Gonorrhoea: symptoms, testing and treatment at HAP.GENT

Dr Didier Hebberecht • 22 October 2026

Gonorrhoea is a sexually transmitted infection (STI) that can cause noticeable symptoms, but can also go unnoticed. Prompt testing and treatment help prevent complications and further transmission. At HAP.GENT, you can receive testing, advice and treatment.

What is gonorrhoea and how is it transmitted?

Gonorrhoea, sometimes called “the clap”, is caused by the bacterium Neisseria gonorrhoeae, also known as the gonococcus. It can be transmitted through vaginal, anal and oral sex, and by sharing sex toys. The infection can affect the urethra, cervix, rectum or throat. You can pass it on even if you have no symptoms. It can also pass from mother to baby during childbirth.

What is the incubation period?

The incubation period is the time between infection and the first symptoms. Symptoms usually appear within a few days to two weeks, but can sometimes take around three weeks. Many people have no symptoms at all. The timing of symptoms therefore cannot reliably tell you when the infection was acquired.

What symptoms can occur?

Symptoms depend on the site of the infection:

• Penis or urethra: burning or pain when passing urine, and white, yellow or greenish discharge. Sometimes there is pain or swelling in the epididymis, the tube behind the testicle.

• Cervix or vagina: increased or unusual discharge, pain when passing urine, bleeding between periods or after sex, and sometimes lower abdominal pain.

• Rectum: itching, pain, discharge, bleeding or pain when passing stools.

• Throat: often no symptoms; sometimes a sore throat.

Infections of the cervix and throat are particularly likely to go unnoticed. Symptoms alone cannot reliably confirm or rule out gonorrhoea.

How is gonorrhoea tested for?

Depending on your symptoms and sexual contacts, I take a urine sample or a swab from the vagina, throat or anus for laboratory testing. In men, I usually test a sample collected from the beginning of the urine stream; if needed, I also take a swab from the urethra, the tube that carries urine out of the body. A urine test alone cannot rule out a throat or rectal infection. A culture may also be needed to check which antibiotics the bacterium is sensitive to. Where appropriate, I discuss testing for chlamydia, HIV and syphilis with you.

If you have symptoms or a partner with gonorrhoea, make an appointment promptly. A test taken soon after exposure may still be negative; I will discuss whether you need a repeat test.

How is gonorrhoea treated?

For uncomplicated gonorrhoea, the recommended first-line treatment in Belgium is a single dose of ceftriaxone 1 gram, injected into a muscle. If you also have chlamydia, you need additional treatment. Complications or a severe antibiotic allergy may require a different approach. Do not use leftover antibiotics: antibiotic resistance makes choosing the right treatment important.

Treatment available at the practice

To avoid unnecessary delays, I keep both ceftriaxone and a suitable lidocaine solution for preparing the injection in stock at HAP.GENT. When treatment is medically indicated, I can give the injection during your appointment, after taking the necessary samples. This means you do not need to buy a whole box yourself first.

The former single-vial pack of Rocephine 1 g with lidocaine has been unavailable in Belgium since August 2026. Ceftriaxone remains available in other pack sizes, including boxes containing ten 1 g vials. Usually, only one vial is needed to treat an uncomplicated infection. Keeping a supply at the practice offers a practical solution.

Whether to treat immediately is a medical decision. If gonorrhoea is suspected, I first assess your symptoms, possible exposure and the need for testing. Not everyone needs an antibiotic straight away.

What side effects can treatment cause?

Possible side effects include pain or tenderness at the injection site, diarrhoea, nausea and a rash. A suitable lidocaine solution can be used to make the injection less painful. Before treatment, tell me about any allergies to antibiotics or lidocaine, any pregnancy, and any medicines you take.

A severe allergic reaction is possible. Call 112 if you develop difficulty breathing, swelling of the lips or tongue, or fainting after the injection. Also seek medical advice if you develop severe or persistent diarrhoea, especially with blood or fever, or a rash with blisters.

What should you do after treatment?

Avoid vaginal, anal and oral sex until at least seven days after both you and your partner(s) have completed treatment, and until symptoms have disappeared. Tell recent sexual partners so they can be tested and treated if needed. You can ask for help notifying partners anonymously.

I discuss the follow-up you need after treatment. For a throat infection, a follow-up test is recommended to check that the bacterium has been cleared. Follow-up testing is also needed during pregnancy, if symptoms persist, or after an alternative treatment. The timing depends on the test used and your situation. Contact me again if symptoms persist or return.

Recovering from gonorrhoea does not make you immune: you can get it again. I therefore recommend testing again after about three months to check for a new infection. This is different from a test to check whether treatment has worked. Condoms and dental dams reduce the risk of infection.

When should you seek urgent medical advice?

Seek a same-day medical assessment if you have fever with lower abdominal pain, testicular pain or swelling, a painful red eye with pus, or joint pain and swelling with fever. Without treatment, gonorrhoea can lead to pelvic inflammatory disease, inflammation of the epididymis and fertility problems. If you are pregnant and may have gonorrhoea, seek medical advice promptly.

Questions or a possible exposure?

Make an appointment at HAP.GENT if you have symptoms, a positive test or a partner with gonorrhoea. I discuss your situation confidentially and without judgement, and work with you to decide which tests, treatment and follow-up you need.

Dr Didier Hebberecht — HAP.GENT

Sources and website details

Editorial appendix — not part of the main article. Medicine availability and practice supplies may change; review this section when circumstances change.

BCFI — Rocephine: discontinued since August 2026
https://www.bcfi.be/nl/keywords/Rocephine?type=trade_family

BCFI — Ceftriaxone and pack sizes
https://www.bcfi.be/nl/vmps/6320

KCE — Diagnosis and management of gonorrhoea and syphilis (2023)
https://kce.fgov.be/nl/diagnose-en-aanpak-van-gonorroe-en-syfilis-0

Department of Care — Gonorrhoea
https://www.departementzorg.be/nl/infectieziekte/gonorroe

FAMHP — Ceftriaxone product information
https://app.fagg-afmps.be/pharma-status/api/files/62bc6a0c1e5c015ab3e47c6c

CDC — Follow-up for throat infections and retesting after three months
https://www.cdc.gov/std/treatment-guidelines/gonorrhea-adults.htm
https://www.cdc.gov/std/treatment-guidelines/clinical-retesting.htm

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