Gonorrhea is a sexually transmitted infection (STI). It’s caused by the bacterium Neisseria gonorrhoeae. It tends to target warm, moist areas of the body, including the:

Gonorrhea passes from person to person through oral, anal, or vaginal sex without a condom or other barrier method. The best protections against transmission are abstinence and proper condom or barrier method usage.

Symptoms usually occur within 2 to 14 days after exposure. However, some people who acquire gonorrhea never develop noticeable symptoms.

It’s important to remember that a person with gonorrhea who doesn’t have symptoms, also called an asymptomatic carrier, can still spread the infection. A person is more likely to transmit gonorrhea to other partners when they don’t have noticeable symptoms.

Symptoms in men and those with a penis

A person with a penis may not develop noticeable symptoms for several weeks. Some men may never develop symptoms.

Typically, symptoms begin to show a week after transmission. The first noticeable symptom in men is often a burning or painful sensation during urination.

As it progresses, other symptoms may include:

  • greater frequency or urgency of urination
  • a pus-like discharge (or drip) from the penis (white, yellow, beige, or greenish)
  • swelling or redness at the opening of the penis
  • swelling or pain in the testicles
  • a persistent sore throat

In rare instances, gonorrhea can continue to cause damage to the body, specifically the urethra and testicles. The condition will stay in the body for a few weeks after the symptoms have been treated.

Pain may also spread to the rectum.

Symptoms in women and those with a vagina

Many people with a vagina don’t develop any overt symptoms of gonorrhea. When they do develop symptoms, they tend to be mild or similar to other diagnoses, making them more difficult to identify.

Gonorrhea symptoms can appear much like common vaginal yeast or bacterial infections.

Symptoms include:

Healthcare professionals can diagnose gonorrhea in several ways. They can take a sample of fluid from the symptomatic area (penis, vagina, rectum, or throat) with a swab and place it on a glass slide.

If your doctor suspects a joint infection or infection of the blood, they’ll obtain the sample by drawing blood or inserting a needle into the symptomatic joint to withdraw fluid.

They’ll then add a stain to the sample and examine it under a microscope. If cells react to the stain, gonorrhea may be diagnosed. This method is relatively quick and easy, but it doesn’t provide absolute certainty. This test may also be completed by a lab technician.

A second method involves taking the same type of sample and placing it on a special dish. This will be incubated under ideal growth conditions for several days. A colony of gonorrhea bacteria will grow if gonorrhea is present.

A preliminary result may be ready within 24 hours. A final result will take up to 3 days.

People with a vagina are at greater risk for long-term complications from an untreated transmission. Untreated, the bacteria may ascend up the reproductive tract and involve the uterus, fallopian tubes, and ovaries.

This condition is known as pelvic inflammatory disease (PID) and can cause severe and chronic pain and damage to the reproductive organs. PID can be caused by other STIs as well.

Women may also develop blocking or scarring of the fallopian tubes, which can prevent future pregnancy or cause ectopic pregnancy. An ectopic pregnancy is when a fertilized egg implants outside the uterus.

Gonorrhea may also pass to a newborn infant during delivery.

People with a penis may experience scarring of the urethra. Gonorrhea may also cause a painful abscess to develop in the interior of the penis. This can cause reduced fertility or sterility.

When gonorrhea spreads to the bloodstream, arthritis, heart valve damage, or inflammation of the lining of the brain or spinal cord may occur. These are rare but serious conditions.

Modern antibiotics can cure most gonorrhea transmissions. Most states also provide free diagnosis and treatment at state-sponsored health clinics.

At home and over-the-counter (OTC) remedies

There are no at-home remedies or OTC medications that’ll treat gonorrhea. Anyone who thinks they may have acquired gonorrhea from a partner should seek care from a healthcare professional.

Antibiotics

Gonorrhea is usually treated with an antibiotic injection of ceftriaxone one time to the buttocks and a single dose of azithromycin by mouth. Once on antibiotics, you should feel relief within days.

The law requires healthcare professionals to report the diagnosis, usually to the county public health department. Public health officials will identify, contact, test, and treat any sexual partners of the person diagnosed to help prevent the spread.

Health officials will also contact other people these individuals may have had sexual contact with.

The emergence of antibiotic-resistant strains of gonorrhea is a growing challenge. These cases may require more extensive treatment, with a 7-day course of an oral antibiotic or dual therapy with two different antibiotics, usually for a total of 7 days of therapy.

The antibiotics used for extended therapy are usually given once or twice a day. Some common antibiotics used include azithromycin and doxycycline.

Scientists are working to develop vaccines to prevent gonorrhea transmission.

The safest way to prevent gonorrhea or other STIs is through abstinence. If you do engage in sexual activities, always use a condom or other barrier method.

It’s important to be open with your sexual partners, get regular testing, and find out if they’ve been tested.

If your partner is showing any symptoms, avoid any sexual contact. Ask them to seek medical attention to rule out any possible conditions that could be passed on.

You’re at a higher risk for acquiring gonorrhea if you’ve already had it or any other STIs. You’re also at a higher risk if you have multiple sexual partners or a new partner.

If you think you may have contracted gonorrhea, you should avoid any sexual activity. You should also contact your doctor immediately.

During your healthcare visit, be prepared to:

  • detail your symptoms
  • discuss your sexual history
  • provide the contact information for previous sexual partners so that public health officials can contact them anonymously on your behalf

If you’re in contact with your sexual partner or partners, let them know they should be tested immediately.

If you’re placed on antibiotics, it’s important to take the full course of medication to ensure that you’re completely treated. Cutting your course of antibiotics short can make the bacteria more likely to develop resistance to the antibiotic.

You also need to follow up with your doctor 1 to 2 weeks later to make sure that everything has cleared.

If the results come back negative and your sexual partner is also clear of any infection, it’s possible to resume sexual activity.

Q:

What is the relationship between gonorrhea and chlamydia?

Anonymous patient

A:

Gonorrhea and chlamydia are both bacteria that cause STIs. The risk factors are the same for both, and both cause similar symptoms.

The complications of a chlamydia diagnosis are very similar to gonorrhea except chlamydia is much less likely to affect sites other than the reproductive tract. Diagnosis and treatment are virtually the same as well.

If you think you may have an STI, you should see a healthcare professional. They can determine what type it is by testing you as described above and then starting proper treatment.

Graham Rogers, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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