Executive summary
- Test with NAAT (self-taken vulvovaginal swab often preferred; first-catch urine for men).
- First-line: doxycycline 100 mg BD for 7 days (avoid in pregnancy/breastfeeding).
- Assess for PID/epididymo-orchitis; arrange partner notification and STI screen per local pathway.
Key steps (primary care workflow)
- Confirm pregnancy status where relevant; offer gonorrhoea testing and HIV/syphilis based on risk.
- Advise no sex until treatment completed and partners treated; consider retest for reinfection (~3 months) per local policy.
When to refer
- Immediate if pelvic pain/fever/bleeding suggests PID or if testicular pain/swelling suggests epididymo-orchitis.
- Sexual health clinic referral is helpful for pregnancy-safe regimens, partner management, and broader STI care.
Frequently asked questions
Do I need a test-of-cure?
Commonly reserved for pregnancy, persistent symptoms, or adherence concerns—follow local sexual health pathways.
Can I be asymptomatic?
Yes—many people have no symptoms, which is why partner notification and retesting for reinfection matter.
Transparency
This page is an educational, clinician-written summary of publicly available NICE guidance intended for trained healthcare professionals. It uses original wording (not copied text) and should be used alongside the full NICE source, local pathways, and clinical judgement. Doses provided are for general reference; always check the BNF/SPC.