Gonorrhea is a common sexually transmitted infection (STI), and it can pass on during any kind of sexual contact. When a doctor diagnoses the issue early, they can usually treat it effectively. Without treatment, it can cause long-term complications.

In 2019, there were 616,392 diagnoses of gonorrhea in the United States.

It is a notifiable disease, which means that a doctor needs to report all cases to the National Notifiable Diseases Surveillance System. This information enables health authorities to plan treatment and prevention strategies.

Gonorrhea is usually easy to treat, but any delays can result in serious and sometimes permanent complications. For example, pelvic inflammatory disease (PID) can develop when gonorrhea affects the uterus or fallopian tubes. This can lead to infertility.

Another complication is epididymitis, which is inflammation of the tube that carries sperm. This, too, can result in infertility.

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Many people with gonorrhea have no symptoms. Those who do often experience a burning sensation during urination.

A person with a penis might also notice:

  • white, green, or yellow discharge
  • pain or swelling in the testicles
  • inflammation or swelling of the foreskin

A person with a vagina might have increased vaginal discharge and bleeding between periods.

Rectal symptoms may also occur if a person has anal sex. These may include:

  • discharge
  • itching around the anus
  • soreness
  • bleeding
  • pain during bowel movements

If gonorrhea results from oral sex, the infection can be located in the throat, but it may cause no symptoms.

Gonorrhea is a bacterial infection, and if semen or vaginal fluid that contains this bacteria enters the eye, the person may develop conjunctivitis, commonly called “pink eye.”

A person might receive a diagnosis of gonorrhea if they see a doctor due to symptoms or suspected exposure to the bacteria.

The doctor will ask the person about their symptoms and medical history. They will also order a test, which might require a urine sample or a swab of the penis, cervix, urethra, anus, eyelid, or throat.

At-home tests are also available. A person using an at-home testing kit sends their sample to a lab and receives the results directly. If the result is positive, they need to see a doctor for treatment, and the doctor may wish to do another test to confirm the result.

It is crucial to use the kit exactly as instructed, or the result may not be accurate. Because the tests can vary in accuracy, it is better to see a healthcare professional, if possible.

If one person has a diagnosis of gonorrhea or another STI, any sexual partners should also receive testing.

Everyone with gonorrhea needs treatment to stop the infection from progressing. The treatment typically involves antibiotics.

It is important to receive treatment as soon as possible. Doctors may not be able to treat complications that the infection has already caused.

The Centers for Disease Control and Prevention (CDC) recommends a single dose of 500 milligrams of intramuscular ceftriaxone (Rocephin).

Doctors used to administer ceftriaxone plus a dose of azithromycin, but health authorities changed the guidelines in 2020. This is because the bacteria that cause gonorrhea, Neisseria gonorrhoeae, are becoming increasingly resistant to azithromycin.

There are certain situations in which a doctor might recommend a different treatment — for example, one that involves taking an oral antibiotic. In this case, it is crucial to take the full course of medication and avoid sharing it with anyone else.

Antibiotic resistance is making gonorrhea increasingly difficult to treat. If a person does not notice any improvement in their symptoms after several days, they should return to their doctor for guidance. Further testing can determine whether the treatment is working.

It is important to attend any follow-up appointments and avoid having sex until a healthcare professional says that it is safe to do so.

If gonorrhea occurs during pregnancy, it is essential to let the healthcare team know. The infection can pass to the baby during delivery, so the newborn may need antibiotics right away.

Some newborns develop conjunctivitis, and gonorrhea is one possible cause. The symptoms usually appear 2–4 days after birth and include red eyes, thick pus in the eyes, and swollen eyelids.

If any of these symptoms arise, seek medical attention immediately.

N. gonorrhoeae bacteria are responsible for gonorrhea. They thrive in warm, moist environments, and the infection can develop in any of the body’s mucous membranes, including those in the genitals, mouth, throat, eyes, and rectum.

Gonorrhea can pass from person to person through sexual contact that involves the penis, vagina, anus, or mouth. It can pass on without a male ejaculating. Gonorrhea can also transmit to a newborn during delivery.

Gonorrhea can cause various severe complications. For this reason, it is important to receive treatment as soon as possible.

For a person with a vagina, gonorrhea can lead to:

Other complications of the infection can occur during pregnancy and delivery. And without treatment, gonorrhea increases the risk of stillbirth.

If the infection transmits to a newborn, it can cause a joint infection, loss of vision, or bacteremia, a life threatening blood infection.

In a person with a penis, gonorrhea can lead to epididymitis, which can cause problems with fertility.

And in everyone, untreated gonorrhea can lead to infections in the joints that could require IV treatment.

The STI can also lead to disseminated gonococcal infection, which can be life threatening. Some signs and symptoms include:

  • dermatitis, which usually involves a rash or itchy, dry skin
  • a fever
  • arthritis
  • inflammation and swelling around the tendons

In addition, people with gonorrhea have a higher risk of contracting or transmitting HIV. One reason is that either infection can cause open sores, which make it easier for viruses and bacteria to enter the body.

Ways to prevent gonorrhea include:

  • avoiding sexual activity if there is the possibility of infection
  • using a barrier method of protection, such as condoms, during vaginal or anal intercourse
  • using condoms or dental dams during oral intercourse
  • only having sexual activity with a mutually monogamous partner who does not have the infection

Q:

I recently ended a relationship when I found out that the person had been unfaithful with someone I know. Until then, I think we were both monogamous. Should I have a test? Will a home test be enough?

A:

If you are concerned that your former partner has had sexual intercourse with another person, it is a good idea to undergo testing for STIs. This will check for gonorrhea, chlamydia, HIV, syphilis, herpes, and, for some people, trichomoniasis, hepatitis B, and hepatitis C. A doctor can advise which tests are right for you.

Some of these require body fluid samples, and some are blood tests, which a healthcare professional will perform in the office or lab. If any comes back positive, you (and perhaps your former partner) will need medical treatment. Your doctor can explain the treatment and help inform your partner anonymously.

Depending on the timing, your doctor may also initiate a discussion about a follow-up, as some of these infections have a longer incubation period, and the initial test results may not be fully accurate.

Carolyn Kay, M.D.Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.