Gonorrhoea Explained: Symptoms in Men and Women, and How It's Treated

Written by Dr. Simon Khela MBChB MRCGP, GMC Registered Doctor

Last reviewed: 03-07-2026

A change in discharge. A burning sensation when you go to the toilet. Or — for a surprising number of people — nothing at all. Gonorrhoea has a reputation for being obvious, but in reality it's often quiet, easy to miss, and easy to pass on without realising. It's the second most common bacterial STI in the UK after chlamydia, and cases have been rising, partly because so many infections produce few or no symptoms until they're picked up on a routine test.

This guide covers what gonorrhoea actually is, how it spreads, the symptoms to watch for in both men and women, how it's diagnosed, and what treatment really involves — including why testing again after treatment matters more than it used to.

What is gonorrhoea?

Gonorrhoea is a bacterial sexually transmitted infection caused by Neisseria gonorrhoeae. It's passed on through vaginal, anal, and oral sex, and can infect the genitals, rectum, and throat. Less commonly, it can be passed from a mother to her baby during childbirth.

Unlike bacterial vaginosis, gonorrhoea is unambiguously an STI — it's spread between partners through sexual contact, not caused by a natural bacterial imbalance. It's also a condition where timing matters: the longer it goes untreated, the greater the chance it will cause complications, which is a big part of why testing promptly (rather than waiting to see if symptoms settle) makes a real difference.

How is gonorrhoea spread?

Gonorrhoea passes between partners through:

• Vaginal sex
• Anal sex
• Oral sex
• Sharing sex toys that haven't been washed or covered with a new condom between partners
• Mother-to-baby transmission during childbirth, which can cause a serious eye infection in the newborn if untreated

It is not spread through casual contact — hugging, sharing cups, toilet seats, or swimming pools don't transmit it. It requires direct sexual contact with an infected area.

Gonorrhoea symptoms in women

Symptoms in women can include:

• Increased or changed vaginal discharge — often thin and watery, sometimes yellow or green
• Pain or a burning sensation when urinating
• Lower abdominal or pelvic pain
• Bleeding between periods or after sex
• Pain during sex

Here's the detail that catches a lot of women out: around half of women with gonorrhoea have no symptoms at all, or symptoms mild enough to dismiss as something else entirely — a mild bladder infection, a normal cycle variation, nothing worth mentioning to a GP. That's exactly how it continues to spread undetected.

Gonorrhoea symptoms in men

Symptoms in men tend to be more noticeable, though not universally:

• Discharge from the penis — often white, yellow, or green
• Pain or a burning sensation when urinating
• Discomfort or swelling in one or both testicles (less common, but worth flagging to a doctor if it occurs)

Roughly 1 in 10 men with gonorrhoea have no symptoms, a much lower rate than in women, which is one reason testing guidance and public awareness has historically focused more heavily on male symptoms — a gap that's left a lot of women undertested by comparison.

Rectal and throat infections

Gonorrhoea can also infect the rectum (causing discomfort, discharge, or bleeding, though often no symptoms at all) and the throat (usually symptomless, occasionally a sore throat). These sites are frequently missed unless you specifically tell your doctor about oral or anal sex, since a standard genital swab won't pick up an infection elsewhere.

Gonorrhoea vs chlamydia: how the symptoms compare

Because gonorrhoea and chlamydia are so often tested for together, it helps to know how they typically differ:

The overlap is exactly why clinics test for both at once rather than guessing from symptoms — treating one while missing the other is a common and avoidable outcome of self-diagnosis. If you've had chlamydia before or are due a check, it's worth reading how chlamydia treatment compares alongside this guide.

How is gonorrhoea diagnosed?

Gonorrhoea is diagnosed using:

• A NAAT (nucleic acid amplification test) — a swab from the vagina, or a urine sample for men
• Swabs from the throat or rectum if you've had oral or anal sex, since these sites need separate testing
• A bacterial culture, sometimes taken alongside the NAAT, which allows the lab to check which antibiotics the specific strain will respond to — increasingly important given rising antibiotic resistance (more on that below)

Results are usually available within a few days. If you're due a broader check, it's often tested alongside chlamydia, HIV, and syphilis as part of a full sexual health screen rather than as an isolated test.

