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What Women Should Know About Gonorrhoea

What is Gonorrhoea?

Gonorrhoea is a sexually transmitted infection (STI) caused by the bacteria Neisseria gonorrhoea (gonococcus). It is the fastest growing STI in Ireland and in 2013 there was a 33% increase in identifications according to the Health Protection and Surveillance Centre.

How is Gonorrhoea Passed on?

The bacteria are mainly found in discharge from the penis or in the vaginal fluid of infected people, however it can also be found in the rectum or throat. The bacteria are easily passed between people through unprotected vaginal, oral or anal sex. It can also be passed on through sharing vibrators or other sex toys that haven't been washed and covered with a new condom each time they are used. Penetrative sex does not necessarily have to occur to pass on the infection, genital contact can also lead to transmission of gonorrhoea. Gonorrhoea can also affect the cervix (neck of the womb) the urethra (tube that carried urine out of the body), the rectum, eyes or throat.

Symptoms of Gonorrhoea

Like other STIs such as chlamydia, gonorrhoea is often asymptomatic which means you may not experience any physical symptoms and it can therefore be passed on without either partner realising they have it. Therefore it is important to get tested if you have had unprotected sex or think you may have been exposed to an STI.

Symptoms in women include:

  • Abnormal vaginal discharge
  • Bleeding between periods, heavy periods or bleeding after sex (this is less common)
  • Pain or burning when urinating
  • Pain of tenderness in the lower abdomen (this is less common)

If gonorrhoea is left untreated then it can lead to series complications:

  • Gonorrhoea can spread to the reproductive organs and cause pelvic inflammatory disease (PID), which is estimated to occur in 10-20% cases of untreated gonorrhoea. PID can lead to long-term pelvic pain, ectopic pregnancy (pregnancy outside the womb) and infertility.
  • During pregnancy, gonorrhoea can cause miscarriage, premature labour and the baby developing conjunctivitis (inflammation of the eye). If the baby is not treated with antibiotics promptly, there is a risk of progressive and permanent damage of their vision.
  • In rare cases, if left untreated, it can spread through the bloodstream to cause infections in other parts of your body. Such as inflammation and swelling of the joints and tendons, skin irritation and redness, inflammation around the brain and spinal cord (meningitis) or the heart, which can be life threatening

Treatment of Gonorrhoea

In most cases, treatment will involve having a single antibiotic injection (usually in the buttocks or thigh) followed by a single dose of an antibiotic, usually azithromycin. If you have tested positive for gonorrhoea it is likely you may also have chlamydia, so you will normally be given these additional antibiotic tablets to treat this too.

If you have any symptoms of gonorrhoea, these will usually improve within a few days of receiving treatment. If they do not, please ensure you go back to your doctor or sexual health clinic straight away. If your symptoms resolve, a follow up appointment two weeks after treatment is recommended, so another test can be carried out to ensure you are clear of infection.

You should avoid having sex until you (and your partner) have been treated and given the all clear to prevent re-infection or passing on the infection to anyone else.

Preventing Gonorrhoea

You should use condoms every time you have sex and a dam (female condom) to cover the female genitals during oral sex. Cover sex toys with a condom and do not share them. You should get tested regularly particularly if you are having unprotected sex or if you have a new or multiple partners. This will help protect you and prevent the spread of gonorrhoea.