Gonorrhoea

Gonorrhoea is a bacterial STI that spreads through sexual contact, often causing no symptoms.

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Dr. G. Varbanov

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Dr. Georgi Varbanov is a family medicine physician dedicated to evidence-based care and disease prevention.
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Treatment Information

Understanding Gonorrhoea

Gonorrhoea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. It spreads through unprotected vaginal, anal, or oral sex and can infect the genitals, rectum, and throat.

Many people with gonorrhoea experience no symptoms, leading to unintentional transmission. If left untreated, it can cause serious health complications, including infertility and pelvic inflammatory disease (PID). Early detection and treatment with antibiotics are crucial for stopping the infection and preventing long-term damage.

Common Causes & Risk Factors of Gonorrhoea

Gonorrhoea spreads through direct sexual contact, including:

  • Unprotected sex (without condoms or dental dams).
  • Multiple sexual partners or a new partner without recent STI testing.
  • Previous gonorrhoea infection, as reinfection is common.
  • Mother-to-child transmission during childbirth, potentially causing eye infections in newborns.

Symptoms & Recognition

Gonorrhoea often has no symptoms, making regular STI screening essential. When symptoms occur, they typically appear 2 to 10 days after exposure. Symptoms vary between men and women:

In Women:

  • Unusual vaginal discharge (yellow, green, or thick).
  • Pain or burning sensation when urinating.
  • Pain during sex or lower abdominal discomfort.
  • Bleeding between periods or after intercourse.

In Men:

  • Thick, white, yellow, or green discharge from the penis.
  • Burning sensation during urination.
  • Painful or swollen testicles.

Rectal Gonorrhoea:

  • Pain, discharge, or bleeding from the rectum.

Oral Gonorrhoea:

  • Sore throat or swollen lymph nodes.

Because gonorrhoea symptoms can be mistaken for other infections, testing is the best way to confirm an infection.

How Is Gonorrhoea Diagnosed?

Gonorrhoea is diagnosed through simple laboratory tests, including:

  • Urine tests – A sample is analysed for bacterial presence.
  • Swab tests – Used for throat, rectal, or genital infections.
  • Rapid STI home test kits – Discreet, at-home testing options for convenience.

Best Treatment Options for Gonorrhoea

Gonorrhoea is treatable with antibiotics. The most commonly used medications include:

  • Ceftriaxone (Rocephin): This is the primary recommended treatment, typically administered as a single intramuscular dose. In case of administration of ceftriaxone is not feasible, then an oral intake of cefixime in a single dose is recommended.
  • Azithromycin (Zithromax): Often prescribed alongside another antibiotic to improve treatment effectiveness. Standalone use is discouraged due to antibiotic resistance.
  • Doxycycline: A 7-day antibiotic course after the single administration of ceftriaxone, effective for gonorrhoea and co-existing chlamydia infections. Also used as a post-exposure prophylaxis (Doxy PEP) to prevent gonorrhoea, chlamydia, and syphilis in high-risk populations.
  • Combination therapy: Due to antibiotic-resistant strains, doctors often prescribe a dual therapy using two antibiotics.

During treatment, it is essential to:

  • Complete the full antibiotic course to ensure the infection is fully cleared.
  • Avoid sexual activity until treatment is completed.
  • Ensure your partner(s) receive treatment to prevent reinfection.
  • Retest after treatment to confirm the infection has cleared.

Additional treatment information

To lower the risk of gonorrhoea, follow these prevention strategies:

  • Use condoms and dental dams during all sexual activities.
  • Get tested regularly for STIs, especially with new or multiple partners.
  • Ensure all sexual partners are tested and treated.
  • Avoid sharing sex toys or properly sanitize them before use.
  • Communicate openly with your partner about STI testing.

Important considerations to keep in mind include the following:

  • Gonorrhoea is often asymptomatic, so regular STI testing is crucial.
  • Reinfection is common, so sexual partners should be treated together.
  • Avoid sex until treatment is completed to prevent further spread.
  • Antibiotic-resistant gonorrhoea strains are emerging, making prompt and proper treatment essential.

Frequently Asked Questions

Get answers to common questions about Gonorrhoea

Most cases clear within 7-14 days with antibiotics. A follow-up test may be needed to ensure the infection is gone.
No, gonorrhoea does not resolve without treatment and can cause serious health complications.
If you've had unprotected sex or suspect exposure, testing is recommended 1-2 weeks after potential contact.
Yes, reinfection is common, especially if partners are not treated together. Regular STI screening is recommended.
No, avoid sexual contact until treatment is completed to prevent spreading the infection.

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