Gonorrhoea
Also known as: gonorrhea, gonococcal infection, Neisseria gonorrhoeae infection, GC
A bacterial sexually transmitted infection caused by Neisseria gonorrhoeae that can affect the genitals, rectum, throat and eyes.
When to seek care
A sexual health clinic or GP surgery can arrange testing when infection is suspected. For someone who has gonorrhoea, or thinks they might, red, itchy or painful eyes, a high temperature, joint pain or swelling, or a spotty or blotchy rash need an urgent GP appointment or help from NHS 111. People who are pregnant and think they have gonorrhoea can contact their GP practice or midwife, because untreated infection can affect the pregnancy and the baby.
Overview
Gonorrhoea is a sexually transmitted infection (STI) caused by a bacterium called Neisseria gonorrhoeae. It can affect the genitals, rectum, throat and eyes. Not everyone has symptoms, so testing matters when infection is possible. In England, UKHSA reports that around half of diagnoses are in gay, bisexual and other men who have sex with men. Treatment is with antibiotics, and if it is given early, lasting problems are unlikely.
Causes
- Infection with the bacterium Neisseria gonorrhoeae
- Passed on through vaginal, anal or oral sex without a condom, or contact with infected secretions
- Sharing sex toys that have not been washed or covered with a new condom each time
- Passed from a mother to her baby during birth
- People without symptoms can still pass it on
Risk factors
- Sex without a condom or other barrier
- Previous infection, which gives no lasting protection against catching it again
- In England, being a gay, bisexual or other man who has sex with men, as this group accounts for around half of diagnoses
Symptoms
What a clinician may find
- Discharge from the penis, or a change in vaginal discharge
- Sore testicles in men
- Lower abdominal pain in women
- Red, itchy or painful eyes when the eyes are infected
Complications
- Pelvic inflammatory disease in women, which can lead to long-term pelvic pain, ectopic pregnancy and infertility
- Painful infection of the testicles and prostate gland in men, which may reduce fertility in a small number of cases
- Rarely, spread through the bloodstream, which can cause sepsis
- Premature birth in pregnancy, and a serious eye infection in a baby infected during birth, which can cause blindness if not treated with antibiotics
Diagnosis
Testing uses a urine sample or a swab, and a person can be tested even without symptoms. Testing is available at sexual health clinics and GP surgeries, and some pharmacies and online services offer it.
Treatment
Gonorrhoea is treated with antibiotics. In most cases this is a single antibiotic injection, given in the buttock or thigh. Sometimes a tablet can be used instead of an injection, if the person prefers. Treatment can start before the test results arrive. The NHS asks people to return about a week after starting treatment to be tested again. Current and recent sexual partners also need testing, and a sexual health clinic can help contact them or contact them for the person.
Prevention
The NHS recommends condoms for vaginal and anal sex, and a condom or dental dam for oral sex. Testing once a year, and when there is a new sexual partner, is also recommended. In England, the 4CMenB vaccine is offered to some people at higher risk of gonorrhoea, mainly gay, bisexual and other men who have sex with men, through specialist sexual health services.
Key facts
| Fact | Detail |
|---|---|
| Cause | The bacterium Neisseria gonorrhoeae |
| How it spreads | Sex without a condom, and from parent to baby during birth |
| Symptoms | Many people have none; others notice discharge or pain when peeing |
| Diagnosed by | A urine sample or a swab, at a sexual health clinic or GP surgery |
| Usual treatment | Antibiotics, most often a single injection |
| Prevention | Condoms or dental dams, regular testing and, for some people in England, the 4CMenB vaccine |
| Urgent help | Red or painful eyes, high temperature, joint pain or rash: urgent GP appointment or NHS 111 |
What are the symptoms of gonorrhoea?
Not everyone with gonorrhoea has symptoms, which is why testing matters if infection is possible. When symptoms appear, they usually start around two weeks after infection, although they sometimes do not appear until many months later.
