Gonorrhoea — testing and treatment
Reviewed by the My London Pharmacy clinical team, Yousef Yaghoubi, Pharmacist
·29 July 2026
·7 min read
Quick answer
Gonorrhoea is a common bacterial STI that often causes no symptoms, so testing is important. It is diagnosed from a urine sample or swab and treated with antibiotics, usually an injection given by a clinician. Recent partners should be tested, and a follow-up test confirms the infection has cleared.
What gonorrhoea is
Gonorrhoea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae, sometimes informally called the clap. It is one of the more common STIs in the UK, with diagnoses having risen in recent years, and it is passed on through unprotected vaginal, anal or oral sex, and by sharing sex toys. It can affect the genitals, rectum, throat and eyes, and it is not spread through everyday contact such as kissing, hugging, sharing towels or toilet seats.
Like many STIs, gonorrhoea is very treatable, and there is nothing shameful about it; sexual health teams manage it every day and their care is confidential and non-judgemental. The key points to understand are that it frequently causes no symptoms, that treatment has changed in recent years because the bacteria have become more resistant to some antibiotics, and that a follow-up check is now an important part of care. Keeping these three points in mind explains why testing, prompt treatment and attending for a repeat test all matter.
Symptoms to look out for
Many people with gonorrhoea have no symptoms, particularly when the infection is in the throat or rectum. Around half of women and around one in ten men notice nothing at all, which is why the infection can be passed on unknowingly. When symptoms do occur, they usually appear within about two weeks of exposure, though sometimes sooner and occasionally not for some time.
In women, signs can include unusual vaginal discharge that may be thin, watery, yellow or green, pain when passing urine, and bleeding between periods or after sex. In men, symptoms often include discharge from the penis, which may be white, yellow or green, discomfort when urinating, and sometimes tender or swollen testicles. A rectal infection can cause discomfort, discharge or bleeding, and a throat infection rarely causes noticeable symptoms.
Because signs are so variable and often absent, they are not a dependable guide, and feeling well does not rule out infection. Testing is the only reliable way to know for certain, which is why screening is worthwhile after any possible exposure, even in the absence of symptoms.
How testing works
Testing is quick and painless. For women, a self-taken vaginal swab is usually recommended, while for men a first-pass urine sample is typical. Swabs can also be taken from the throat, rectum or eyes where relevant, which is important because these sites are often missed if only urine is tested. A clinician can advise which samples are appropriate for your circumstances, and testing is always confidential.
It is worth knowing that tests are most reliable after a short window has passed following possible exposure, so if you test very soon after a risk, a clinician may suggest repeating it to be sure. Many services offer discreet self-sampling kits that can be done at home and posted to a laboratory, which some people find more comfortable, although a clinic visit is needed if swabs from the throat or rectum are required, or if you have symptoms that need examining. If gonorrhoea is found, the sample may also be cultured to check which antibiotics will work best, and this step directly guides effective treatment.
How gonorrhoea is treated
Gonorrhoea is treated with antibiotics. Because the bacteria have become resistant to several older options, the current first-line treatment in the UK is a single antibiotic injection of ceftriaxone, given by a clinician. This is the most reliable way to clear the infection, and it is why treatment is not simply a course of tablets for most people. Symptoms usually begin to settle within a few days of treatment.
Where injection is not possible, or where an infection is known from culture results to be susceptible, an oral option such as Ciprofloxacin may be appropriate, and in some situations Azithromycin is used alongside treatment. A clinician will decide the safest and most effective choice based on your test results, any allergies and where in the body the infection is. It is important to complete any treatment exactly as prescribed and to avoid sex until treatment is finished and symptoms have fully settled.
Gonorrhoea and antibiotic resistance
One reason gonorrhoea is treated and followed up so carefully is that the bacteria have become increasingly resistant to antibiotics over the years. Treatments that once worked reliably are no longer dependable, and health services around the world, including the UK, monitor resistance closely. This is why the recommended treatment has shifted towards a single, well-chosen antibiotic injection rather than the tablets that were once standard, and why a laboratory may culture the sample to check exactly which antibiotics will still work.
