Gonorrhoea Symptoms

Quick Glance: Common Gonorrhoea Symptoms

Symptoms of gonorrhoea depend on the part of the body affected. Common symptoms may include:

• Burning or pain while urinating

• Unusual vaginal discharge

• Discharge from the penis

• Bleeding between periods or after sexual intercourse

• Lower abdominal or pelvic pain

• Painful or swollen testicles

• Anal pain, itching, discharge or bleeding

• Sore throat or throat discomfort

Gonorrhoea can also occur without noticeable symptoms, particularly in women and when the infection affects the throat or rectum.

Symptoms of Gonorrhoea That Should Not Be Ignored

Some symptoms of gonorrhoea may indicate an infection that needs prompt medical assessment or a possible complication. The table below explains what some important symptoms may indicate:

These symptoms do not confirm gonorrhoea. A healthcare professional may recommend testing to identify the cause and check for other sexually transmitted infections.

Why Do Gonorrhoea Symptoms Occur?

Gonorrhoea is caused by the bacterium Neisseria gonorrhoeae, which can infect mucosal areas such as the urethra, cervix, rectum and throat. The infection triggers inflammation in the affected tissues, causing symptoms that vary according to the site of infection.

Inflammation of the urethra can cause burning or pain while urinating and discharge from the penis. Cervical infection may cause vaginal discharge, bleeding between periods or bleeding after sexual intercourse. Rectal infection can cause anal pain, itching, discharge or bleeding. A throat infection is often symptom-free but may cause a sore throat.

In uncommon cases, N. gonorrhoeae can enter the bloodstream and spread to other parts of the body. This is called disseminated gonococcal infection (DGI) and can cause fever, joint pain or swelling, skin lesions and inflammation of the tendon sheaths. Rarely, DGI can affect the heart or the membranes surrounding the brain.

Symptoms of Gonorrhoea That Require Immediate Medical Attention

Seek urgent medical attention if a person with possible gonorrhoea develops:

• Red, painful or swollen eyes with thick or pus-like discharge

• Fever with joint pain, swelling or difficulty moving a joint

• A rash accompanied by fever and joint symptoms

• Severe pelvic or lower abdominal pain

• Severe testicular pain or swelling

• Severe headache, stiff neck or other neurological symptoms

• Fainting, confusion or other signs of serious illness

• A newborn with red or swollen eyes or thick eye discharge

These symptoms can indicate complications such as gonococcal eye infection, disseminated gonococcal infection or serious infection in a newborn. Gonococcal infection in newborns can, in rare cases, spread and cause conditions such as sepsis, arthritis or meningitis.

Symptoms of Gonorrhoea-Specific Conditions

Gonorrhoea can cause specific clinical symptoms when it affects particular organs or spreads beyond the initial site of infection. The table below summarises the main gonorrhoea-specific conditions and their associated symptoms:

DGI occurs when N. gonorrhoeae enters the bloodstream from a mucosal infection and spreads to distant sites. Gonococcal conjunctivitis can occur in adults, while infection acquired during birth can cause eye infection in newborns.

Symptoms of Gonorrhoea in Men

Gonorrhoea symptoms in men commonly affect the urethra and may include:

• Burning or pain while urinating

• White, yellow or greenish discharge from the penis

• Painful or swollen testicles

• Anal pain, itching, discharge or bleeding if the rectum is affected

• Sore throat if the throat is affected

Some men may have no noticeable symptoms, particularly when gonorrhoea affects the rectum or throat. Rectal and throat infections are often asymptomatic, so the absence of symptoms does not rule out gonorrhoea.

Symptoms of Gonorrhoea in Women

Gonorrhoea is often asymptomatic in women. When symptoms occur, they may include:

• Vaginal discharge

• Burning or pain while urinating

• Bleeding between periods

• Bleeding after sexual intercourse

• Lower abdominal or pelvic pain

• Anal pain, itching, discharge or bleeding if the rectum is affected

• Sore throat if the throat is affected

As gonorrhoea can cause few or no noticeable symptoms in women, an infection may remain undetected. An untreated infection can spread to the upper reproductive tract and may cause complications such as pelvic inflammatory disease, ectopic pregnancy or infertility.

Symptoms of Gonorrhoea in Children

Gonorrhoea in children is uncommon, and symptoms depend on the affected area. In prepubertal children, possible symptoms include:

• Vaginal discharge

• Redness or irritation around the genitals

• Burning or pain while urinating

• Anal discharge, pain or irritation

• Sore throat if the throat is affected

Rectal and throat infections may occur without noticeable symptoms. Gonorrhoea diagnosed in a prepubertal child requires thorough medical assessment by an appropriately trained healthcare professional, including consideration of safeguarding and possible sexual abuse.

Can You Have Gonorrhoea Without Symptoms?

Yes. Gonorrhoea can occur without noticeable symptoms, particularly in women and when the infection affects the throat or rectum. WHO notes that infections at non-urethral sites are frequently asymptomatic, while gonococcal infection of the cervix is also often without obvious symptoms. This means that a person can have gonorrhoea without realising it.

Since symptoms are not always present, testing may be recommended based on symptoms, sexual exposure or other clinical factors. A lack of symptoms does not rule out gonorrhoea.

When Can Gonorrhoea Symptoms Become Life-Threatening?

Most gonorrhoea infections do not become life-threatening, but rare complications can require urgent medical care. The table below explains the serious complications of gonorrhoea that can become dangerous if they occur:

Severe eye symptoms, fever with joint symptoms, neurological changes or signs of serious illness in a newborn require immediate medical assessment. DGI and serious neonatal infection are uncommon, but they can cause severe illness.

How are Gonorrhoea Symptoms Diagnosed?

A healthcare professional may assess symptoms, sexual exposure and the affected body areas before recommending laboratory testing. Symptoms alone cannot confirm gonorrhoea because other infections can cause similar symptoms. The table below explains the main tests and specimens used to identify gonorrhoea:

NAATs and culture are established laboratory methods for diagnosing gonorrhoea. Culture and antimicrobial susceptibility testing are particularly important when antibiotic resistance or treatment failure needs to be investigated.