Gonorrhea is a sexually transmitted infection (STI) caused by infection with the bacterium Neisseria gonorrhea. Gonorrhea can result in infertility. Commonly known as "the clap", gonorrhea is transmitted through oral, genital, or anal sex with someone who has the infection. It can also be spread from mother to child during birth.
This bacterial infection is on the rise in Canada and is becoming increasingly resistant to antibiotics. Of more concern, in recent years there have been two cases of drug-resistant gonorrhea in Canada related to travel to Southeast Asia. Being aware of the risks of STI during travel (to any location) as well as using safer sex measures while travelling are important factors in preventing additional cases of drug resistant gonorrhea in Canada.
In females, untreated gonorrhea can lead to pelvic inflammatory disease (PID). PID health risks include abdominal pain, fever, internal abscesses, long-lasting pelvic pain, and scarring of the fallopian tubes, which can cause infertility and increase the chance of ectopic and/or tubal pregnancies.
Men can develop epididymitis, a painful inflammation in the tubes attached to the testicles. If left untreated, it can on rare occasions lead to infertility.
If untreated, you and your partner are at risk of the infection spreading through the bloodstream and infecting other parts of the body, including joints. This condition can be life-threatening.
If a person has gonorrhea and is pregnant, the infection can be passed to the baby in the birth canal during delivery, causing blindness, joint infection, or a life-threatening blood infection.
For couples where one has HIV infection and the other doesn't (i.e., serodiscordant), the risk of contracting and transmitting HIV is increased if you or your partner already have another STI.
Risk factors for contracting gonorrhea and other STIs include:
- Having condomless vaginal, oral, or anal sex
- Being younger (15-29 years old)
- Having multiple sexual partners
The symptoms of gonorrhea infection are different in males and femalesFootnote 1. People with a gonorrhea infection, especially females, may have no symptoms at all. If symptoms do occur, they usually appear two to seven days after infection was contracted.
For men who do experience symptoms, these may include:
- a burning sensation when urinating
- yellowish/white discharge from the penis
- burning or itching at the opening of the penis
- painful or swollen testicles
For femalesFootnote 1, the early symptoms of gonorrhea are often mild and non-specific and are often mistaken for a bladder or vaginal infection and many of those with the infection have no symptoms at all. In other cases, femalesFootnote 1 may mistake the symptoms for a bladder or vaginal infection. For femalesFootnote 1 who do experience symptoms, these can include:
- a burning sensation when urinating
- vaginal discharge
- pain in the lower abdomen
- pain during sex
- vaginal bleeding between periods or after sex
FemalesFootnote 1 with mild or no symptoms are still at risk of serious complications from the infection.
In both male and femalesFootnote 1, gonorrhea can infect the rectum. Symptoms of rectal infection may include:
- anal itching
- painful bowel movements
People infected through oral sex may have a sore throat, however usually have no other symptoms.
Even without symptoms, gonorrhea can be transmitted to others. Anyone at risk should be tested.
Testing for gonorrhea can be done with a simple urine test or a swab. Gonorrhea can be treated with antibiotics however; the infection is becoming increasingly resistant to antibiotics.
Following these suggestions can help you avoid contracting and transmitting gonorrhea:
- Learn about safer sex methods and practice them.
- Make informed decisions. Talk to your partner(s) about their STI status.
- Correctly and consistently use a condom and oral/dental dams during sex.
- Get tested for gonorrhea, and other STIs, if you are sexually active, and encourage your sexual partner(s) to get tested.
- It is important that you or someone from your public health department notify any sexual partners who may have been put at risk of infection. They will also need to be tested and possibly treated.
Many of the gonorrhea strains circulating today, both in Canada and around the world have become resistant to previously recommended treatments. Along with the increasing number of gonorrhea cases in Canada in recent years, we are also seeing an increase in antimicrobial resistance.
If you are diagnosed with gonorrhea, be sure to follow your healthcare professional's treatment and follow-up recommendations. Both you and your sexual partner(s) will require treatment. To avoid re-infection after treatment it is important to avoid unprotected sexual activities with your sexual partner(s) until you and your partner(s) have completed your treatment and have been informed that the infection is cured. Remember condoms are your best protection against STIs.
- Addressing the rising rates of gonorrhea and drug-resistant gonorrhea: There is no time like the present – Canada Communicable Disease Report (February 2019)
The rates of reported cases of gonorrhea have risen more than 81% percent over the past ten years. The recent rise in gonorrhea can be partly attributed to improved lab tests and screening, as well as people not practicing safer sex methods. Gonorrhea disproportionately affects sexually active youth and young adults 20-29 years of age, especially men.
- Chlamydia, gonorrhea and infectious syphilis in Canada, 2017 - infographic
- Report on sexually transmitted infections in Canada, 2017
- Report on the enhanced surveillance of antimicrobial-resistant gonorrhea (ESAG) - Results from 2014 and 2015
- 2016 National Surveillance of Antimicrobial Susceptibilities of Neisseria gonorrhoeae in Canada
- 2015 National Surveillance of Antimicrobial Susceptibilities of Neisseria gonorrhoeae in Canada
- Summary of trends observed in gonorrhea rates for 2010-2015 in Canada - Canada Communicable Disease Report
- Chlamydia, gonorrhea and syphilis in Canada (infographic)
For health professionals
- Treatment of N. gonorrhoeae in response to the discontinuation of spectinomycin: Alternative treatment guidance statement (May 2017)
- Pathogen Safety Data Sheets: Neisseria gonorrhoeae
- Case definition: Gonorrhoea
Based on biological sex characteristics.
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