Gonorrhea: Symptoms, Treatment, and Diagnosis

By Gila Lyons
Medically reviewed checkmarkMedically reviewed
September 9, 2020

Gonorrhea, along with chlamydia, is one of the most common sexually transmitted diseases (STDs). While you can’t acquire gonorrhea from sitting on public toilet seats or touching bathroom faucets or handles, it is highly contagious and can be acquired through unprotected vaginal, anal, and oral sex. Left untreated, gonorrhea can lead to chronic pelvic infections, pain, and infertility. In this article we’ll explain how to recognize the symptoms of gonorrhea, and what to do if you have it.

Gonorrhea Symptoms in Women

Many women with gonorrhea do not exhibit any symptoms. When present, the most common symptoms include:

If untreated, gonorrhea can lead to more serious health consequences for women. The biggest risks are:

  • Pelvic inflammatory disease (PID): The most common symptom of PID is lower abdominal cramping and pain. Other symptoms can include fever, painful sex and urination, and increased or changed vaginal discharge. Acute PID symptoms include vomiting, fainting, and fever. Chronic PID can lead to inflammation and scarring of the fallopian tubes and ovaries, which can impact fertility. PID is treatable with antibiotics, and should be investigated by your gynecologist.
  • Pregnant women with gonorrhea are at risk of miscarriage, premature birth, and passing the infection to their baby while giving birth through the vaginal canal. Babies who get gonorrhea can get eye infections that lead to blindness, as well as scalp sores and infections. Pregnant women should be tested for gonorrhea and immediately treated with antibiotics.

Gonorrhea Symptoms in Men

Like women, many men with gonorrhea often experience no symptoms at all. However, when men do have symptoms, they can include:

  • Painful or burning sensation when urinating
  • White, yellow, or green purulent discharge from the penis
  • Painful or swollen testicles (less common)

Men with untreated gonorrhea can develop:

  • Epididymitis: Inflammation of the epididymis, the tube that holds the testicles in place, causing pain and inflammation around the testicles. Epididymitis is treatable, but if left untreated, it can lead to male infertility.

Generalized Symptoms of Gonorrhea

While gonorrhea most commonly affects the genitals and reproductive organs, it can also spread throughout your body, causing a variety of symptoms. These include:

  • Rectum: Signs and symptoms of rectal or anal gonorrhea include anal itching, bleeding, rectal discharge, and bleeding or pain during bowel movements.
  • Eyes: Gonorrhea that affects the eyes can cause sensitivity to light, eye pain, and pus-like discharge from the eyes.
  • Throat: Symptoms of a throat infection can include a sore throat and swollen glands in the neck.
  • Joints: If gonorrhea spreads through the bloodstream, joints can become affected. This can cause hot and swollen joints that are stiff and painful with movement. You might also experience fever, rash, and skin sores.
  • Increased risk of HIV/AIDS: Having gonorrhea makes you more susceptible to infection with HIV, the virus that causes AIDS.

Gonorrhea Risk Factors

Anyone who has unprotected vaginal, anal, or oral sex can contract gonorrhea. Individuals at highest risk include:

  • Those with new or multiple sex partners, especially if not using condoms
  • People who currently or previously had an STD, particularly chlamydia

Diagnosing Gonorrhea

Testing for gonorrhea can be done through a simple urine test, or by swabbing the infected site, including the genital area, rectum, or throat.

Treating Gonorrhea

Gonorrhea is treated with antibiotics. Most commonly, treatment includes an injection of ceftriaxone, along with an oral dose of either azithromycin (Zithromax, Zmax) or doxycycline (Monodox, Vibramycin).

Some types of gonorrhea have become resistant to commonly used antibiotics and can’t be cleared with the standard treatment. If your symptoms continue for more than a week after receiving medication, you should return to your doctor for a different medication or a longer course of antibiotics.

Women with advanced or widespread gonorrhea, such as pelvic inflammatory disease or gonococcal arthritis may require more aggressive treatment including higher doses or a longer duration of antibiotic treatment.

If you’ve been diagnosed with and treated for gonorrhea, your sex partner(s) must also be tested and treated. It’s important to avoid any sexual activity until you have fully completed treatment for gonorrhea and your symptoms have resolved.

Preventing Gonorrhea

Using condoms during genital, oral, or anal sex offers very effective protection because the bacteria that causes gonorrhea can only survive on moist tissues. While refraining from sexual contact is the only way to absolutely prevent gonorrhea and other STDs, there are other steps that you can take to decrease your chances of infection while being sexually active.

  • Get tested before starting a sexual relationship with a new partner
  • Have honest and open conversations with potential partners about your sexual histories, and make sure that you both are tested
  • Always use condoms
  • Avoid sexual activity with a partner who is symptomatic with an STD
  • Sexually active women should get a Pap smear every 3-5 years and be regularly tested for other STDs
  • To help stop the spread of STDs, if you’ve been diagnosed with one, let your partner/s know so they can be tested

When to See a Doctor

If you are sexually active and displaying symptoms of gonorrhea, or any other STD, it’s important to see a doctor for evaluation and treatment as soon as possible. The CDC advises pregnant women to get screened for gonorrhea as soon as they become pregnant, and that sexually active women under 25 years old get screened every year. It’s also a good idea to be tested when beginning a sexual relationship with a new partner.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Gila Lyons

Gila Lyons' health writing has appeared in The New York Times, Oprah Magazine, Vice, Cosmopolitan, Health Magazine, Healthline, and other publications. Connect with her at www.gilalyons.com.