🔬 Men's Health
Gonorrhoea in Nigeria
Nigeria's most common STI, and the growing antibiotic resistance crisis
Gonorrhoea is the most common bacterial sexually transmitted infection in Nigeria. Caused by Neisseria gonorrhoeae, it infects the urethra, cervix, rectum, throat, and eyes. Nigeria faces a mounting crisis: antibiotic resistance is rendering previously effective treatments useless. Many gonorrhoea infections in Nigeria are resistant to penicillin, tetracycline, and ciprofloxacin. Only dual therapy (ceftriaxone + azithromycin) reliably treats it.
Signs and Symptoms
✓ In men: yellowish or greenish penile discharge; burning on urination; testicular pain or swelling
✓ In women: often ASYMPTOMATIC (60–80%); vaginal discharge; burning urination; pelvic pain
✓ Rectal gonorrhoea: rectal discharge, soreness, bleeding (often asymptomatic)
✓ Throat gonorrhoea: usually asymptomatic; occasionally sore throat
✓ Disseminated gonococcal infection (rare): fever, joint pain (septic arthritis), skin rash
✓ In newborns: eye infection (ophthalmia neonatorum) causing blindness if untreated
Risk Factors
- Multiple sexual partners
- Inconsistent condom use
- Young age (15–35): highest prevalence group
- Previous STI: increases susceptibility to others
- Sex work
- Not knowing your partner's STI status
When to Seek Help
Penile or vaginal dischargeSee a doctor or attend an STI clinic, self-treatment with leftover antibiotics guarantees treatment failure and resistance.
Painful urination lasting more than 3 daysNeeds proper diagnosis: urinary tract infection and gonorrhoea require different treatment.
Pelvic pain in a womanPelvic inflammatory disease (gonorrhoea ascending to the uterus and fallopian tubes), risk of infertility if untreated.
Recent sexual contact with someone diagnosed with gonorrhoeaRequires treatment even without symptoms: asymptomatic gonorrhoea is common and transmissible.
Tests & Diagnosis
🧪 Urethral/cervical swab: NAAT (nucleic acid amplification test)
The gold standard: highly sensitive and specific. Available at private STI clinics and some teaching hospital labs. At Mascot Healthcare we test for gonorrhoea with a rapid antigen swab test instead, with same-day results. At Mascot Healthcare we test for gonorrhoea with a rapid antigen swab test instead, with same-day results. At Mascot Healthcare we test for gonorrhoea with a rapid antigen swab test instead, with same-day results. At Mascot Healthcare we test for gonorrhoea with a rapid antigen swab test instead, with same-day results.
🧪 Gram stain + microscopy
Quick, cheaper test: useful for symptomatic urethral gonorrhoea in men (sensitivity 90%+). Less sensitive in women.
🧪 Culture and sensitivity
Grows the organism and tests antibiotic resistance, essential for treatment guidance in an era of resistance. Requires 24–48 hours.
🧪 Co-testing for chlamydia, syphilis, HIV
Gonorrhoea rarely occurs alone: always test for co-infections.
Treatment Options
1
Current first-line Nigeria: ceftriaxone 500 mg IM injection single dose
Injectable ceftriaxone is now the only reliably effective single-dose treatment given the widespread resistance to oral antibiotics. Must be given in a clinical setting.
2
Plus azithromycin 1g oral (dual therapy)
Covers co-infection with chlamydia and provides some protection against resistance. Used alongside ceftriaxone.
3
Do NOT use: ciprofloxacin, penicillin, tetracycline, co-trimoxazole
Resistance rates above 50% for all these agents in Nigeria. Self-treatment with these drugs guarantees failure.
4
Partner notification and treatment
All recent sexual partners must be tested and treated. Untreated partners reinfect treated patients, a treated infection without treating the partner is not a cure.
5
Test of cure at 1–2 weeks
Confirms treatment success: essential with rising resistance rates.
6
Condom use for all sexual activity
Prevents transmission and protects against other STIs.
Frequently Asked Questions
Can I buy treatment for gonorrhoea at a pharmacy?
Self-treatment with pharmacy antibiotics almost always fails in Nigeria, most available oral antibiotics are no longer effective against gonorrhoea. You need a diagnosis (swab or microscopy), the correct drug (ceftriaxone injection), and treatment of your partner. Going to a clinic is essential.
Can gonorrhoea make me infertile?
Yes, untreated gonorrhoea in women causes pelvic inflammatory disease (PID), which can permanently scar the fallopian tubes, causing infertility and increasing ectopic pregnancy risk. In men, it can cause epididymo-orchitis with testicular damage. Early treatment prevents these complications.
Is gonorrhoea the same as an STD?
STI (sexually transmitted infection) is the current preferred term: STD (disease) implies symptoms, while many infections are asymptomatic. Gonorrhoea is an STI. Both terms are used.
How long after exposure do symptoms appear?
In men: 1–14 days (usually 2–5 days). In women: often no symptoms at all, or mild symptoms ignored. Asymptomatic infection can persist for months, during which transmission continues.
Can gonorrhoea be prevented?
Consistent, correct condom use reduces risk by 90%+. PrEP does not prevent gonorrhoea. Vaccines are in development but not yet available. Regular STI testing for sexually active people with multiple partners is essential for detection before transmission.
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💬 Book on WhatsAppLast updated 18 October 2026.