Gonorrhoea in Men

What is gonorrhoea?

Gonorrhoea is an infection caused by a bacterium (germ) called the gonococcus.

How do you get gonorrhoea?

It is passed on if you have sex with an infected person. This is usually during vaginal sex. Therefore, in men, the infection usually affects the urethra (the tube between the bladder and the end of the penis).

Oral sex or anal sex can also transmit infection to the mouth or anus.

What are the symptoms of gonorrhoea?

• Infection of the urethra (urethritis) is the typical infection in men. This commonly develops 5-7 days after having sex with an affected person. Symptoms include:
  • A discharge (fluid) from the penis. This may stain your underpants.
  • Pain or burning when you pass urine.
  • Irritation inside the penis, or a feeling of wanting to pass urine frequently.
  • Redness at the opening of the urethra at the end of the penis.
• Other symptoms. Irritation, itch, and discharge from the anus may occur if the infection is in the anus. A sore throat may occur if oral sex was the route of infection. In a small number of cases the infection travels up the urethra to the prostate. Rarely, a stricture (narrowing) of the urethra may develop.
• Spread in the bloodstream to other parts of the body is rare.
• Up to 1 in 10 men with gonorrhoea infection do not develop any symptoms.

The symptoms may clear over time, even without treatment. This may take up to six months, but can be just a couple of weeks or so. However, without treatment, some bacteria usually remain in the urethra. It is just that the symptoms may go.

Therefore, even if symptoms go, there is a good chance that you can pass on the infection if you do not have treatment.

Do I need tests?

You will normally be advised to have tests if gonorrhoea is suspected - even if symptoms go. You may be referred to a local genito-urinary clinic (GUM clinic) for this. You can also go to the local GUM clinic without a referral from your GP. (See later for details.)

A urine sample and/or a 'swab' of the discharge is taken to try and identify the bacterium that causes gonorrhoea. You may also be advised to have tests for other sexually transmitted infections.

What is the treatment for gonorrhoea?

A short course of an antibiotic clears most cases of gonorrhoea. The antibiotic prescribed may depend on whether you also have any other infection. For example, about 1 in 5 men with gonorrhoea are also infected with another bacterium called chlamydia. This too is usually easily treated with a short course of antibiotics.

Does my sexual partner need treatment?

Yes. They should be tested for infection, even if they do not have any symptoms. A course of antibiotics is usually advised for sexual partners, even if the tests are negative, because:

• Bacteria that cause gonorrhoea are often passed on during sex. Tests for bacteria are not foolproof. A course of antibiotics helps to make sure that any possible infection is cleared.
• Some women who are infected with gonorrhoea do not have symptoms. If this is left untreated, it can cause complications at a later time such as a serious infection of the uterus ('pelvic inflammatory disease') and infertility.
• If your sexual partner is infected and not treated, the infection can be passed back to you.

If you have gonorrhoea without symptoms then you may have had it for some time. In this situation any sexual partners within the previous three months should be tested and treated.

Follow-up

A doctor or health care professional will often want to know that treatment has worked. It is common to be reviewed soon after you finish treatment to check that symptoms have gone. Sometimes re-testing and a second antibiotic is needed if symptoms persist.

You should not have sex until both you and your sexual partner have finished treatment.

Can gonorrhoea be prevented?

Wearing a condom during sex (including anal sex and oral sex) helps to prevent the spread of sexually transmitted infections. The risk of sexually transmitted infections increases with the number of changes of sexual partner.

Further help and information

If you suspect that you have gonorrhoea or any other sexually transmitted infection, then contact your local genito-urinary medicine (GUM) clinic or see your GP. You can go to the local GUM clinic without a referral from your GP. You can ring the local hospital or health authority and ask where the nearest clinic is. It may also be listed in the phone book under 'Genito-Urinary Medicine'.

fpa
Helpline: 0845 122 8690
Web: www.fpa.org.uk
Provides information and advice on all aspects of contraception and sexual health.

British Association for Sexual Health and HIV (BASHH)
www.bashh.org
BASHH is a professional association but their website includes contact details of GUM clinics in the UK and the Republic of Ireland.