Gonorrhoea in South Africa: Symptoms, Testing & Treatment | Epicentre
🦠 Neisseria gonorrhoeae · Bacterial STI

Gonorrhoea: The STI That's Becoming Harder to Treat

Also known as "the clap." Curable with treatment from your doctor, but antibiotic resistance is rising fast in South Africa. 50% of women have no symptoms at all. Often found alongside chlamydia.

✓ Curable with treatment ⚠ Rising antibiotic resistance 🧬 PCR detectable in 3-5 days 🏥 No referral needed
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50%
of women with gonorrhoea
have no symptoms
🩺
Medically Reviewed
Dr. Samantha Naidoo
MB ChB, FCP (SA) · Medical Director, Epicentre Laboratories
Published: 2 August 2025 · Last reviewed: 1 March 2026
Key facts

How common is gonorrhoea in South Africa?

82M
new cases per year globally
WHO, 2020
6.6%
of SA women (15-49) infected
NICD Sentinel Surveillance
40%
also have chlamydia
Co-infection is common
⚠
Antibiotic resistance rising
Maduna et al., 2020
3,200+
gonorrhoea cases detected at Epicentre in 2025
Across JHB, CPT & DBN labs
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Symptoms

What are the symptoms of gonorrhoea?

Symptoms vary by anatomy and by the site of infection. Gonorrhoea can infect the genitals, rectum, and throat. Tap below to see symptoms for each group.

Up to 50% of women with gonorrhoea have no symptoms, or symptoms so mild they're mistaken for a bladder infection.
💧Increased or altered vaginal discharge (up to 50%)
🔥Pain or burning when urinating (10-15%)
😖Lower abdominal pain (up to 25%)
🩸Bleeding between periods or after sex
⚠️Pain during sex
~90% of men with urethral gonorrhoea DO have symptoms, making it more noticeable than chlamydia.
💧Thick, yellow-green discharge from the penis (80%+)
🔥Painful or burning urination (50%+)
🔴Swollen or painful testicles (less common)
⚠️Redness or swelling at the tip of the penis
Rectal and throat gonorrhoea are almost always asymptomatic (90%+). Only PCR testing catches them reliably.
🔴Anal discharge, pain, itching, or bleeding (uncommon)
🤒Persistent sore throat (usually no symptoms at all)
⚠️Over 90% of throat/rectal infections produce zero symptoms
Symptoms typically appear 2-10 days after exposure, but can take up to 30 days. Many infections, especially in women, produce no noticeable symptoms. The only reliable way to detect gonorrhoea is to test.
"
"Gonorrhoea and chlamydia are co-detected in roughly 40% of our positive cases at Epicentre. This is why every one of our PCR panels tests for both. If you only test for one, you risk missing the other. And with gonorrhoea resistance rising in South Africa, getting the right diagnosis matters more than ever."
Dr. Samantha Naidoo, MB ChB, FCP (SA), Medical Director, Epicentre
The growing threat

Why is gonorrhoea antibiotic resistance a problem?

Neisseria gonorrhoeae has developed resistance to every class of antibiotic used against it over the past decades. South Africa is not immune to this trend.

What this means for you: Your doctor now needs to use a specific combination of antibiotics to treat gonorrhoea, and they may need to confirm which strain you have. PCR testing at Epicentre identifies the infection precisely, helping your doctor choose the right treatment first time.
Co-infection matters: Because 40% of gonorrhoea cases also involve chlamydia, your doctor will typically treat for both. Testing with Epicentre's PCR panels confirms exactly which infections are present, so treatment is targeted, not guesswork.
If untreated

What happens if gonorrhoea is left untreated?

Gonorrhoea is curable, but only if detected. Without treatment, it can cause serious and permanent damage.

1
Days 2-10: Early infection
Bacteria colonise the urethra, cervix, throat, or rectum. Men may notice discharge and burning. Women and throat/rectal infections are often silent.
2
Weeks 2-6: Spreading infection
In women, bacteria can ascend to the uterus and fallopian tubes. Up to 1 in 3 women with untreated gonorrhoea develop PID.
3
Months 1-6: Pelvic Inflammatory Disease
PID causes chronic pelvic pain (~40%), tubal infertility (~10%), and ectopic pregnancy (~10%). It can also cause abscesses and premature labour.
4
Rare but serious: Disseminated Gonococcal Infection (DGI)
Gonorrhoea enters the bloodstream, causing joint infection (septic arthritis), skin lesions, and in rare cases, heart valve infection. Requires hospital treatment.
5
In men: Epididymitis and infertility
Infection spreads to the epididymis (the tube behind the testicles), causing pain and swelling. Can reduce fertility if not treated.
6
HIV risk: significantly increased
Active gonorrhoea infection makes you 3-5× more likely to contract or transmit HIV. Testing and treating gonorrhoea is also an HIV prevention strategy.
Get tested

Where can I test for gonorrhoea in South Africa without a referral?

