Gonorrhoea: Know the Symptoms in Men and Women

Gonorrhoea is the second most common bacterial STI in the UK (UKHSA, 2024), behind chlamydia. Unlike chlamydia, which tends to hide quietly, gonorrhoea often announces itself with symptoms that are hard to ignore - at least in men. In women, the picture is different. Up to 50% of women with gonorrhoea have no symptoms at all (BASHH, 2024), and when symptoms do appear, they are frequently mistaken for a urinary tract infection or thrush.

If you are checking this page because something feels wrong, keep reading. If the symptoms match, get tested. A gonorrhoea test costs £103.75 at our clinic with results in 1 to 3 days.

"Gonorrhoea symptoms in men are usually obvious — but in women, the infection is frequently silent. If your partner has been diagnosed, get tested regardless of whether you have symptoms."

Dr Mohammad Bakhtiar, Sexual Health Physician, GMC 4694470

What are the symptoms of gonorrhoea?

Gonorrhoea is a bacterial infection caused by Neisseria gonorrhoeae, typically producing symptoms within 1 to 14 days of exposure; in men, the most common symptom is a thick yellow-green urethral discharge with painful urination, while many women experience mild or no symptoms, making testing the only reliable method of detection.

Symptoms differ significantly between men and women, and also vary depending on the site of infection (genital, rectal, pharyngeal).

Gonorrhoea symptoms in men

Men with urethral gonorrhoea typically develop noticeable symptoms within 2 to 5 days of exposure (BASHH, 2024), though it can take up to 14 days.

The classic presentation includes:

A thick, yellow-green or sometimes white discharge from the penis. This is usually obvious - it stains underwear and is present without squeezing. It is the symptom that most commonly brings men to our clinic.

Painful or burning urination (dysuria). The pain is often described as sharp and is most noticeable at the start of urination.

Increased urinary frequency or urgency.

Less commonly, men may experience testicular pain or swelling on one side, which can indicate epididymitis (infection of the tube behind the testicle). Epididymitis from gonorrhoea requires prompt treatment to prevent complications.

Around 10% of men with urethral gonorrhoea have no symptoms. The infection is still transmissible and still causes damage if untreated.

Gonorrhoea symptoms in women

Gonorrhoea in women is trickier. About half of infected women are entirely asymptomatic. When symptoms do appear, they can include:

Increased vaginal discharge. The discharge may be thin or watery, or yellow-green. It is often mistaken for normal variation or attributed to another cause.

Painful urination. Similar to a UTI, and frequently treated as one without gonorrhoea ever being considered.

Lower abdominal pain or pelvic discomfort. This can indicate the infection is spreading to the upper reproductive tract.

Bleeding between periods or after sex. Irregular bleeding is easy to dismiss, but in a sexually active woman, it warrants STI screening.

Heavier or more painful periods than usual.

If gonorrhoea spreads from the cervix to the uterus and fallopian tubes, it can cause pelvic inflammatory disease (PID). PID is a serious complication that can lead to chronic pelvic pain, ectopic pregnancy, and infertility. It is one of the main reasons why asymptomatic gonorrhoea in women is not a benign situation.

Rectal gonorrhoea symptoms

Gonorrhoea can infect the rectum through anal sex (receptive) or, in women, through spread from a genital infection. Symptoms of rectal gonorrhoea include:

• Rectal discharge (mucus or pus)
• Anal itching or soreness
• Pain during bowel movements
• Rectal bleeding

Many cases of rectal gonorrhoea are asymptomatic. Our MSM screening packages include rectal and pharyngeal testing because these sites are frequently infected without symptoms.

Pharyngeal (throat) gonorrhoea

Gonorrhoea acquired through oral sex usually infects the throat. The vast majority of pharyngeal infections cause no symptoms at all. When symptoms do occur, they are typically a mild sore throat that resolves without treatment.

The clinical issue is not the throat symptoms themselves but the fact that pharyngeal gonorrhoea can be transmitted to a partner's genitals during oral sex. It also contributes to antibiotic resistance because the throat is an environment where Neisseria gonorrhoeae can exchange genetic material with other bacteria.

Throat swabs are not included in all STI screens, so if you have had unprotected oral sex, make sure your testing covers this site. Our Silver Screen (£325 men / £375 women) and above include multi-site testing.

How quickly do gonorrhoea symptoms appear?

The incubation period for gonorrhoea is typically 1 to 14 days, with most symptomatic men noticing unusual discharge within 2 to 5 days. Women who develop symptoms tend to notice them within 10 to 14 days, though the timeline is less predictable.

If you had unprotected sex and develop urethral discharge or burning within a few days, gonorrhoea is high on the list of possible causes. But timing alone is not diagnostic. Chlamydia, mycoplasma, ureaplasma, and non-gonococcal urethritis can produce similar symptoms with overlapping timescales.

Gonorrhoea testing

Testing involves a urine sample (for urethral infection in men), a vaginal swab (for women, self-taken or clinician-taken), or site-specific swabs for rectal and pharyngeal testing. The test uses PCR (nucleic acid amplification), which is the most sensitive and specific method available.

