gonorrhea

Overview
Gonorrhea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. It commonly infects the genitals, rectum, and throat, and can be spread through vaginal, anal, or oral sex. While many people with gonorrhea may not have symptoms, it can still be passed to others and lead to serious health issues if left untreated. It's often referred to as “the clap” in colloquial language.

Why It’s Important
Gonorrhea is highly contagious and can have long-term consequences, especially in people assigned female at birth, including infertility, pelvic inflammatory disease (PID), and increased risk of ectopic pregnancy. In men, it can cause painful inflammation of the testicles. Untreated gonorrhea also increases the risk of HIV transmission and can lead to disseminated gonococcal infection (DGI), a life-threatening condition where the infection spreads to the blood or joints. The rise of antibiotic-resistant strains makes early detection and appropriate treatment even more critical.

Quick Facts

  • Affects sexually active people, especially ages 15–29

  • Over 700,000 new infections per year in the U.S. (CDC estimate)

  • Many people have no symptoms—especially women

  • Treatable, but antibiotic resistance is a growing concern

  • Can infect genitals, rectum, throat, and eyes

What Happens in the Body
The Neisseria gonorrhoeae bacteria infect the mucous membranes of the urethra, cervix, rectum, throat, or eyes. The immune system responds with inflammation, leading to pain, discharge, and other symptoms. If left untreated, the bacteria can ascend into the reproductive organs, causing more severe infections such as PID. It can also spread through the bloodstream, affecting the skin, joints, and heart.

Common Signs and Symptoms
In men:

  • Burning sensation when urinating

  • White, yellow, or green penile discharge

  • Pain or swelling in one testicle

In women:

  • Increased vaginal discharge

  • Painful urination

  • Vaginal bleeding between periods

  • Pelvic or abdominal pain (especially if PID develops)

Infections of the rectum (any gender):

  • Discharge, anal itching, soreness, bleeding, or painful bowel movements

Throat infections:

  • Often no symptoms, but may include sore throat or swollen glands

Eye infections:

  • Redness, discharge, and swelling (can occur from contact with infected fluids)

Diagnosis

  • Nucleic acid amplification test (NAAT)—most accurate and commonly used (urine, vaginal, or throat/rectal swabs)

  • Culture testing may be done if drug resistance is suspected

  • Routine STI screening recommended for sexually active individuals under 25 or those with multiple partners

See a doctor if:

  • You have any unusual genital discharge or burning

  • You’ve had unprotected sex with a new or multiple partners

  • You’ve been notified by a partner of possible exposure

Treatment and Management

  • Antibiotic injection (usually ceftriaxone) is the current standard

  • Oral antibiotics may be given in combination or for partner treatment

  • Abstain from sex for 7 days after treatment and until all partners are treated

  • Retesting may be recommended after 3 months due to reinfection risk

Risks and Complications

  • Pelvic inflammatory disease (PID) in women

  • Infertility in both men and women

  • Epididymitis (testicular inflammation)

  • Ectopic pregnancy

  • Disseminated gonococcal infection (DGI)—can affect joints, heart, and skin

  • Increased susceptibility to HIV

Who Is at Risk

  • Sexually active adolescents and young adults (especially ages 15–29)

  • People with multiple sex partners

  • Those who don’t use condoms or dental dams consistently

  • Men who have sex with men (MSM)

  • Previous STI history

  • Individuals with limited access to regular healthcare or STI screening

Related Conditions

  • Chlamydia (often co-infected)

  • Pelvic inflammatory disease (PID)

  • Epididymitis

  • HIV/AIDS

When to See a Doctor

  • If you have any symptoms of an STI or genital discomfort

  • If a partner is diagnosed with gonorrhea or another STI

  • For routine STI screening, especially if under 25 or at higher risk

  • If you are pregnant—to prevent passing it to your baby during delivery

Last Updated: July 30, 2025