Gonorrhea: Signs, Symptoms and Treatment

Gonorrhea is a sexually transmitted infection (STI) caused by the bacteria Neisseria gonorrhoeae. Gonorrhea is the second most common STI reported in the United States (U.S.) after chlamydia. In 2018, the CDC estimated over one million new cases, and since gonorrhea is often without symptoms, this may be a fraction of the actual number of cases. Untreated gonorrhea can cause severe complications such as pelvic inflammatory disease (PID), ectopic (tubal) pregnancy, and infertility. Treatment is available to cure a gonorrhea infection.

How does gonorrhea spread?

Gonorrhea is an STI spread by sexual contact with the penis, vagina, or mouth, and those at the highest risk are teenagers, young adults, and African Americans. Healthcare providers (HCPs) should screen all sexually active people for STIs. Being honest about your sexual health with your HCP is essential to getting the correct care.

If you are pregnant, gonorrhea can be passed to your baby as it is born. Babies born to mothers with gonorrhea can have blindness, joint infections, or life-threatening blood infections. It is essential to be under an HCP’s care throughout pregnancy.

Untreated gonorrhea can cause severe complications. For women, complications include PID, ectopic pregnancy, infertility, and chronic pelvic pain. For men, possible complications are epididymitis – swelling or pain in the back of the testicle in the tube (epididymis) that stores and carries sperm and infertility.

In both women and men, gonorrhea causes an increased risk of HIV – the virus that causes AIDs. The bacteria that cause gonorrhea can travel in your blood and infect joints and other body areas.

Gonorrhea often has no symptoms. However, symptoms may be present and mistaken for other health conditions.

Signs and symptoms of gonorrhea

Most people with gonorrhea have no symptoms (asymptomatic), or they have symptoms and attribute them to a bladder or vaginal infection.

According to the CDC, symptoms can appear between one and fourteen days after exposure.

If you develop any of these signs or symptoms, see an HCP as soon as possible.

  • Painful, burning, or frequent urination
  • Vaginal or penile discharge
  • Testicle swelling
  • Red or swollen urethra (opening of the penis) in men
  • Vaginal bleeding between periods
  • Vaginal bleeding after sex
  • Lower abdominal pain in women
  • Rectal discharge
  • Rectal itching
  • Rectal bleeding
  • Sore throat
  • Swollen lymph nodes in the neck
  • Conjunctivitis (discharge from one or both eyes)
  • Sensitivity to light
  • Eye pain
  • Warm, red, swollen, painful joints

Gonorrhea can be cured. Take care of your sexual health by seeing your HCP for testing, diagnosis, and treatment to decrease the chances of developing severe complications.

Testing for gonorrhea

The CDC recommends testing for gonorrhea if you are sexually active. There are other behaviors that may increase your risk. Openly discuss your sexual health with your HCP so that any testing you need is completed at your visit. The only way to know if you have an STI is to get tested.

Contact your HCP or health clinic and get tested if:

  • You are pregnant.
  • You are sexually active.
  • Your partner has tested positive for gonorrhea.
  • Your HCP suggests it.

If you test positive for gonorrhea, antibiotics can cure your infection.

How is gonorrhea treated?

Gonorrhea can be cured with the right antibiotics. Take all the medication prescribed and follow all the directions from your HCP.

Antibiotics can cure an infection from gonorrhea but will not repair any damage already done to your body. Getting immediate treatment as soon as you test positive is urgent so you can be cured and will not pass gonorrhea to anyone else.

Gonorrhea treatment for adults

Adults with gonorrhea are cured with an antibiotic called ceftriaxone. Usually, the treatment is a one-dose option. If you are allergic to cephalosporin antibiotics, your HCP will prescribe an alternative. After treatment, do not have sex until your treatment is complete and all your symptoms have disappeared.

Gonorrhea treatment for partners

You need to inform any partners of your diagnosis since they will need to get tested and, if positive, treated for their gonorrhea infection. Your HCP can help you prepare for the conversation with your partner if you feel anxious about it.

Remember, even after treatment, you can get reinfected with gonorrhea by having sexual contact with an infected partner.

"“A person with gonorrhea and all of his or her sex partners must avoid having sex until they have completed their treatment for gonorrhea and until they no longer have symptoms.”"

Important notice from the CDC

Gonorrhea treatment for babies

Babies born with gonorrhea infection passed from their mothers during birth can be treated and cured with antibiotics.

Gonorrhea prevention

Abstinence means not having sex of any kind (vaginal, anal, or oral), and it is the only method to avoid gonorrhea and other STIs altogether.

Ways to decrease your risk of getting infected with gonorrhea:

  • Have sex with only one partner in a mutually monogamous relationship – you only have sex with each other, and you both have tested negative.
  • Use new latex condoms correctly every time you have sex.
  • Wait before you have sex with a new partner until you both have tested negative.

If you decide to be sexually active, take every step to decrease your risk of getting infected with gonorrhea or other STIs. Good sexual health is necessary for your physical, emotional, and mental well-being.

Conclusion

Gonorrhea is the second most reported STI in the U.S. Often, infection with gonorrhea produces no symptoms (asymptomatic), and getting tested is the only way to know you have it. Any sexually active person can contract gonorrhea through vaginal, oral, or anal sex with an infected partner. Untreated gonorrhea can cause serious, permanent complications, including PID, ectopic pregnancy, and infertility.

If you test positive for gonorrhea, getting immediate treatment is the only way to cure the infection and reduce the risk of permanent damage from complications.

Key takeaways

Gonorrhea is the second most reported STI in the U.S, and there may be no symptoms to alert you to its presence.

Get tested for gonorrhea if you are sexually active. See your HCP for advice, testing, and treatment for all potential STIs.

If you are pregnant, you can pass on gonorrhea to your baby. Getting treatment as soon as possible can reduce the risk to your baby.

See your HCP and discuss your sexual health if you are sexually active. Maintaining your sexual health is part of staying healthy overall.

Resources:

CDC. Gonorrhea fact sheet

Urology Care Foundation. What are Epididymitis and Orchitis?

Mayo Clinic. Gonorrhea

Mount Sinai. Gonorrhea

CDC. Gonorrhea detailed fact sheet

HopkinsMedicine.org. Sexually transmitted diseases

Tulane University. STI vs. STD

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