Gonorrhoea can be passed on through unprotected vaginal, oral or anal sex. It can also be passed on through the shared use of sex toys.
On this page, we’ll look at how gonorrhoea is transmitted through:
We’ll also discuss:
- what the most common route of transmission is
- who is most at risk of gonorrhoea
- and what you can do to limit your risk of getting gonorrhoea.
The bacteria that causes gonorrhoea is called Neisseria gonorrhoeae. In an infected person, this bacteria can be present in discharge from the penis, or in vaginal fluid.
When a couple have vaginal sexual intercourse, transmission occurs when this bacteria-containing discharge comes into contact with the mucus membrane of an infected person’s partner (the mucus membrane is the soft pinkish-red tissue that lines the inside of the vagina and the penis).
So during vaginal sex, man to woman transmission might occur when a man enters their partner’s vagina, and ejaculates infected sperm or expels infected discharge from the penis. Women to man transmission can occur when discharge from the vagina enters the male’s urethra (the opening at the head of the penis, where urine comes from).
As is the case with vaginal sex, the bacteria responsible for causing gonorrhoea can infect mucus membrane during oral sex. The mouth and throat is lined with this tissue, and infection occurs when infected sperm, vaginal fluid or discharge comes into contact with it.
The person performing oral sex is thought to be more at risk. However, it is thought to be possible (although much less likely) for transmission to occur in the opposite direction; and for a man or women receiving oral sex to catch the infection from someone with oral gonorrhoea.
The inside of the anus contains mucous membranous tissue. This can become infected with gonorrhoea when discharge from the penis or infected sperm comes into contact with it.
The person receiving anal sex is at higher risk of infection. But infected discharge from the person receiving anal sex can enter the urethra of the male performing it, and cause them to develop gonorrhoea.
When someone with gonorrhoea inserts a sex toy into their vagina or anus, infected discharge can transfer from them to the toy. If this is then used by a second person, the infected discharge can then transfer to the site of insertion (be it the inside of the anus or vagina).
It isn’t easy to say with complete certainty what kind of sex causes the most gonorrhoea infections alone. In many cases, people who become infected with the condition may engage in several different types of sex.
However anal sex is thought to be the route that poses the highest risk of transmitting STIs in men and women.
According to Public Health England, 47% of all gonorrhoea cases in 2017 were diagnosed in men who have sex with men; which indicates that men in this group were disproportionately affected. Overall, diagnoses were highest in the 25-34 age group, which accounted for 37% of the total.
But generally, people who:
- don’t use condoms or barrier contraception during sex
- have more than one sexual partner
- share sex toys
- or engage in risky practices, such as chemsex
are more at risk.
It’s important to use barrier contraception, such as condoms, to prevent the potential spread of infection, particularly if you’re having sex with someone whose STI status you are not sure of.
Getting tested regularly if you’re sexually active can also help to identify the infection early, and stop it from developing or spreading. If you’re sexually active, you should aim to do this at least once a year.
Before having sex, it can be useful to talk to you each other about your history and be open about your status, and whether or not you’ve recently been tested.