In people with a penis, the most common signs are discharge from the tip of the penis, pain when peeing and sore testicles. In people with a vagina, signs include more vaginal discharge, pain in the lower abdomen, pain when peeing, and bleeding between periods or after sex. Infection of the throat usually causes no symptoms, while infection of the rectum or the eyes can cause discharge, pain or irritation.
Because symptoms can be mild or absent, a person can pass the infection on without knowing. The NHS advises an urgent GP appointment or help from NHS 111 for someone who has, or may have, gonorrhoea and has red, itchy or painful eyes, a high temperature, joint pain or swelling, or a spotty or blotchy rash.
How is gonorrhoea passed on?
Gonorrhoea is caused by a bacterium called Neisseria gonorrhoeae. It is passed on through vaginal, anal or oral sex without a condom. Sharing sex toys that have not been washed or covered with a new condom each time can also pass it on. A parent can pass the infection to a baby during birth, and the bacteria can sometimes pass from the genitals to the fingers and then to the eyes, where they may cause an eye infection.
The bacterium cannot survive outside the human body for long. NHS sources say that kissing, hugging, swimming pools, toilet seats and sharing towels, cups, plates or cutlery do not spread it. People without symptoms can still pass it on.
Having had gonorrhoea before does not give lasting protection, so it can be caught again. UKHSA data show that around half of gonorrhoea diagnoses in England in 2024 were in gay, bisexual and other men who have sex with men. UKHSA also reported fewer gonorrhoea diagnoses in England in 2024 than in 2023, though the fall was smaller in this group of men than overall.
How is gonorrhoea diagnosed?
Testing uses a urine sample or a swab. A person can be tested even when they have no symptoms. The NHS lists sexual health clinics and GP surgeries as places that test for gonorrhoea, and some pharmacies and online services also offer testing. Some services provide a free self-test kit, although home tests can vary in accuracy, and NHS 111 Wales advises using a local sexual health service.
NHS 111 Wales lists testing as sensible after symptoms, after sex with a new partner without a condom, after a partner is diagnosed with an STI, and when pregnant or planning a pregnancy. Some clinics can give rapid results. After recent sex, a person may be advised to wait up to a week to be tested, or to repeat the test two weeks later.
Treatment can start before the test results arrive when infection is likely. Current and recent sexual partners need testing too. Clinic leaflets describe telling partners from roughly the last six months, and a sexual health clinic can contact them anonymously for the person if they wish. Treatment at sexual health clinics is free.
How is gonorrhoea treated?
Gonorrhoea is treated with antibiotics. In most cases this is a single antibiotic injection, given in the buttock or thigh. Sometimes a tablet can be used instead of an injection, if the person prefers. Treatment can start before the test results arrive.
The NHS asks people to return to the GP surgery or sexual health clinic about a week after starting treatment to be tested again, while other services describe a follow-up after about two weeks. BASHH's 2025 guideline says a routine test of cure is not necessary for infections of the genitals or anus treated with ceftriaxone when the infection is susceptible to it. It still recommends one for some people, including those with persistent symptoms, a throat infection, an unknown susceptibility or pregnancy, so follow-up advice can differ.
The NHS advises no vaginal, anal or oral sex until the person and any partner have completed treatment and tests show the infection has gone. The BASHH leaflet advises waiting until seven days after both the person and their partners have taken treatment, and that this includes sex with a condom.
Reinfection is possible, because earlier treatment does not give immunity. Some strains of gonorrhoea are becoming resistant to antibiotics. The UKHSA GRASP report says that most ceftriaxone-resistant cases continue to be associated with travel to the Asia-Pacific region.
What problems can untreated gonorrhoea cause?
If gonorrhoea is treated early, it is unlikely to cause lasting problems. Left untreated, it can spread and cause serious harm. The NHS says the more times a person has gonorrhoea, the more likely complications become.