Test	Cost	Turnaround	What it covers
Chlamydia & Gonorrhoea (urine or swab)	£103.75	1-3 days	Genital site
FAST CT/GC (urine or swab)	£75	6 hours	Genital site
Bronze Screen	£250	Bloods 24 hrs, urine up to 3 days	HIV, syphilis, chlamydia, gonorrhoea
Silver Screen	£325 (M) / £375 (F)	Bloods 24 hrs, urine/swab up to 3 days	9-11 infections
Gold Screen	£475 (M) / £490 (F)	Bloods 24 hrs, urine/swab up to 3 days	11+ infections + hepatitis
FAST Screen Simple	£350	6 hours	HIV, syphilis, chlamydia, gonorrhoea

If you need results quickly, our FAST chlamydia and gonorrhoea test returns results in 6 hours for £75. The FAST Screen includes HIV and syphilis alongside chlamydia and gonorrhoea for £350 with 6-hour turnaround.

We recommend testing at least 2 weeks after potential exposure for optimal accuracy, though PCR testing can detect gonorrhoea as early as 2 to 5 days post-exposure if bacterial load is sufficient.

If you have symptoms right now (discharge, burning), do not wait 2 weeks. Walk in to our clinic today or book an appointment. Symptoms warrant immediate investigation.

What happens if gonorrhoea is not treated?

Untreated gonorrhoea does not resolve on its own. The bacteria continue to multiply and can spread to other parts of the body.

In women: PID is the most serious complication. The infection ascends from the cervix through the uterus to the fallopian tubes, causing inflammation and scarring. This can lead to chronic pelvic pain, ectopic pregnancy, and tubal infertility. Around 10–20% of women with untreated gonorrhoea develop PID (NICE CKS, 2024).

In men: epididymitis (infection of the epididymis behind the testicle) causes testicular pain and swelling. If left untreated, it can rarely lead to reduced fertility.

In both sexes: disseminated gonococcal infection (DGI) is rare but occurs when the bacteria enter the bloodstream. Symptoms include joint pain and swelling, skin lesions, and fever. DGI requires hospital treatment.

Untreated gonorrhoea also increases susceptibility to HIV infection and makes HIV transmission more likely if co-infected.

How we treat gonorrhoea

The standard treatment recommended by BASHH (2024) is a single intramuscular injection of ceftriaxone 1g. This has replaced previous dual-therapy regimens due to increasing antibiotic resistance.

Antibiotic resistance in gonorrhoea is a genuine clinical concern. The UK has reported cases of gonorrhoea resistant to most oral antibiotics (UKHSA, 2024), and BASHH updated its guidelines accordingly. This is why we do not prescribe oral antibiotics alone for gonorrhoea unless specifically indicated.

After testing positive at our clinic, you receive a prescription. For oral medications (used in certain situations or as part of dual therapy), you can collect your prescription from a pharmacy two minutes from our clinic. We coordinate follow-up, and a test of cure is recommended 2 weeks after treatment to confirm the infection has cleared.

All screening packages include consultation, examination, testing, and prescription.

When to get tested

Test if you have:

• Unusual penile or vaginal discharge
• Painful or burning urination
• A partner diagnosed with gonorrhoea or another STI
• Testicular pain or swelling (men)
• Lower abdominal or pelvic pain (women)
• Bleeding between periods or after sex (women)
• Rectal discharge, itching, or soreness
• A persistent sore throat after unprotected oral sex
• Had a new partner or unprotected sex

Even without symptoms, routine screening is recommended for anyone with new or multiple partners. Gonorrhoea is one of the asymptomatic STIs that can cause serious harm while producing no warning signs.

Frequently asked questions

Can gonorrhoea clear up on its own?

No. Gonorrhoea is a bacterial infection that requires antibiotic treatment. Without treatment, the bacteria persist and can cause complications. There are no effective home remedies. If you have been diagnosed with gonorrhoea, treatment with the correct antibiotic is the only way to clear the infection.

How long after sex can you test for gonorrhoea?

PCR testing can detect gonorrhoea from approximately 2 to 5 days after exposure, though testing at 2 weeks post-exposure is recommended for optimal sensitivity. If you have symptoms (discharge, burning), get tested immediately regardless of timing: symptoms themselves warrant investigation.

Can you get gonorrhoea from oral sex?

Yes. Pharyngeal gonorrhoea from oral sex is common and usually produces no throat symptoms. It can be transmitted to a partner's genitals during oral sex. If you have had unprotected oral sex, request throat swab testing in addition to genital testing. Our Silver, Gold, and Platinum packages include multi-site testing. Our page on STI myths addresses this and other common misconceptions.

What is the difference between gonorrhoea and chlamydia?

Both are bacterial STIs that affect similar sites (urethra, cervix, rectum, throat). Gonorrhoea tends to produce more obvious symptoms in men (thicker discharge, more pain) and has a shorter incubation period. Chlamydia is more commonly asymptomatic. They frequently co-infect, which is why combined testing is standard. Our chlamydia test page has more detail, and all our screening packages test for both simultaneously.

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Concerned about gonorrhoea symptoms? Walk in to our Harley Street clinic for testing with results from 6 hours, or book an appointment online. Consultation, examination, and prescription are included in all screening packages.

References

• BASHH (2024). UK National Guideline for the Management of Gonorrhoea in Adults.
• NICE CKS (2024). Gonorrhoea.
• UKHSA (2024). Sexually transmitted infections and screening in England: 2023 report.
• NHS (2024). Gonorrhoea — Symptoms.