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What is Gonorrhea and How to Get Tested in Your Area
Gonorrhea is a common sexually transmitted disease (STD) caused by the bacterium Neisseria gonorrhoeae. This infection targets the mucous membranes of the reproductive tract, including the cervix, uterus, and fallopian tubes in women, and the urethra in both men and women. Gonorrhea can also infect the mouth, throat, eyes, and rectum.
Often referred to as “the clap” or “the drip,” gonorrhea is highly contagious and can be transmitted during vaginal, anal, or oral sex. According to the CDC, gonorrhea is the second most commonly reported bacterial sexually transmitted infection in the United States, with approximately 677,000 new cases reported annually.
If you’re concerned about gonorrhea or other STDs, call (866) 566-8711 to learn about testing options.
How Common is Gonorrhea?
- Second most common bacterial STDin the United States
- Approximately 677,000 new casesreported annually
- Actual number estimated much higherdue to unreported cases
- Rates increased by 45%between 2016 and 2020
- Highest rates in young peopleages 15-24
- Men and women affected almost equally
How Gonorrhea Spreads
Gonorrhea is transmitted through sexual contact with an infected person. The bacteria can spread from person to person through the penis, vagina, mouth, or anus.
Gonorrhea is transmitted through:
- Vaginal sex
- Anal sex
- Oral sex
- Mother to babyduring childbirth
Gonorrhea is NOT spread through:
- Casual contact
- Sharing food or drinks
- Kissing (unless there’s an oral infection)
- Toilet seats
- Swimming pools
- Sharing towels or clothing
Gonorrhea Symptoms
Gonorrhea is often asymptomatic, especially in women. When symptoms do occur, they typically appear 1-14 days after infection.
Symptoms in Women
- Increased vaginal dischargethat may be yellow or greenish
- Painful or burning sensation when urinating
- Abnormal vaginal bleedingbetween periods or after sex
- Pain during sexual intercourse
- Lower abdominal or pelvic pain
- Rectal pain, discharge, or bleeding(if infection is rectal)
- Sore throat(if infection is in the throat)
Symptoms in Men
- Yellow, white, or green discharge from the penis
- Painful or burning sensation when urinating
- Painful or swollen testicles(less common)
- Rectal pain, discharge, or bleeding(if infection is rectal)
- Sore throat(if infection is in the throat)
Important Facts About Gonorrhea Symptoms
- Up to 80% of women and 10% of menwith gonorrhea show no symptoms
- Symptoms may appear within 1-14 daysafter infection
- Many people mistake symptoms for other conditions like urinary tract infections
- Rectal infectionsare often asymptomatic but can cause discharge, itching, soreness, bleeding, or painful bowel movements
- Pharyngeal (throat) infectionstypically cause no symptoms but might include sore throat
Gonorrhea Complications
Left untreated, gonorrhea can lead to serious health complications:
- Pelvic Inflammatory Disease (PID)
- Occurs in up to 10-20% of untreated infections
- Can cause permanent damage to the reproductive system
- May lead to chronic pelvic pain
- Can be asymptomatic until damage has occurred
- Infertility
- PID can scar and block fallopian tubes
- May lead to ectopic pregnancy (pregnancy outside the uterus)
- Risk increases with each episode of PID
- Increased risk of HIV transmission
- Gonorrhea infection makes it 3-5 times easier to acquire HIV if exposed
- Disseminated Gonococcal Infection (DGI)
- Occurs when the infection spreads to the blood and joints
- Can cause fever, skin rashes, joint pain, and swelling
- Rare but serious condition requiring immediate treatment
- Epididymitis
- Inflammation of the epididymis (tube that carries sperm)
- Can cause testicular pain and swelling
- May lead to infertility in rare cases
- Urethral stricture
- Scarring and narrowing of the urethra
- Can cause difficulty urinating
- May require surgical correction
- Prostatitis
- Inflammation of the prostate gland
- Can cause pain, difficult urination, and sexual dysfunction
- Disseminated Gonococcal Infection (DGI)
- Same as in women, affecting blood and joints
- Can cause arthritis-like symptoms
- Increased risk of HIV transmission
- Makes acquiring HIV easier if exposed
- Premature labor and delivery
- Premature rupture of membranes
- Transmission to the babyduring childbirth, which can cause:
- Eye infections (ophthalmia neonatorum)
- Joint infections
- Blood infections (sepsis)
- Blindness if eye infections are not promptly treated
Antibiotic Resistance in Gonorrhea
One of the most concerning aspects of gonorrhea is its ability to develop resistance to antibiotics. This makes the infection increasingly difficult to treat.