How to get rid of gonorrhoea: treatment explained

Gonorrhoea is treated with antibiotics — usually a single injection, most commonly ceftriaxone, given into the muscle. Unlike some STIs, this typically doesn't need a week-long course of tablets; one appointment is often enough. In some cases, a second antibiotic tablet may be added, depending on the specific circumstances of your infection and current treatment guidance at the time.

There's an important reason treatment protocols have tightened up in recent years: antibiotic-resistant gonorrhoea — sometimes referred to in the press as "super-gonorrhoea"  has been identified in the UK, meaning some strains no longer respond to older, first-line antibiotics. This is exactly why a test of cure (checking a few weeks after treatment that the infection has actually cleared) is now a standard part of gonorrhoea care rather than an optional extra, particularly if symptoms persist or if you were treated based on a positive test at a different site (throat or rectum) that responds less predictably to treatment.

What about my partner?

Any sexual partner from the period before your diagnosis needs to be tested and treated too; even if they have no symptoms otherwise, reinfection is almost guaranteed. Most clinics offer confidential partner notification support if you're not sure how to approach that conversation. You'll also usually be advised to avoid sex until both you and your partner(s) have completed treatment and any recommended follow-up tests.

Can gonorrhoea come back?

Gonorrhoea itself doesn't "recur" the way BV does — each infection comes from re-exposure, not from your body's own bacterial balance shifting. If you test positive again after treatment, it usually means either the original infection wasn't fully cleared (hence the importance of a test of cure) or you've been re-exposed by an untreated partner.

Complications of untreated gonorrhoea

Left untreated, gonorrhoea can lead to:

• Pelvic inflammatory disease (PID) in women, which can cause chronic pelvic pain, and increases the risk of infertility and ectopic pregnancy
• Epididymitis in men: inflammation of the tube that stores and carries sperm, which can cause pain and, rarely, affect fertility
• Disseminated gonococcal infection: a rare complication where the infection spreads into the bloodstream, causing joint pain, skin rash, and fever

None of this is inevitable, and prompt treatment resolves the infection in the vast majority of cases without any lasting effect. But it's a meaningful part of why testing sooner rather than later matters, particularly if you're also concerned about future fertility — something we support through our infertility clinic if PID or a related complication has been part of your history.

Gonorrhoea and pregnancy

If untreated during pregnancy, gonorrhoea can pass to the baby during birth, potentially causing a serious eye infection (ophthalmia neonatorum) that can lead to permanent damage if not treated quickly. Because of this, pregnant women are tested for gonorrhoea as a matter of course, and treatment is considered safe and is recommended promptly if the result is positive.

Is there a vaccine for gonorrhoea?

Not yet, in the sense of a dedicated, licensed vaccine. There is genuinely interesting emerging research, though: several studies have found that the 4CMenB meningococcal B vaccine appears to offer some cross-protection against gonorrhoea, because the two bacteria are closely related. This isn't a reason to treat the MenB vaccine as gonorrhoea protection it isn't licensed or proven for that purpose  but it's an active area of research worth knowing about if you're asking why a gonorrhoea-specific vaccine doesn't already exist.

When to see a doctor

Get tested if you notice any of the symptoms above, or if:

• A partner has told you they've tested positive for gonorrhoea or another STI
• You've had unprotected sex and are due a routine check
• You've completed treatment and need a test of cure
• Symptoms persist or worsen after treatment

Why choose private testing and treatment

At Private Medical Clinic, we offer confidential, same-day private testing for gonorrhoea, with results turned around quickly and treatment available without an NHS clinic wait. Every consultation is with a GMC-registered GP, and if you'd rather start the conversation privately before coming in, our online GP consultations let you do exactly that. We also offer full sexual health screening covering chlamydia, HIV, syphilis, herpes, and genital warts/HPV in a single visit, so you're not left wondering what you might have missed.

Clinics are available across Birmingham, London, Newcastle, Leicester, Oxford, Derby, Sutton Coldfield, and Bournemouth & Dorset. Check current pricing on our fees page, or browse our FAQs if you have questions before booking.

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