Gonorrhea is a bacterial infection that is the second most common sexually transmitted disease (STD) in the United States. More than half of gonorrheal infections occur in people aged 15-24, though any sexually active person can be infected with gonorrhea.
When left untreated, gonorrhea can lead to more serious, long-term health problems, including pelvic inflammatory disease (PID) in people with vaginas, epididymitis in people with penises, and infertility in both.
Fortunately, gonorrhea can be treated with antibiotics. In this article, I’ll tell you more about gonorrhea, including its symptoms and how it’s diagnosed.
I’ll also talk about the antibiotics used to treat the infection, as well as ways to prevent contracting gonorrhea.
What is Gonorrhea?
Gonorrhea is a highly contagious STD caused by the Neisseria gonorrhoeae bacterium. Though infections are often found in the genitals, they can also be found in the rectum and throat.
Gonorrhea cannot be spread through touching surfaces like a toilet seat, but it can be spread through unprotected anal, oral, and vaginal sex.
Not all people infected with gonorrhea experience symptoms. When symptoms are present they can differ between people with vaginas and people with penises.
The most common symptoms of gonorrhea in people with vaginas include:
- Vaginal itching, burning, swelling, or redness
- Increased or yellowish vaginal discharge
- Painful or burning sensation when urinating
- Urinating more frequently than usual
- Bleeding between menstrual periods, or experiencing prolonged, heavier than usual menstrual periods
- Painful intercourse
- Abdominal or pelvic pain
The most common symptoms of gonorrhea in people with penises include:
- Painful or burning sensation when urinating
- White, yellow, or green discharge from the penis
Though any sexually active person can become infected with gonorrhea, there are some factors that can increase your risk of the disease. These factors include:
- Having unprotected sex with new or multiple partners
- Having a sex partner with confirmed gonorrhea or another STI
- If you currently have an STI, like chlamydia
- If you’ve recently had another STI, like chlamydia
When left undiagnosed and untreated, gonorrhea can lead to serious health conditions, including:
- Pelvic inflammatory disease (PID): This disease affects people with vaginas and can cause severe abdominal and pelvic pain. Over time, PID can lead to internal abscesses, damaged fallopian tubes, infertility, and an increased risk of miscarraige, premature birth, and ectopic pregnancy.
- Epididymitis: An inflammation of the tube that holds the testicles in place in people with penises. In rare cases, epididymitis can lead to infertility.
- Disseminated gonococcal infection (DGI): DGI occurs when gonorrhea spreads to the blood. The infection can cause arthritis, tenosynovitis (inflammation of the lining of the sheath around a tendon), or dermatitis. It can be life-threatening.
How is Gonorrhea Diagnosed?
There are several ways in which gonorrhea can be diagnosed. The most common diagnostic test is nucleic acid amplification testing (NAAT) using a urine, urethral, endocervical, or vaginal specimen.
Your provider may also test for gonorrhea by swabbing the infected site. For infections of the rectum or throat, there are FDA-cleared rectal and oral diagnostic tests as well.
How is Gonorrhea Treated?
Gonorrhea cannot be treated at home, which is why it’s important to get tested and talk to a healthcare provider about an effective treatment plan. Because gonorrhea is caused by a bacterial infection, it must be treated with antibiotics.
Though antibiotics can clear the infection in most cases, there are strains of Neisseria gonorrhoeae that are resistant to antibiotic treatment. Unfortunately, these strains have been increasing in the US. For this reason, scientists are researching new alternative antibiotics for the treatment of gonorrhea.
Antibiotics Used to Treat Gonorrhea
If you’re diagnosed with gonorrhea, your healthcare provider will talk with you about treatment options. The first-line treatment for gonorrhea is an injection of an antibiotic called ceftriaxone. This is often followed by an oral dose of another antibiotic (usually azithromycin or doxycycline).
|Drug||Class||Administration||Standard dosage||Side effects|
|Ceftriaxone (Rocephin)||Cephalosporin antibiotic||Injection||250 mg, delivered either intramuscularly or intravenously||Swelling at the injection side, nausea, diarrhea|
|Azithromycin (Zithromax)||Macrolide antibiotic||Oral tablet||1 g taken alongside an injection of ceftriaxone||Diarrhea, vomiting, headache|
|Doxycycline (Vibramycin)||Tetracycline antibiotic||Oral tablet||100 mg taken twice daily for one week alongside an injection of ceftriaxone||Diarrhea, vomiting, nausea|
Depending on your circumstances and allergies, other options may be available.
In addition to discussing your treatment options, talk to your provider about your care plan.
They will recommend screening for other STIs (like chlamydia), abstaining from sexual activity during treatment and for at least one week after, and contacting all recent anal, oral, and vaginal sexual partners about your diagnosis.
Three months after finishing treatment, your provider may recommend that you get re-tested for gonorrhea to ensure that the antibiotics cleared the infection. In some cases, your provider may recommend re-testing even earlier.
How to Prevent Gonorrhea
Because gonorrhea is spread through unprotected vaginal, oral, and anal sex, using latex condoms consistently and correctly can significantly reduce your risk of contracting the infection. Condoms can also reduce your risk of becoming infected with other STIs, including chlamydia and syphilis.
Though abstinence is the only way to completely eliminate your risk of getting the disease, practicing safe sex can be an effective preventive measure.
If you’re in a long-term, monogamous relationship, getting tested with your partner can also decrease your risk.
When to See a Doctor
If you’re sexually active and experiencing symptoms of gonorrhea or another STI, talk to a healthcare provider as soon as possible.
Additionally, if you’re sexually active but have never been tested for an STI, reach out to your provider for guidance. For people with vaginas under the age of 25 and people with new or multiple sex partners, the CDC recommends STI testing at least once a year.
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Gonorrhea — CDC Fact Sheet (Detailed Version). (2021).
Sexually Transmitted Infections Among US Women and Men: Prevalence and Incidence Estimates, 2018. (2021).