In women, the infection can reach the reproductive organs and cause pelvic inflammatory disease. This can lead to long-term pelvic pain, ectopic pregnancy and infertility. In men, it can cause a painful infection of the testicles and prostate gland, which may reduce fertility in a small number of cases.
In rare cases the infection spreads through the bloodstream to other parts of the body, which can cause life-threatening infection (sepsis). The UKHSA Green Book describes this wider spread as disseminated gonococcal infection.
In pregnancy, gonorrhoea can increase the risk of premature birth, a low birth weight baby and miscarriage. The infection can also pass to the baby during birth, and it can cause blindness if it is not treated with antibiotics. Babies at risk are usually given antibiotics straight after birth. For this reason the NHS says treatment during pregnancy is important.
Can gonorrhoea be prevented?
The NHS recommends condoms for vaginal and anal sex, and a condom or a latex or plastic dam for oral sex. Testing once a year, and when there is a new sexual partner, is also recommended.
There is currently no licensed vaccine against the gonorrhoea bacterium itself, according to the UKHSA Green Book. Developing one has been difficult.
In England, the 4CMenB vaccine, which is licensed for meningococcal group B disease, began to be offered for gonorrhoea prevention on 1 August 2025. It is offered mainly to gay, bisexual and other men who have sex with men who are at higher risk of gonorrhoea, through specialist sexual health services. Protection against gonorrhoea is not a licensed use of the vaccine, so this use is off-label.
UKHSA guidance describes the protection as partial, with studies reporting roughly 30 to 40% protection, and says the vaccine is not complete protection, so condoms remain important. The main benefit is expected across the community rather than for each person.
Frequently asked questions
Can gonorrhoea be treated?
Gonorrhoea is treated with antibiotics, most often a single injection, and sometimes a tablet can be used instead. The NHS asks people to return about a week after starting treatment to be tested again. Having had gonorrhoea does not give lasting protection, so it can be caught again. Some strains of gonorrhoea are becoming resistant to antibiotics.
Can you have gonorrhoea without symptoms?
Not everyone with gonorrhoea has symptoms, and a person without symptoms can still pass it on. A person can be tested even when they have no symptoms. Testing is available at sexual health clinics and GP surgeries, and some pharmacies and online services also offer it. Infection of the throat usually causes no symptoms.
Does gonorrhoea cause infertility?
Infertility is a possible complication of gonorrhoea that is not treated. The NHS says that if it is treated early, lasting problems are unlikely. In women, spread to the reproductive organs can cause pelvic inflammatory disease, which can lead to infertility. In men, a painful infection of the testicles and prostate may reduce fertility in a small number of cases.
Can gonorrhoea affect pregnancy?
Gonorrhoea in pregnancy can increase the risk of premature birth, a low birth weight baby and miscarriage. It can also pass to the baby during birth and cause blindness if not treated with antibiotics. NHS inform advises anyone who is pregnant and thinks they have gonorrhoea to contact their GP practice or midwife.
Is there a vaccine for gonorrhoea?
There is currently no licensed vaccine against the gonorrhoea bacterium itself. Since August 2025, England has offered the 4CMenB vaccine, an off-label use, to some people at higher risk, mainly gay, bisexual and other men who have sex with men. UKHSA guidance describes the protection as partial rather than complete, so condoms remain important.
Connected pages in detail
What each linked page on Anatomy Nexus covers, in a line, for Gonorrhoea.
Conditions
- Sepsis Life-threatening organ dysfunction caused by a dysregulated body response to infection.
Symptoms
- Abdominal pain Pain between the ribs and the pelvis.
- Pelvic pain Pain felt low in the abdomen, below the navel and between the hip bones.
- Fever A body temperature of 38 °C (100.4 °F) or more, produced when the hypothalamus raises its set point in response to inflammatory signals.
- Joint pain Pain in one or more joints.
- Rash Any change in the colour or texture of the skin.
Medical tests
- Microbiology tests Tests that find the organism causing an infection: growing it on culture, detecting its genes by PCR, its proteins by antigen tests.