How do I know if I have an anal Gonorrhoea infection?

Often, you can’t. Most Gonorrhoea infections in the rectum cause no symptoms, so a test is the only way to know for sure.

When there are symptoms, they usually start around 2 weeks after infection, but they can take months to appear. Look out for:

• discharge from your bottom
• pain or discomfort in your bottom, especially when you poo
• bleeding from your bottom
• itching around your anus
• feeling that you need to poo even when your bowels are empty

These symptoms can have other causes too, so it’s worth getting tested rather than guessing, and seeing a doctor if they don’t go away. Read more in “I have an itchy anus. Could it be an STI?”

Gonorrhoea infects the moist lining of the body parts it comes into contact with, like the rectum, the genitals, the throat and the eyes. Anal Gonorrhoea is mostly passed on through:

• anal sex without a condom
• sharing sex toys that haven’t been washed or covered with a new condom
• possibly rimming (oral sex on the anus), or using saliva as lube, if your partner has Gonorrhoea in their throat, where it usually causes no symptoms

Women can also have Gonorrhoea in the rectum without having had anal sex, usually alongside an infection in the genitals. Read more in “Is unprotected anal sex dangerous?”

Gonorrhoea tests look for the genetic material of the bacteria in your sample. A urine test or vaginal swab only checks your genitals, so it can miss an infection in your bottom or throat.

If you’ve had receptive anal sex, or you have symptoms in your bottom, you need a rectal swab. You can usually take it yourself, and self-taken swabs are very reliable.

UK guidance says gay and bisexual men, and sex workers, should have a throat swab, a rectal swab and a urine or genital test when they test. For everyone else, the samples you need depend on the kind of sex you’ve had.

A test in the first 2 weeks after sex can miss Gonorrhoea, so test from 14 days after sex, or straight away if you have symptoms.

Gonorrhoea is treated with antibiotics. In the UK, the usual treatment is a single injection of ceftriaxone, usually into the buttock. If you can’t have an injection, or ceftriaxone isn’t suitable, a doctor may use other antibiotics, sometimes two together.

After treatment:

• Don’t have sex until 7 days after you and your partners have finished treatment.
• You may need a test of cure at least 2 weeks after treatment, for example if you still have symptoms, you also had it in your throat, you’re pregnant, the lab didn’t check which antibiotics work on your infection, or you were treated with something other than ceftriaxone.
• Your partners from the last 3 months should be tested and treated too.
• Get tested for Chlamydia, Syphilis and HIV as well, as UK guidance advises for everyone with Gonorrhoea.

If you test positive with Better2Know, our doctors can help you get the treatment you need.

Even without symptoms, an infection in your bottom can be passed on to your partners. Untreated Gonorrhoea may also make it easier to get or pass on HIV, and gay and bisexual men who keep getting rectal infections are at a much higher risk of HIV.

Gonorrhoea is also getting harder to treat. Cases resistant to ceftriaxone, the main antibiotic, are still rare in England, but they’re rising:

• 29 cases in 2025, more than double the 13 in 2024
• 21 more by the end of August 2026, including some with no link to travel abroad

That’s why it’s important to finish treatment and have a test of cure when you’re advised to. Read more in “What is Super Gonorrhoea and should I be worried?”

These steps lower your risk of anal Gonorrhoea:

• Use a condom for anal sex, and a new one each time you have sex.
• Don’t share sex toys. If you do, wash them and put a new condom on them before anyone else uses them.
• Use a condom or a dam (a thin latex square) for oral sex and rimming.
• Test regularly. UK advice is to test once a year, or with each new partner. Gay and bisexual men with new or casual partners should test every year, or every 3 months if they have sex without condoms.

Better2Know offers:

• Chlamydia and Gonorrhoea (Rectal Swab): a swab from your bottom for anyone who has had receptive anal sex, from 14 days after sex, with results in 2 days. You can book it at one of our clinics or order it as a home test kit.
• FAST Chlamydia and Gonorrhoea Test (Rectal Swab): the same test with results in 1 day, from 14 days after sex, at one of our clinics.
• Confidence Screen: the Full Screen plus throat and anal swabs for Chlamydia and Gonorrhoea, from 28 days after sex, with results in 5 days. If you test before 45 days, a negative HIV result needs a repeat test. It is designed for gay and bisexual men, and you can also order a Confidence Screen home test.

Not sure which test you need? Our Patient Care Team is available 24/7 on 020 7099 0955.

Can women get anal Gonorrhoea?

Yes. Women can get it through anal sex, and some women have Gonorrhoea in the rectum without having had anal sex, usually alongside an infection in the genitals.

Can you get anal Gonorrhoea from rimming?

It’s possible, if your partner has Gonorrhoea in their throat. UK guidance says rimming, or using saliva as lube, may pass Gonorrhoea between body sites. Rimming can also pass on gut infections. Read more in “Can you get an STI from rimming?”

Is there a vaccine for Gonorrhoea?

Since August 2025, the MenB vaccine has been offered in England to people at higher risk of Gonorrhoea, mainly gay and bisexual men. Two doses give around 30 to 40% protection, so condoms and testing still matter. Read more in “England to roll out world’s first vaccine for Gonorrhoea”

Anal Gonorrhoea often causes no symptoms, so you can have it without knowing. A urine test won’t find it, but a simple swab from your bottom will, and it’s usually treated with a single injection.

If you’ve had receptive anal sex, include a rectal swab when you test. Book a Chlamydia and Gonorrhoea (Rectal Swab) test at a clinic near you or order it as a home test kit. Our Patient Care Team is available 24/7 on 020 7099 0955.

Not in the UK? Choose your country from the selector at the top of the page for local tests and prices.

This article originally appeared on 21 June 2024 and was last updated on 30 September 2026.

Medical review. This article was medically reviewed by Dr Steve Chapman, Doctor with a wealth of clinical experience in the field of STIs, on 29 July 2024. It is general information and not a substitute for personal medical advice.

Sources

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