Gonorrhea

The number of gonorrheal infections have nearly doubled in the last 10 years in Canada.

How would I get it?

  • Spread through unprotected oral, vaginal or anal sex with an infected partner, mutual masturbation and sharing of sex toys
  • Can cause infections in the penis and vagina, and occasionally throat and rectum
  • Can be passed from an infected mother to infant during birth

What kind of symptoms could I have if I am infected?

You may have NO SYMPTOMS at all if you are infected. Other times you may have some or all of the symptoms listed below.

All sexes:

  • Pain when peeing
  • Pain, itching, bleeding, mucus discharge of the rectum (rectal infection)
  • Throat infection

Vaginal symptoms:

  • Vaginal bleeding after sex or between periods
  • Vaginal discharge
  • Pelvic or lower back pain
  • Pain during sex

Penile symptoms:

  • Itchy urethra
  • Thick, yellowish-green discharge from the penis
  • Testicular pain or swelling

How do I prevent this?

  • Condoms and dental dams

How do I get tested?

  • Urine and/or swabs of exposed sites; expect results to come back in 1-2 weeks

What if I test positive?

  • This infection is treated with antibiotics and curable (this generally does include an injection)
  • If left untreated, gonorrhea can cause serious health problems
  • Gonorrhea is a reportable infection – meaning someone from Public Health may contact you for further information
  • Any partners from the last 60 days need to be notified; if you have not had a partner in the last 60, then the most recent partner needs to be notified. Should you prefer to remain anonymous, Public Health can assist by notifying any or all partners.

Treatment

Gonorrhea is treated with antibiotics, which are prescribed based on the latest guidelines and the patient’s medical history.

Antibiotics Used for Treatment

  • Ceftriaxone: The current standard treatment involves a single injection of ceftriaxone (500 mg) administered intramuscularly. This antibiotic is highly effective and is the first-line treatment recommended by health authorities.
  • Azithromycin: Often, ceftriaxone is combined with a single oral dose of azithromycin (1 g) to provide dual therapy, although recent guidelines are moving away from this due to resistance concerns.

Alternative Antibiotics:

  • Gentamicin (240 mg intramuscularly) combined with azithromycin (2 g orally).
  • Cefixime (800 mg orally) is another option, though it is less effective against pharyngeal gonorrhea.

Patients undergoing treatment for gonorrhea should abstain from sexual intercourse until seven days after completing the treatment and until their sexual partners have also been treated and tested negative. This precaution helps to prevent reinfection and the spread of the infection to others.

Due to the increasing resistance of gonorrhea to antibiotics, follow-up testing is crucial. A test-of-cure is typically recommended about two weeks after treatment completion, especially in cases where pharyngeal gonorrhea was diagnosed or if the patient’s symptoms persist.

All recent sexual partners should be notified, tested, and treated for gonorrhea, regardless of whether they show symptoms. This step is critical to prevent the spread of the infection and to avoid reinfection of the treated individual.

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