This background also explains the emphasis on completing treatment as prescribed, avoiding sex until you are given the all-clear, and attending a follow-up test. Using the wrong antibiotic, or not finishing treatment, can allow more resistant bacteria to persist and spread. Understanding this makes the extra steps feel less like bureaucracy and more like sensible, shared protection — both for you and for the wider community.
Why follow-up testing matters
Because of growing antibiotic resistance, a follow-up test, known as a test of cure, is recommended after treatment for gonorrhoea. This is usually done a couple of weeks later and confirms that the infection has genuinely cleared, rather than assuming it has because symptoms have gone.
This step is more important for gonorrhoea than for some other STIs, so it is worth attending even if you feel completely well and your symptoms have settled. If the infection has not cleared, a clinician can arrange alternative treatment promptly, before it has a chance to be passed on or cause further problems.
Telling partners
Anyone you have had sex with recently should be tested and treated, even if they have no symptoms, to stop the infection being passed back and forth. This is called partner notification, and sexual health services can help do this confidentially, including anonymously, if you would prefer not to raise it directly. There is support available, and staff are used to helping with these conversations.
Avoiding sex until you and your partners have finished treatment and been given the all-clear protects everyone involved and reduces the chance of reinfection. Reinfection is common when one partner is treated and another is not, so treating everyone at the same time is the most effective approach.
Preventing gonorrhoea and reinfection
Once treatment is complete, it is natural to want to avoid going through it again. Condoms, used correctly for vaginal, anal and oral sex, substantially reduce the risk of gonorrhoea and other STIs, although no method removes the risk entirely. Regular testing is also part of prevention: many sexual health services suggest a check-up when you have a new partner, or periodically if you have several partners, since infections are so often silent.
Reinfection usually happens when a partner has not been treated, which is why partner notification and avoiding sex until everyone involved has finished treatment matter so much. If you have ongoing risk, a clinician can talk through a testing routine that suits your circumstances, so that any future infection is picked up and treated early, before it has a chance to cause problems.
Why prompt treatment matters
Untreated gonorrhoea can cause serious problems. In women it can spread to the reproductive organs and cause pelvic inflammatory disease, which is linked to long-term pelvic pain, ectopic pregnancy and reduced fertility. In men it can cause painful inflammation of the testicles, which can also affect fertility. In pregnancy, gonorrhoea can be passed to the baby during birth and cause a serious eye infection, so it is checked for and treated where needed.
Rarely, the infection can spread through the bloodstream to affect the joints and skin, causing a more widespread illness. While this sounds concerning, these outcomes are largely preventable with prompt testing and treatment, which is exactly why acting early is so worthwhile.
Seeking advice quickly if you have symptoms or a possible exposure keeps the risks low and gives the best chance of a simple recovery. A discreet, non-judgemental consultation is all it takes to get the process started, and support is available whenever you need it.
Frequently asked questions
Can gonorrhoea be treated with tablets alone?
For most people the recommended treatment is a single antibiotic injection, because the bacteria have become resistant to many oral antibiotics. Tablets are only used in specific situations guided by test results.
Do I really need a follow-up test?
Yes. A test of cure after treatment is recommended for gonorrhoea because of antibiotic resistance, and it confirms the infection has cleared even if you feel well.
Will I know if I have gonorrhoea?
Often not, as many infections cause no symptoms, especially in the throat or rectum. Testing is the only reliable way to find out.
When can I have sex again?
Wait until you and any partners have completed treatment, symptoms have settled, and your clinician confirms it is safe, usually after the follow-up check.
How can I reduce the risk of getting it again?
Using condoms correctly, ensuring partners are tested and treated, and having regular check-ups with new partners all help reduce the risk of reinfection.
Can I be assessed online?
A clinician can often review your symptoms and history through a discreet consultation and arrange testing, though treatment usually involves attending in person for an injection.