untreated, gonorrhoea can lead to pelvic inflammatory disease (PID) in women, which can cause infertility. Symptoms of PID include:

• lower abdominal pain and tenderness
• deep pain during sexual intercourse
• heavy and painful periods
• fever.

Women who have had PID are at increased risk from long term consequences of gonorrhoea. The risk of infertility increases with each episode of inflammation, especially if left untreated for long periods.

How often should I get checked for gonorrhoea?

Sexual health check-ups STIs (such as gonorrhoea, chlamydia, syphilis and HIV) are recommended for anyone who is sexually active. The frequency and type of testing included in these checks depends on your STI risk. Talk to your doctor about how often you should get a sexual health check. It is recommended that sexually active young people (< 30 years old) have an STI check at least once a year.

You can find more information about the types and frequency of testing recommended for certain groups from theSTI Guidelines Australia website.

The frequency of these checks depends on your STI risk:

• men who have sex with men, and have more than 1 partner – should get checked every 3 to 6 months
• men who have sex with men, and have 1 partner – should get checked once a year
• people who have new sexual partners should get tested before having sex with a new sexual partner or after every new partner
• sexually active women who feel they are at risk of STIs (because gonorrhoea may not cause symptoms until PID has already developed).

How is gonorrhoea diagnosed?

A sexual health check-up and testing with your doctor or sexual health centre can detect gonorrhoea. The doctor or nurse will ask you for a:

• urine sample (peeing in a small jar)
• swab test – collected from the penis, vagina, anus or throat.

Getting your gonorrhoea test results

Test results are typically available within a week.

How is gonorrhoea treated?

Gonorrhoea is treated effectively with antibiotics.

Symptoms resolve quickly – usually within a week. Tell your doctor or nurse if you still have symptoms.

Avoid having any type of sex for one week after treatment is finished (not even with condoms or internal protection such as dams).

Some strains of gonorrhoea are now resistant to antibiotics. This means that some antibiotics are less effective or no longer effective in treating the infection.

Tell your doctor if you have been travelling overseas because many of the resistant strains have originated outside Australia.

Your doctor will prescribe an appropriate antibiotic based on the current treatment guidelines.

It is important to a see your doctor about a week after finishing treatment to confirm the infection has cleared. This follow-up is especially important if you have a resistant strain of gonorrhoea, as further testing may be needed.

Can you get reinfected with gonorrhoea?

Previously having had gonorrhoea once does not protect you from getting it again.

Even after you’ve been successfully treated, you can still be reinfected by having sex with a partner who has gonorrhoea.

Letting partners know you have gonorrhoea

It is important to let your sexual partner or partners know that you have been diagnosed with gonorrhoea. Most people will appreciate being told they may have an infection, and it is an important step in preventing further infection in the community. If your partner is treated it will also prevent you from getting the infection again.

You do not have to do this alone. Your doctor, or your sexual health centre can help you through this process and ensure your identity is not revealed.

You can anonymously notify your sexual partners of the need to get tested and treated for gonorrhoea via the Let Them Know website.

Nurses (called partner notification officers) at the Department of Health and public health officers at Local Public Health Units can help you anonymously notify your partners. They can be contacted on (03) 9096 3367.

Reducing gonorrhoea transmission

Remember, gonorrhoea may be spread through unprotected oral sex.

You can protect yourself against gonorrhoea by taking these steps:

• always use condoms or other barrier protection (e.g., dental dams and internal condoms) for all types of sex
• always use water-based lubricant with condoms for vaginal or anal sex. if you are sexually active, even if you have no symptoms, talk to your doctor about how often you should get a sexual health check
• if you are at greater risk of STIs, get tested regularly.

Where to get help

• Your doctor
• Your school nurse or school welfare coordinator
• Some secondary schools provide access to an adolescent health trained GP on site
• Your local community health service
• Some secondary schools provide access to an adolescent health trained GP on site
• Sexual Health Victoria (SHV). To book an appointment call SHV Melbourne CBD Clinic: (03) 9660 4700 or call SHV Box Hill Clinic: (03) 9257 0100 or (free call): 1800 013 952. These services are youth friendly.
• Melbourne Sexual Health Centre Tel. (03) 9341 6200 or 1800 032 017 or TTY (for the hearing impaired) (03) 9347 8619
• Victorian Sexual Health Network – where to get tested – visit Melbourne Sexual Health Centre's GP partner clinics for STI check-ups and treatment
• Thorne Harbour Health (formerly Victorian AIDS Council) Tel. (03) 9865 6700 or 1800 134 840
• Equinox Gender Diverse Health Centre Tel. (03) 9416 2889
• PRONTO! Tel. (03) 9416 2889
• Ballarat Community Health Sexual Health Clinic Tel. (03) 5338 4500
• Bendigo Community Health Sexual Health Clinic Tel. (03) 5434 4300 Or (03) 5448 1600
• Gateway Health Clinic 35, Wodonga Tel. (02) 6022 8888 or 1800657 573
• Sunraysia Community Health Services Tel. (03) 5022 5444
• Barwon Health Sexual Health Clinic Tel. (03) 5226 7489
• 1800MyOptions Tel. 1800 696784 is a statewide phone service for information about sexual health as well as contraception and pregnancy options
• Victorian Aboriginal Health Service Tel. (03) 9419 3000.