Gonorrhoea in gay / bisexual men
What is gonorrhoea?
- Gonorrhoea is a bacterial sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoea.
- It infects the urethra (urine canal) rectum or anus and sometimes the throat and eyes (conjunctivitis).
- The most common symptom is a discharge from the tip of the penis.
- Testing needs to be done in a specialised sexual health clinic such as the Wolverton Centre as specific tests are required to ensure the correct antibiotics are given.
- If you have gonorrhoea we recommend that you should have a full STI screen including an HIV test.
How common is gonorrhoea?
- Gonorrhoea is the second most common STI (after NSU) found in gay and bisexual men in the UK.
- Gonorrhoea infections are continuing to increase amongst gay and bisexual men.
- Infections occur predominantly in the 25 -34 year age group.
How do you catch gonorrhoea?
- Gonorrhoea is passed on through:
- Unprotected anal, oral or vaginal sex (or sharing sex toys) with someone that has gonorrhoea
- from an infected mother to her baby at birth
- sometimes from genitals to fingers to eyes where it may cause conjunctivitis
- Gonorrhoea cannot be caught by kissing, or from swimming pools, saunas or toilet seats.
What would I notice if I had gonorrhoea?
- Most men will notice the following:
- a discharge from the tip of the penis
- a burning pain when passing urine
- Symptoms usually appear within a few days of catching the infection.
- Up to 10% men may not notice anything wrong.
- Infections in the throat or anus normally go unnoticed.
How do I get tested for gonorrhoea?
- A urine sample – but you must not have passed urine for at least an hour.
- A swab from the tip of the penis (if you have a discharge).
- The swab and urine samples are sent to Kingston Hospital laboratory where a specific NAATS test and cultures for gonorrhoea are done. Together these tests provide an accurate diagnosis.
- Some results for gonorrhoea may be available during your first visit (by direct microscopy) – but the final results will be ready in 3 days. These will be sent to you via a text message or the nurse may call you.
How is gonorrhoea treated?
- Gonorrhoea can be easily treated with antibiotics. The most commonly used antibiotics are as follows but different ones may be prescribed depending on the sensitivity profile of your strain of gonorrhoea – some strains are resistant to certain antibiotics.
- a single injection of ceftriaxone 250mg
- a single dose of cefixime 400mg (2 tablets)
- Azithromycin 1g (4 tablets) to cover chlamydia at the same time
- All treatments from the Wolverton Centre are free and are given to you in the clinic.
- Allow 7 days for the treatment to work before having sex again.
- The nurse will phone you one week later to discuss your results and make sure you don’t need any more treatment or a follow up test.
What about my partner?
- Gonorrhoea is a sexually transmitted infection so it is important that all partners are tested and treated before resuming sex again.
- Some of your previous partners may also need treatment – the nurse will advise about this.
What problems can untreated gonorrhoea lead to?
- Gonorrhoea may spread to the epididymis (tube that carries sperm from the testicle) and cause pain and swelling of the testicle (epididymitis). Rarely this may affect fertility.
- Gonorrhoea can spread to the blood or joints and lead to very serious infection.
- These problems can be prevented by early treatment of gonorrhoea.
Will gonorrhoea come back again after treatment?
- Treatment for gonorrhoea always works – as long as you have taken the right antibiotics correctly (your doctor will advise about this) and checked that your partner has been tested and treated too.
- But you could catch gonorrhoea again so it is important to use condoms with new partners and both get tested for STIs before having sex without a condom.