Gonorrhea

What is Gonorrhea

Gonorrhea is a sexually transmitted infection (STI) caused by the bacteria Neisseria gonorrhoeae. This infection can occur in the genitals, anus, throat and eye. The bacteria can also be found in body fluids such as semen, pre-ejaculate, vaginal fluids, and anal fluids.

Gonorrhea can be cured with antibiotics. It is a common STI in British Columbia.

Causes

Gonorrhea is passed through vaginal, oral, and anal sexual contact. This includes both penetrative sex and sexual activities where there is an exchange of body fluids. You can also get gonorrhea by sharing sex toys. Once you have this infection, you can pass it to others even if you don’t have symptoms.

Symptoms

If you have gonorrhea, it is common to not notice any symptoms.  If you do get symptoms, they will most likely show up between 2 to 7 days.  Your symptoms will depend on where the infection is located. Genital symptoms might be different if you have had lower surgery (also called bottom surgery or gender-affirming surgery). The most common symptoms occur in the penis. 

The most common symptoms include:

• Penis:  You may notice abnormal discharge and an unusual, painful, or itchy sensation.  You may also have pain or trouble when urinating.  If you have testicles you may experience pain and sometimes a little swelling in the area.
• Vagina:  You may notice abnormal discharge and bleeding.  Other symptoms may include lower abdominal pain and sometimes pain during sex.
• Anus:  You may notice abnormal discharge.  You can also have generalized pain in the area.
• Throat:  It is rare to have symptoms, but you might experience a sore throat.
• Eye: You may notice swelling or abnormal discharge.

Tests and Diagnosis

A health care provider will recommend tests depending on the types of sex that you’re having. Testing is usually done with a urine sample or a swab of the throat, rectum and/or vagina.

It is best to get tested for gonorrhea if you:

• have symptoms
• are doing routine screening for STIs
• have a sexual partner who has recently tested positive for gonorrhea
• are pregnant
• are going to have an IUD inserted, a surgical abortion, or a gynecological procedure

Window Period (how long to wait before testing):  Most test results are accurate 7 days after you come in contact with gonorrhea. In British Columbia, most test results should be ready in 10 days.

Pregnancy: If you are pregnant you should be screened for gonorrhea.  You can pass gonorrhea to your child during birth.

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Treatment

Gonorrhea is treated with prescription antibiotics, usually through injection by a health care provider. 

If you are given oral medication, it is important to take all your medications as directed. If you miss any doses, the infection may not be cured.

See your health care provider if you miss doses or if you still have symptoms after you finish your treatment.

The medications used to treat gonorrhea are available for free in BC. Talk to your health care provider to see if they have them in stock.

After Getting Treatment

• It is important to not have sex (including oral sex and sex with a condom) for 7 days after the start of your treatment. If you do have sex, you could pass gonorrhea to your sexual partners or get it again. If this happens, talk to your health care provider.
• Tell your healthcare provider if:
  • your symptoms (if any) do not go away.
  • if you did not finish your medication
  • if you experienced vomiting after taking medication (ie. it did not absorb).
• Before having sex with a recent partner, be sure they started treatment at least 7 days ago. If your partner was not treated (even if they tested negative), they could still have the infection and can pass it back to you
• Retest in 6 months to confirm that there was no re-infection. If you retest sooner, wait at least 4 weeks after completing treatment. This is because dead bacteria may still be detected if you test too soon after treatment. It is sometimes recommended to have a test-of-cure. Talk to your health care provider for their recommendation.

Sexual Partners

Your sexual partners within the last two months should be tested and treated for gonorrhea. If you haven’t had sex in the last two months, your last partner should be tested and treated. Recent sexual partners should be treated even if they test negative, contacts can have a new/recent infection and still test negative.

There are a few ways to tell partners, talk to your health care provider about what is right for you. Some ways to let sexual partners know to get tested:

• Tell your partners in person or over the phone. It can help if you prepare for this conversation, we’ve developed some tips to help talk to partners.
• Tell your partners with your healthcare provider. Your healthcare provider can help answer any questions that you or your partners might have.
• Your healthcare provider might be able to tell your partners for you. They can inform them they have been exposed to an STI and need to get tested without giving your name. Not all providers offer this option.

How to talk to your partners

Complications

If you treat gonorrhea early, there are usually no other health problems. If left untreated, it can lead to serious complications including:

• higher chance of getting and passing HIV
• pelvic inflammatory disease
• epididymitis
• infertility
• ectopic pregnancy
• chronic pelvic pain
• reactive arthritis
• disseminated gonococcal infection