Gonorrhoea
Quick facts:
- Gonorrhoea is a common sexually transmissible infection (STI) that can be cured with antibiotics.
- Gonorrhoea most commonly infects the urethra and the cervix but can also infect the anus and throat.
- Gonorrhoea can often occur without symptoms and is easy to test for in a urine sample or swab from the urethra, vagina, cervix, throat, or anus.
- Gonorrhoea has been increasing, with rapid rises in some locations, and there were over 6,000 notifications in Queensland in 2022.
Gonorrhoea is a common STI caused by the bacterium Neisseria gonorrhoeae. It can be passed on during vaginal, anal, or oral sex. It most commonly affects the genitals, anus, and throat, and can also infect the eyes. Transmission can occur from fingers and sex toys during sex play.
Gonorrhoea notifications have increased in Australia, particularly in women and men who have sex with men. There have been 2 cases of multi-drug resistant gonorrhoea detected in Australia. These cases were highly resistant to all the antibiotics routinely used to treat gonorrhoea. Increasing resistance to first-line treatment is being monitored closely and alternative antibiotics are available for treatment if needed.
Signs and symptoms
People often don't know they have an infection because they may have no symptoms. Anal and throat infections of gonorrhoea are asymptomatic in most people. Vaginal gonorrhoea is asymptomatic in 80% of cases, but urethral gonorrhoea in the penis shows symptoms in 85-90% of cases.
If symptoms do occur, they usually develop a few days or within a week after transmission. Experiencing the symptoms listed below doesn't necessarily mean you have gonorrhoea, but they can be associated with the condition. If you have any symptoms, get a check-up with a health professional as soon as possible.
Vagina
You may notice:
- a change in vaginal discharge
- pain and/or burning sensation when passing urine
- bleeding or spotting between periods or after having sex
- pain during or after sex
- cramping pain in the lower abdomen.
Penis/testicles
You may notice:
- a discharge from the penis
- redness around the opening of the penis
- pain and burning sensation when passing urine
- swollen and sore testes.
Anus
- You may experience pain, blood staining, or discharge from the anus.
Throat
- You may experience a sore, dry throat.
Gonorrhoea can also cause conjunctivitis with pus in the eyes, and on rare occasions, it can spread to the bloodstream causing fever, joint pain, skin lesions, and meningitis.
Testing
Testing for gonorrhoea is a simple process. It can be done by a urine sample and/or swabs from the urethra, vagina, cervix, throat, anus, or eyes, which is sent to the laboratory for testing. Swabs can often be self-collected while you are at the clinic or pathology collection centre.
How often you test depends on your lifestyle and how sexually active you are. For sexually active people under 30, it is recommended to get checked at least once each year, but there are situations where getting tested more regularly is advised. Testing every 3 months is recommended for sexually active men who have sex with men.
It is important for pregnant women to have antenatal checks which include STI tests. Having gonorrhoea during pregnancy may lead to premature birth or passing the infection to the baby during childbirth.
If you are concerned you have an STI, have had sexual contact with someone who has an STI, or require routine testing you should discuss with your local doctor, family planning clinic, or sexual health clinic and avoid having sex until you have received medical advice.
Queensland residents aged 16 years or older can order a free chlamydia and gonorrhoea urine test online through 13 HEALTH Webtest. This service currently offers users the option to download a pathology request form so a urine sample can be provided at a pathology collection centre, plus provides support and reminders to get treatment if your test is positive.
If you test positive for gonorrhoea or receive immediate treatment because of symptoms, additional samples may be taken for a culture analysis. This is to determine whether the infection is drug resistant. You will also be asked to return 2 weeks after treatment to do another test to make sure the antibiotics worked to cure the infection.
If you test positive for gonorrhoea, anyone you have had sex with in the past few months should be tested and may need treatment. Sample conversations and services that assist with telling partners in a confidential and anonymous way (if desired) are available online:
Advising sexual partners that they have been exposed to an STI is important for their health and the health of any other people they may have sex with.
Treatment
Gonorrhoea can be effectively treated with the correct antibiotics. Completing the treatment and any follow-up examinations and tests are essential to make sure the infection has been cured. You should not have sex, not even sex with a condom, for 7 days after treatment as you could still pass the infection to your partners.
Anyone who has had gonorrhoea should have another test 3 months after treatment to make sure that they have not been reinfected. It is common for people to get gonorrhoea again from a sexual partner who has not been treated.
Transmission
You can get an STI such as gonorrhoea by having sex without a condom.
If you're having sex without a condom, the risk of getting an STI is higher:
- if you have casual partners
- the more casual partners you have
- if you have partners who have had sex in some countries outside Australia (especially if they haven't used a condom in the past)
- if you have partners who have injected drugs
- for men who have anal sex with other men.
Prevention
Practise safe sex, talk to your partners about sexual health, and make sure you get enthusiastic consent. Condoms are the best way to prevent STIs and using them with a water-based lubricant will be more pleasurable and reduce the risk of the condom breaking.
The only way to know that you do not have an infection is to get a sexual health check. If you have sex with new or different partners and do not use condoms, you'll need to have more frequent sexual health checks.
Health outcome
If not treated properly gonorrhoea can lead to pelvic inflammatory diseases, which can lead to chronic pelvic pain, infertility, and ectopic pregnancy. Other complications may be painful infected glands near the vaginal opening (Bartholin's Glands).
Babies born to mothers with untreated gonorrhoea may develop eye or anogenital infections. If an eye infection caused by gonorrhoea is not recognised and treated in the baby it can cause blindness.
If not treated properly gonorrhoea can progress to the testes and lead to infertility. Other complications may be painful, red swollen testicles, or inflammation of the prostate gland.
Help and assistance
Call 13 HEALTH (13 43 25 84) for qualified health advice 24/7 for the cost of a local call.
This factsheet provides general information and is not intended to replace the need to see a health professional or have a sexual health check. For more information on gonorrhoea or sexual health please talk to a healthcare provider. A doctor, nurse or health worker can assist with:
- providing appropriate tests, treatment and information about how to prevent STIs
- helping people to ensure that their sexual partners get tested and treated.
Other resources
- Learn more about safe sex.
- For short animations about common STIs, see Queensland Health's YouTube channel Your Sexual Health.
- For comprehensive information about safe sex, STIs, testing and treatment for young adults, see Stop the Rise of STIs.
- For videos and resources developed with Aboriginal and Torres Strait Islander communities, see Young Deadly Free.
- For information on gonorrhoea in Arabic, Chinese, Filipino, Japanese, Korean, Spanish, Thai, or Vietnamese go to the StaySTIFree website. Other translated resources about STIs are available from the Ethnic Communities Council of Queensland.