Sexual health tests

What is Gonorrhoea?

Gonorrhoea is a sexually transmitted infection caused by the bacterium called Neisseria gonorrhoeae. The bacteria are normally present in discharges from the penis or in vaginal fluids. Gonorrhoea can be passed on to another person via -

• Unprotected vaginal or anal sex
• Unprotected oral sex
• The sharing of sex aids such as toys, which haven't been washed between uses or covered with a condom.

In woman it is possible for the bacteria to spread from the vagina to the anus through vaginal discharge. This means it is not essential for anal sex to have taken place to have a gonorrhoea infection present in the rectum.

It cannot be passed by holding hands, hugging, kissing, toilet seats, swimming pools or by sharing equipment such as towels, plates, crockery, cups, etc.

What are the symptoms of gonorrhoea?

It is estimated that 10% of men and 50% of women will present with no symptoms if they contract a gonorrhoea infection. For most patients with the infection, they will have some or all of the following symptoms -

• Pain when passing urine
• A thick green or yellow discharge from the penis or the vagina
• Women may often bleed between periods or after having sex. In general, their periods can also be heavier
• Tenderness or pain in the lower groin region
• In men - inflammation of the foreskin and rarely they may experience pain or swelling of the testicles
• Infection of the rectum can cause pain, discomfort and a discharge
• Infection of the eye can cause localised irritation, swelling and conjunctivitis
• Infection of the throat usually present with no symptoms

If you suspect you may have a gonorrhoea infection, then is important to get tested as soon as possible.

Is gonorrhoea serious?

If treated quickly, gonorrhoea is not likely to result in any long-term health issues or complications. However, if treated late or left untreated then patient can experience serious health problems in future. These can include -

• In women the infection can spread causing pelvic inflammatory disease (PID), ectopic pregnancies or infertility.
• In pregnancy the infection can also be spread to the unborn child
• In men the infection can spread to the testicles, which can cause pain, swelling and in a small number of cases, lead onto infertility.
• In rare cases gonorrhoea can spread via the bloodstream to other parts of the body can cause life-threatening infections elsewhere (sepsis)

If you have successfully been treated for gonorrhoea in the past this does not mean you are immune to the infection. You can contract the infection more than once and if you are tested as positive then you will be encouraged to be checked for other STI's also, as it is possible to have more than one infection at any given time.

What does the test for gonorrhoea involve?

Testing for men usually involves providing a urine sample. The sample should be taken at least one hour after you last passed urine (if there is an infection present, this allows sufficient time for the bacteria to be present in the urine).

Test for females usually involve taking a sample using a swab. This can be obtained by using a swab (which looks similar to a cotton bud) around the inside of the vagina at home by the patient themselves. Alternatively, your doctor/nurse can take a swab when they conduct an examination of your vagina and cervix.

A doctor might request a swab to be taken from the entrance to the urethra (the tube which connects to the bladder and from which you pass urine). If you have engaged in oral or anal sex, then the doctor may also request a sample from your throat and from your rectum. On the rare occasion if conjunctivitis is suspected to be linked to gonorrhoea then a sample from the discharge produced by the eye may also be required.

The swabs are not designed to be painful as they normally just require rubbing across the area to collect a sample. Depending on the lab, sometimes it is possible to examine the discharge collected under a microscope immediately and you may be able to get the results whilst you wait. Other times the samples require to be sent away which may take up to 2 weeks for the results to return.

What are the treatment options for gonorrhoea?

Gonorrhoea can usually be treated by using a short course of antibiotics. You will be treated if -

• Your test comes back positive for gonorrhoea
• There is a high probability you have the infection, even if your test is negative or your results have not returned yet
• Your partner has tested positive for the infection

Treatment involves an antibiotic injection followed by one antibiotic tablet. If the injection is not the most suitable treatment course, then an alternative oral antibiotic course is available which your doctor can recommend. Symptoms of gonorrhoea will usually improve after 2-3 days following the treatment. Pelvic pain and testicular pain can take up to two weeks to full go back to normal.

When can I have sex again?

Patients should have a follow-up test, which is usually done 1-2 weeks after the completion of the treatment course. This is known as a “test of cure” and is to ensure the treatment has been successful and you are now clear of the infection. Patients should avoid engaging in sexual activity until they have been given the all clear by their doctor after the second test to ensure they do not get re-infected or pass the infection onto a partner. There is usually a minimum of seven days to wait after the treatment course has been completed.

Gonorrhoea in pregnancy?

Gonorrhoea can be passed to your child during birth. This will usually present as conjunctivitis.

The infection can be treated whilst you are pregnant. The antibiotics used are not harmful to the baby and treatment should be sought as soon as possible if you suspect you may have the infection.

During pregnancy if the infection is left untreated then you are at a higher risk of -

• miscarriage
• premature labour
• and you baby being born with conjunctivitis as mentioned above.

If the new born baby is not treated straight away it can lead to permanent visual damage and even blindness.

Useful Information

Click here for NHS information page on Gonorrhoea

Click here for information on sexually transmitted diseases provided by Sexwise