Maybe a partner has just told you they've tested positive. Or you've read about record gonorrhoea numbers and want to know how much of that applies to you.
Gonorrhoea is caused by a bacterium, and it spreads through sex: unprotected vaginal, anal or oral sex with someone who has it. Poor hygiene, toilet seats and swimming pools play no part. Knowing exactly how it spreads, and what raises your risk, makes it much easier to decide when to test.
If you'd rather skip the reading, a combined chlamydia and gonorrhoea test is £104 at 117a Harley Street, with results within 3 working days. Walk in, or book online.
UK gonorrhoea rates have risen sharply since 2019. UKHSA data shows record numbers of diagnoses, partly because more people are testing and partly because transmission has genuinely increased. If you're sexually active, it's relevant to you.
"Antibiotic resistance is a growing concern with gonorrhoea. Current BASHH guidelines specify intramuscular ceftriaxone as first-line treatment, which is why a clinic visit matters more than a home kit."
Dr Mohammad Bakhtiar, Clinical Lead, GMC 4694470
What causes gonorrhoea?
Gonorrhoea is caused by the bacterium Neisseria gonorrhoeae. It passes through unprotected vaginal, anal or oral sex with an infected person, and infects the mucous membranes of the urethra, cervix, rectum and throat. It can also pass from mother to baby during childbirth.
The bacterium can't survive outside the human body for more than a few seconds, so it needs direct contact between mucous membranes. Casual contact, shared objects, food and water carry no risk.
How gonorrhoea spreads
Gonorrhoea is passed on through infected bodily fluids (semen, pre-ejaculate, vaginal secretions) and through direct contact with an infected site.
Vaginal sex is the most common route worldwide. An infected man passes gonorrhoea to a female partner in an estimated 50-70% of single acts of unprotected vaginal sex. Female-to-male transmission is lower, at around 20-25% per act.
Anal sex carries a high risk, particularly for the receptive partner. Rectal gonorrhoea is common in men who have sex with men and in women who have receptive anal sex, because the lining of the rectum is highly susceptible to infection.
Oral sex passes gonorrhoea to and from the throat. Performing oral sex on an infected partner can lead to throat (pharyngeal) gonorrhoea. Receiving oral sex from a partner with throat gonorrhoea can lead to urethral or cervical infection. Throat gonorrhoea usually causes no symptoms, which makes it a hidden source of ongoing transmission.
Genital-to-genital contact without penetration can pass gonorrhoea on if infected discharge reaches a partner's mucous membranes, though this is less efficient than penetrative sex.
Mother-to-baby transmission during vaginal delivery can cause gonococcal ophthalmia neonatorum, a serious eye infection in newborns. It's one of the reasons routine STI screening in pregnancy is standard.
Sharing sex toys can pass gonorrhoea on if toys are shared without cleaning, or without a new condom for each user.
Myths about catching gonorrhoea
This comes up a lot, so here are the plain facts. Our page on non-sexual transmission of STIs covers the wider picture.
Toilet seats, swimming pools, hot tubs, doorknobs and shared towels carry no risk. The bacterium dies almost immediately outside the body.
Current BASHH guidance doesn't consider kissing a significant route, although there is emerging research on deep kissing and throat gonorrhoea.
Hugging, handshakes and general social contact carry no risk at all.
Having had gonorrhoea before gives you no immunity, so you can catch it again.
Risk factors for gonorrhoea
Some people are statistically more likely to be diagnosed with gonorrhoea. The main risk factors are these.
Age. Rates are highest in people aged 15-24, the most affected group in both men and women according to UKHSA surveillance data.
Multiple sexual partners. Each new partner adds to the overall chance of meeting gonorrhoea. That's simple mathematics, not a moral statement.
Inconsistent condom use. Used correctly and every time, condoms reduce gonorrhoea transmission by an estimated 70-80%. They aren't 100% effective, because they don't cover all skin that could be infected, but they cut risk substantially.
Men who have sex with men (MSM). MSM account for a disproportionate share of gonorrhoea diagnoses in the UK. That's driven by higher rates of throat and rectal infection and by how sexual networks work, not by sexual orientation itself. Our MSM screening packages reflect these specific risk patterns.
Previous STI diagnosis. Having had one STI makes another more likely. Partly that's shared risk factors, and partly it's because inflammation from the first infection makes it easier for a second one to take hold. If you've recently been treated for chlamydia or another STI, testing for gonorrhoea is sensible.