Evolution of Gonorrhea Resistance
- 1940s:Easily treated with penicillin
- 1980s:Became resistant to penicillin and tetracycline
- 2000s:Developed resistance to fluoroquinolones
- 2010s:Started showing resistance to cephalosporins
- Present:Dual antibiotic therapy now recommended as standard treatment
Superbug Concerns
- Some strains show resistance to multiple antibiotics
- Limited treatment options for highly resistant strains
- CDC monitors resistance patterns through the Gonococcal Isolate Surveillance Project (GISP)
- Research for new antibiotics and treatment approaches is ongoing
The Biology of Gonorrhea
Gonorrhea is caused by the bacterium Neisseria gonorrhoeae, which has several characteristics that make it particularly effective at causing infection:
- Adhesion propertiesthat allow it to attach to mucous membranes
- Ability to evade the immune systemby changing surface proteins
- Production of enzymesthat damage tissue and facilitate spread
- Formation of biofilmsthat protect against antibiotics
- Rapid development of antibiotic resistancethrough genetic mutations and gene transfer
The bacterium primarily infects columnar epithelial cells found in the genital tract, rectum, throat, and eyes. It can rapidly reproduce in these environments, leading to symptoms and potential tissue damage.
Gonorrhea and Other Conditions
Gonorrhea is often found alongside other infections:
Co-infection with Chlamydia
Relationship to PID
Ocular Gonorrhea
- Up to 50% of peoplewith gonorrhea also have chlamydia
- Both infections can cause similar symptoms
- Dual treatment is often recommended even without confirmed dual diagnosis
- Gonorrhea is a leading cause of PID
- Women with gonorrhea have a 10-20% risk of developing PID if untreated
- Each episode of PID doubles the risk of infertility
- Infection of the eye that can occur through direct contact with infected fluids
- Can cause conjunctivitis (pink eye) with severe symptoms
- May lead to corneal scarring and vision loss if untreated
- Requires urgent treatment to prevent complications
Risk Factors for Gonorrhea
Certain factors increase the risk of contracting gonorrhea:
- Age– Young people (15-24) have the highest rates of infection
- Multiple sexual partners– Increases potential exposure
- History of STDs– Previous infection increases risk of new infections
- Inconsistent condom use– Proper condom use significantly reduces risk
- New sexual partner– Any new sexual relationship increases risk
- Men who have sex with men– Higher prevalence in this population
- Commercial sex work– Higher exposure risk
- Drug use– Can lead to risky sexual behaviors
- Military service– Higher rates in some military populations
Socioeconomic factors– Limited healthcare access increases risk of untreated infections
Preventing Gonorrhea
The best way to prevent gonorrhea is to practice safe sex:
- Use condoms correctlyevery time you have vaginal, anal, or oral sex
- Limit your number of sexual partners
- Get tested regularly, especially when starting with new partners
- Ensure all partners get tested and treatedif an infection is found
- Avoid sexual contactif you or your partner has symptoms or is being treated
- Consider dental damsfor oral sex to reduce risk
- Complete all prescribed medicationsif diagnosed with gonorrhea
- Abstain from sexual activityfor 7 days after completing treatment
Get retested 3 months after treatmentas reinfection is common
Gonorrhea Facts and Statistics
- Gonorrhea is the second most reported bacterial STDin the United States
- Antibiotic-resistant gonorrheais classified as an “urgent threat” by the CDC
- Rates have been increasingsince 2009 after decades of decline
- Men who have sex with menaccount for a disproportionate number of cases
- Rectal and pharyngeal (throat) infectionsare often overlooked in testing
- The economic burden of gonorrheain the U.S. is estimated at $162 million annually
- Untreated gonorrheacan remain transmissible for months or even years
- Re-infection ratescan be as high as 40% within one year of initial infection
Frequently Asked Questions About Gonorrhea
If symptoms occur, they typically develop 1-14 days after infection, with most appearing within a week. However, many infections cause no symptoms.
Gonorrhea is not typically transmitted through casual kissing. However, if someone has gonorrhea in the throat, deep kissing could potentially, though rarely, transmit the infection.
No, gonorrhea requires antibiotic treatment. Without treatment, it can persist for months or years and lead to serious health complications.
While both are bacterial STDs with similar symptoms, they’re caused by different bacteria and may require different treatments. Gonorrhea is more likely to cause noticeable discharge and has developed more antibiotic resistance.
Yes, up to 80% of women and 10% of men with gonorrhea have no symptoms, which is why regular STD testing is important for sexually active individuals.
Yes, you can be reinfected with gonorrhea after treatment if you’re exposed again. Having had gonorrhea once does not create immunity.
Gonorrhea is almost always transmitted through sexual contact (vaginal, anal, or oral). It cannot be spread through casual contact, toilet seats, or sharing items.
Yes, untreated gonorrhea can lead to PID in women, which can cause infertility. In men, it rarely affects fertility but can cause epididymitis.
Modern nucleic acid amplification tests (NAATs) are highly accurate, with sensitivity and specificity above 95%.
Learn More About Gonorrhea Testing
If you’re concerned about gonorrhea or want to get tested, call (866) 566-8711 to speak with a care advisor who can help you understand your testing options.
LocalSTDTesting is not a substitute for professional medical advice, diagnosis, or treatment.
Always seek the advice of your physician with any questions about medical conditions.
