What are the symptoms of gonorrhoea?

Not everyone infected with gonorrhoea will develop symptoms. Men with gonorrhoea are most likely to do so, with around 90% developing symptoms. Women are less likely to develop symptoms, with only 30–60% doing so. Moreover, symptoms are almost exclusively the result of an infection of the genitalia. When gonorrhoea infects the throat or the anus, only 10% of patients develop symptoms. Gonorrhoea can lead to the following symptoms:

Men

• Pain or a burning sensation when urinating
• A puss-like discharge from the penis (‘the clap’)

If gonorrhoea in men is not treated in time, they may develop more serious symptoms:

• Inflammation of the epididymides
• Prostatitis

Women

• Pain or a burning sensation when urinating
• Increased or abnormal vaginal discharge
• Bleeding between periods

If gonorrhoea in women is not treated in time, they may develop more serious symptoms:

• Pelvic inflammatory disease (lower abdominal pain, often accompanied by a fever, abnormal vaginal discharge and irregular menstruation)
• Reduced fertility
• Ectopic pregnancy

Women who become infected with gonorrhoea when pregnant may experience complications during pregnancy, such as endometritis or premature birth. They may also transmit the infection to their baby when giving birth. This may cause neonatal conjunctivitis and blindness (also see the page on gonorrhoea and pregnancy). In rare cases, the gonorrhoea bacterium can enter the bloodstream – in both men and women – and cause infections elsewhere in the body, leading to arthritis, septicaemia or meningitis.

How to prevent becoming infected with gonorrhoea

The leading cause of gonorrhoea infections is unsafe sex. The bacterium may be present in the vaginal mucosa, urethra, anus or throat. The most common way of contracting the bacterium is through penile-anal or penile-vaginal intercourse. The infection can also be transmitted via the hands, sex toys and oral sex. Gonorrhoea is a highly contagious STI and is transmitted more easily than even chlamydia. To prevent the spread of gonorrhoea, always use a condom or dental dam during sex.

Gonorrhoea can be treated with antibiotics. If you become infected with gonorrhoea, your sexual partners must be traced, tested and (if necessary) treated as well. This will prevent the infection from spreading. Once you have been tested by your general practitioner, the Municipal Public Health Service or a sexual health clinic, you can alert your sexual partners that you have an STI through the website partnerwaarschuwing.nl (you can do so anonymously if you wish).

The gonorrhoea bacterium may become resistant to certain antibiotics. This means the antibiotics no longer work.

How common is gonorrhoea?

Gonorrhoea is more common in men who have sex with men (MSM) than in heterosexual men and women. It is also more common in MSM infected with HIV and in people with a migration background.

Since mid-2022, there has been an increase in gonorrhoea infections among young adults. This mainly concerns young people under the age of 25, with heterosexual women affected slightly more often than heterosexual men.

In 2022, 10,600 people who had themselves tested for an STI with the Municipal Public Health Services had gonorrhoea. In the same year, general practitioners diagnosed gonorrhoea around 12,700 times.