A partner diagnosed with gonorrhoea. If a sexual partner has been diagnosed, come and get tested whether or not you have symptoms. Partner notification is one of the most effective tools for controlling the spread of gonorrhoea.
Living with HIV. People living with HIV have higher rates of gonorrhoea and other STIs. Co-infection matters clinically too, because gonorrhoea increases HIV viral shedding and makes transmission of HIV more likely.
Sex while travelling. Antibiotic resistance patterns vary by country. Gonorrhoea caught in parts of Southeast Asia, for example, may resist antibiotics that work against UK strains. If you've had unprotected sex abroad, tell your doctor, as it may affect treatment choices.
Substance use during sex. Alcohol and recreational drugs are linked with less condom use and more sexual risk-taking. That's a public health observation, not a judgement.
Antibiotic resistance: why it matters for you
Gonorrhoea is remarkably good at developing antibiotic resistance. Over the past 80 years it has become resistant to sulfonamides, penicillin, tetracyclines, fluoroquinolones and, most recently, azithromycin. Current UK first-line treatment is a single injection of ceftriaxone, and cases with reduced ceftriaxone susceptibility have already been found.
This matters for two practical reasons.
First, oral antibiotics alone are no longer recommended for gonorrhoea in the UK. If another provider gave you oral ciprofloxacin or azithromycin alone for gonorrhoea, it may not have cleared the infection. BASHH recommends a test of cure 2 weeks after treatment.
Second, testing beats treating blind. If you have gonorrhoea symptoms such as discharge or burning, the right approach is to test, confirm the diagnosis, then treat with the right antibiotic. Guessing with the wrong drug wastes time and may encourage further resistance.
We test using PCR, the gold standard for detecting gonorrhoea. When it's clinically needed, our UKAS-accredited laboratory partners also run culture and antibiotic sensitivity testing, which tells us exactly which antibiotics will work against your strain.
Prevention
Since August 2025, the NHS in England has offered the 4CMenB (meningitis B) vaccine to help protect some people at higher risk of gonorrhoea, mainly gay, bisexual and other men who have sex with men who have recently had an STI or several partners (UKHSA; NHS). If that sounds like you, ask an NHS sexual health clinic whether you're eligible.
The most effective ways to protect yourself are these.
Use condoms every time for vaginal, anal and oral sex. They reduce the risk of genital gonorrhoea by 70-80%.
Test regularly. If you have new or multiple partners, periodic routine screening catches infections early, before symptoms appear and before they pass to anyone else. BASHH recommends at least annual screening for sexually active people under 25 and for MSM.
Fewer concurrent partners means less overall exposure.
Test before sex with a new partner, which is increasingly common. Our screening packages return results for blood tests in about 24 hours, and urine and swab results within 3 working days. Our FAST Screen returns all results in 6 hours: FAST Screen Simple (£350) covers HIV, syphilis, chlamydia and gonorrhoea, and FAST Screen Complex (£450) adds hepatitis B and C.
Talk openly with partners about STI status and testing.
Keep sex toys to yourself, or put a new condom on them and clean them between users.
Our STI prevention page covers these in more detail.
When to get tested
It's worth getting tested for gonorrhoea if:
- You have unusual discharge from the penis, vagina or rectum
- You have painful urination
- A partner has been diagnosed with gonorrhoea or another STI
- You've had unprotected vaginal, anal or oral sex with a new or casual partner
- You're sexually active and under 25 (the highest-risk age group)
- You're an MSM with new or multiple partners
- You've had sex abroad, particularly in regions with high STI prevalence
- You have a known exposure to any STI
A combined chlamydia and gonorrhoea test costs £104, with results within 3 working days. For same-day results, our FAST CT/GC test returns in 6 hours for £124. Every screening package includes gonorrhoea testing alongside other common infections.
Walk in to our clinic at 117a Harley Street or book online. No GP referral is needed, and we accept pseudonymous registration and cash payment.
Think you may have been exposed to gonorrhoea? Walk in for testing at 117a Harley Street with results from 6 hours, or book an appointment online. All screening packages include consultation, examination and prescription.
References
- UKHSA (2024). Sexually transmitted infections and screening in England: 2023 report.
- UKHSA (2024). Antimicrobial resistance in Neisseria gonorrhoeae in England and Wales.
- BASHH (2024). UK National Guideline for the Management of Gonorrhoea in Adults.