Gonorrhea

Date Updated: 10/05/2021

Overview

Gonorrhea is an infection caused by a sexually transmitted bacterium that infects both males and females. Gonorrhea most often affects the urethra, rectum or throat. In females, gonorrhea can also infect the cervix.

Gonorrhea is most commonly spread during vaginal, oral or anal sex. But babies of infected mothers can be infected during childbirth. In babies, gonorrhea most commonly affects the eyes.

Abstaining from sex, using a condom if you have sex and being in a mutually monogamous relationship are the best ways to prevent sexually transmitted infections.

Symptoms

In many cases, gonorrhea infection causes no symptoms. Symptoms, however, can affect many sites in your body, but commonly appear in the genital tract.

Gonorrhea affecting the genital tract

Signs and symptoms of gonorrhea infection in men include:

Painful urination
Pus-like discharge from the tip of the penis
Pain or swelling in one testicle

Signs and symptoms of gonorrhea infection in women include:

Increased vaginal discharge
Painful urination
Vaginal bleeding between periods, such as after vaginal intercourse
Abdominal or pelvic pain

Gonorrhea at other sites in the body

Gonorrhea can also affect these parts of the body:

Rectum. Signs and symptoms include anal itching, pus-like discharge from the rectum, spots of bright red blood on toilet tissue and having to strain during bowel movements.
Eyes. Gonorrhea that affects your eyes can cause eye pain, sensitivity to light, and pus-like discharge from one or both eyes.
Throat. Signs and symptoms of a throat infection might include a sore throat and swollen lymph nodes in the neck.
Joints. If one or more joints become infected by bacteria (septic arthritis), the affected joints might be warm, red, swollen and extremely painful, especially during movement.

When to see your doctor

Make an appointment with your doctor if you notice any troubling signs or symptoms, such as a burning sensation when you urinate or a pus-like discharge from your penis, vagina or rectum.

Also make an appointment with your doctor if your partner has been diagnosed with gonorrhea. You may not experience signs or symptoms that prompt you to seek medical attention. But without treatment, you can reinfect your partner even after he or she has been treated for gonorrhea.

Causes

Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. The gonorrhea bacteria are most often passed from one person to another during sexual contact, including oral, anal or vaginal intercourse.

Risk factors

Sexually active women younger than 25 and men who have sex with men are at increased risk of getting gonorrhea.

Other factors that can increase your risk include:

Having a new sex partner
Having a sex partner who has other partners
Having more than one sex partner
Having had gonorrhea or another sexually transmitted infection

Complications

Untreated gonorrhea can lead to major complications, such as:

Infertility in women. Gonorrhea can spread into the uterus and fallopian tubes, causing pelvic inflammatory disease (PID). PID can result in scarring of the tubes, greater risk of pregnancy complications and infertility. PID requires immediate treatment.
Infertility in men. Gonorrhea can cause a small, coiled tube in the rear portion of the testicles where the sperm ducts are located (epididymis) to become inflamed (epididymitis). Untreated epididymitis can lead to infertility.
Infection that spreads to the joints and other areas of your body. The bacterium that causes gonorrhea can spread through the bloodstream and infect other parts of your body, including your joints. Fever, rash, skin sores, joint pain, swelling and stiffness are possible results.
Increased risk of HIV/AIDS. Having gonorrhea makes you more susceptible to infection with human immunodeficiency virus (HIV), the virus that leads to AIDS. People who have both gonorrhea and HIV are able to pass both diseases more readily to their partners.
Complications in babies. Babies who contract gonorrhea from their mothers during birth can develop blindness, sores on the scalp and infections.

Prevention

To reduce your gonorrhea risk:

Use a condom if you have sex. Abstaining from sex is the surest way to prevent gonorrhea. But if you choose to have sex, use a condom during any type of sexual contact, including anal sex, oral sex or vaginal sex.
Limit your number of sex partners. Being in a monogamous relationship in which neither partner has sex with anyone else can lower your risk.
Be sure you and your partner are tested for sexually transmitted infections. Before you have sex, get tested and share your results with each other.
Don't have sex with someone who appears to have a sexually transmitted infection. If your partner has signs or symptoms of a sexually transmitted infection, such as burning during urination or a genital rash or sore, don't have sex with that person.
Consider regular gonorrhea screening. Annual screening is recommended for sexually active women younger than 25 and for older women at increased risk of infection. This includes women who have a new sex partner, more than one sex partner, a sex partner with other partners, or a sex partner who has a sexually transmitted infection.

Regular screening is also recommended for men who have sex with men, as well as their partners.

To avoid getting gonorrhea again, abstain from sex until after you and your sex partner have completed treatment and after symptoms are gone.

Diagnosis

To determine whether you have gonorrhea, your doctor will analyze a sample of cells. Samples can be collected by:

Urine test. This can help identify bacteria in your urethra.
Swab of affected area. A swab of your throat, urethra, vagina or rectum can collect bacteria that can be identified in a lab.

For women, home test kits are available for gonorrhea. They include vaginal swabs for self-testing that are sent to a specified lab for testing. You can choose to be notified by email or text message when your results are ready. You can view your results online or receive them by calling a toll-free hotline.

Testing for other sexually transmitted infections

Your doctor may recommend tests for other sexually transmitted infections. Gonorrhea increases your risk of these infections, particularly chlamydia, which often accompanies gonorrhea.

Testing for HIV also is recommended for anyone diagnosed with a sexually transmitted infection. Depending on your risk factors, tests for additional sexually transmitted infections could be beneficial as well.

Treatment

Gonorrhea treatment in adults

Adults with gonorrhea are treated with antibiotics. Due to emerging strains of drug-resistant Neisseria gonorrhoeae, the Centers for Disease Control and Prevention recommends that uncomplicated gonorrhea be treated with the antibiotic ceftriaxone — given as an injection — with oral azithromycin (Zithromax).

If you're allergic to cephalosporin antibiotics, such as ceftriaxone, you might be given oral gemifloxacin (Factive) or injectable gentamicin and oral azithromycin.

Gonorrhea treatment for partners

Your partner also should go through testing and treatment for gonorrhea, even if he or she has no signs or symptoms. Your partner receives the same treatment you do. Even if you've been treated for gonorrhea, a partner who isn't treated can pass it to you again.

Gonorrhea treatment for babies

Babies born to mothers with gonorrhea who develop the infection can be treated with antibiotics.

Preparing for an appointment

You'll likely see your family doctor or a general practitioner. Here's some information to help you get ready for your appointment.

What you can do

When you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet.

Make a list of:

Your symptoms, if you have any, including any that may seem unrelated to the reason for which you scheduled the appointment, and when they began
All medications, vitamins or other supplements you take, including doses
Questions to ask your doctor

For gonorrhea, questions to ask your doctor include:

What tests do I need?
Should I be tested for other sexually transmitted infections?
Should my partner be tested for gonorrhea?
How long should I wait before resuming sexual activity?
How can I prevent gonorrhea in the future?
What gonorrhea complications should I be alert for?
Are there brochures or other printed material that I can have? What websites do you recommend?
Will I need a follow-up visit?

Don't hesitate to ask other questions.

What to expect from your doctor

Questions your doctor is likely to ask you include:

Have your symptoms been continuous or occasional?
How severe are your symptoms?
Have you been exposed to sexually transmitted infections?

What you can do in the meantime

Abstain from sex until you see your doctor. Alert your sex partners that you're having signs and symptoms so that they can arrange to see their doctors for testing.