PCR testing detects gonorrhoea in 3-5 days after exposure, weeks faster than culture tests. No referral. No blood draw for PCR. Walk in or order a home kit.

Small PCR (4 pathogens)

R1,235🎓 R1,112

Gonorrhoea + chlamydia + herpes (HSV-2) + trichomoniasis. Good starting point.

4× R309/mo with Payflex
🎓 10% student👴 10% pensioner
Learn More →Book

Medium PCR (9 pathogens) ⭐

R1,508🎓 R1,357

Adds Mycoplasma, Ureaplasma, HSV-1, E. coli. Most popular. Catches co-infections rapid tests miss.

4× R377/mo with Payflex
🎓 10% student👴 10% pensioner
Learn More →Book

Large (14-17 pathogens)

R1,925🎓 R1,733

Cervical (17 targets) or Penile (14 targets). Full ecosystem analysis including BV, Candida, HPV.

4× R482/mo with Payflex
🎓 10% student👴 10% pensioner
Compare →Book

Gonorrhoea is included in every Epicentre sexual health package. View all packages →

💑 Tested positive? How to tell your partner

Both partners must be treated, otherwise reinfection is almost guaranteed. Because gonorrhoea and chlamydia often occur together, your partner should be tested for both.

1
Tell them directly

"I tested positive for gonorrhoea. It's treatable. We both need to see a doctor."

2
Test together

Come into Epicentre together. Same-day testing. Private rooms. No judgment.

3
Both get treatment

Your GP or our partner doctors will prescribe the right combination of antibiotics for gonorrhoea.

4
Wait 7 days, then retest

Avoid sex for 7 days after treatment. A follow-up test 2 weeks later confirms the infection has cleared.

Follow-up testing matters for gonorrhoea. Because of antibiotic resistance, a test-of-cure 2 weeks after treatment is recommended to confirm the infection is gone. WhatsApp Epicentre to arrange it.
FAQ

Gonorrhoea: Your Questions Answered

Can you have gonorrhoea without symptoms?

Yes. 50% of women and ~10% of men have no symptoms. Throat and rectal gonorrhoea are asymptomatic over 90% of the time.

How soon can I test after exposure?

PCR: 3-5 days. Symptoms appear in 2-10 days but can take up to 30 days. Culture tests take longer. Epicentre uses PCR for all panels.

How is gonorrhoea treated?

A combination of antibiotics prescribed by your doctor. Because of rising resistance, treatment is now dual-therapy. Both partners must be treated. A test-of-cure 2 weeks later is recommended.

Why is antibiotic resistance a concern?

Neisseria gonorrhoeae has developed resistance to multiple classes of antibiotics over the decades. South African studies show high resistance rates. PCR testing helps your doctor choose the right treatment first time.

Is gonorrhoea often found with chlamydia?

Yes, up to 40% co-infection rate. Every Epicentre PCR package tests for both. If you only test for one, you risk missing the other.

Can I get gonorrhoea from oral sex?

Yes. Throat gonorrhoea is common and almost always asymptomatic. It transmits through giving or receiving oral sex.

How much does gonorrhoea testing cost?

Gonorrhoea is included in all Epicentre PCR packages: Small R1,235, Medium R1,508, Large R1,925. Students 10% off. Payflex 4× interest-free. View all packages →

STI guide

Other infections in this guide

🦠 Chlamydia 🧬 Genital Herpes 🧬 HIV / AIDS 🧬 HPV 🦠 Syphilis 🔬 Trichomoniasis 🦠 Mycoplasma genitalium 🦠 Mycoplasma hominis 🦠 Ureaplasma 🧬 Viral Hepatitis 🦠 Male Urethritis 🦠 Chancroid
📚 Interactive STI Guide 🔬 All Packages & Pricing 📦 Home Test Kits 🎓 Student Discount

Gonorrhoea is Curable. But Only If You Test.

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