Gonorrhea

What is gonorrhea?

Gonorrhea is a sexually transmitted infection (STI) caused by bacteria (germs), called Neisseria gonorrhoeae.  It is one of the most common bacterial STIs.

How does gonorrhea spread?

Gonorrhea spreads through unprotected oral, vaginal, and/or anal sex with an infected partner.  Mothers may also pass it to their newborn baby during a vaginal birth.

What are the symptoms of gonorrhea?

• Thick discharge from the penis, vagina, or rectum
• Itching, pain, or burning sensation when peeing
• Itching or pain around the tip of the penis or rectum
• Pain during intercourse
• Lower abdominal pain
• Abnormal vaginal bleeding, such as bleeding during or after sex
• Pain or swelling of the testes
• Sore throat
• Redness or swelling of the conjunctiva (white part of the eye) if exposed.

Many people do not show any symptoms, but can still spread the germs to others without knowing it.  Testing may then be the only the way to know that you have gonorrhea.  Symptoms usually appear 1 to 14 days after the germs enter your body.

What are complications of gonorrhea?

If left untreated, the germs can spread and cause an infection of the blood (septicemia).  It can also cause an infection of the uterus, fallopian tubes, and ovaries, known as pelvic inflammatory disease (PID).  Even without symptoms, this can lead to serious complications, such as:

• Chronic pelvic pain
• Ectopic pregnancy (fertilized egg attaches outside of the uterus)
• Infertility (unable to get pregnant)
• During pregnancy, early labour, and infection of the eyes and lungs of the newborn.
• Arthritis (inflammation of the joints)
• Skin lesions
• Meningitis (inflammation of the lining of the brain and spinal cord)
• Endocarditis (inflammation of the lining of the heart)

Infections, including gonorrhea, of the genital area may increase the risk of getting human immunodeficiency virus (HIV).

How do I get tested for gonorrhea?

A urine sample and/or swabs of the cervix, urethra, throat, or rectum may be collected by a health care provider to test for gonorrhea.

How is gonorrhea treated?

• If you have these symptoms, see a health care provider as soon as possible. 
• Tell your health care provider about any type of unprotected sex (oral, vaginal, or rectal) and if you or your partners have been travelling. 
• Treatment includes antibiotics (medications that kill bacteria).  In Canada, gonorrhea may be resistant to some antibiotics.  It is important to take the medication as prescribed by your health care provider.  You may also need to have a follow up test to make sure that the medications have worked.  See your health care provider if the symptoms do not go away after treatment.
• Your partners will also need to receive treatment. 
• Do not have any type of sex for 3 days after you and your partners have completed treatment.  Do not have sex if you or your partners still have any symptoms.
• The Health Unit can help you notify your partners, while keeping your identity confidential.
• You can also be re-infected with gonorrhea after treatment, so it is recommended that you repeat testing 6 months after treatment. 

How do I prevent the spread of gonorrhea?

Ways to prevent infection include:

• Practicing safer sex, such as:
  • Abstinence (not taking part in any types of sex),
  • Mutual monogamy (both partners agree to only have sex with each other and have been tested for sexually transmitted and bloodborne infections (STBBIs)), and
  • Using latex and polyurethane male and female condoms and dental dams.  Condoms are available for free at the Health Unit.
  • Not sharing sex toys or thoroughly washing them with disinfectants between use
• Getting tested for STBBIs, if you had unprotected sex and/or are not sure if you or your partners have a STBBI.

For more information contact the Health Unit or speak to your health care provider.

• SexualHealthOntario (also has live online chat and Sexual Health Infoline): 1-800-668-2437
• The Society of Obstetricians and Gynaecologists of Canada – Sex & U

References:

• Government of Canada. (2019). Section 5-6: Canadian guidelines on sexually transmitted infections - Management and treatment of specific infections: Gonococcal Infections. Retrieved from https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines.html.
• Heymann, D.L. (Ed.). (2015). Control of communicable diseases manual (20th ed.). Washington, DC: American Public Health Association.
• Ontario Agency for Health Protection and Promotion (Public Health Ontario). (2018). Ontario Gonorrhea Testing and Treatment Guide, 2nd Edition. Toronto, ON:  Queen’s Printer for Ontario.