Gonorrhea

Overview

Gonorrhea spreads through vaginal, anal, or oral sex. It can infect the genitals, rectum, and throat. It can also pass to a baby during birth.

Untreated gonorrhea can cause serious problems, like infection of the womb and tubes in women and painful swelling near the testicles in men. Rarely, it spreads to the blood and joints. The bacteria have become resistant to nearly every antibiotic used before, so getting the right treatment matters.

Symptoms

Many people have no symptoms, especially women.

• Discharge from the penis (white, yellow, or green)
• Unusual vaginal discharge
• Burning when urinating

Less common

• Pain or swelling in one testicle
• Bleeding between periods
• Lower belly or pelvic pain
• Sore throat
• Rectal pain, discharge, or bleeding
• Painful, swollen joints or a rash (rare)

How it usually goes

• Days to weeks: Symptoms may start, if any.
• After the shot: Wait 7 days before sex.
• 3 months: Get retested.

When to get medical care

Causes

Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. It spreads through vaginal, anal, or oral sex with someone who has it, even without symptoms.

Does it spread or run in families?

• Yes, it can spread from person to person.
• How it spreads: sex.
• Condoms lower the risk. Sex partners should be tested and treated too.

Who is more likely to get it

• Being sexually active and young
• A new partner or more than one partner
• Not using condoms
• Having had an STI before

Possible complications

• Pelvic inflammatory disease: Infection of the womb and tubes
• Epididymitis: Painful swelling near the testicle
• Joint infection: Rare spread to the joints

Diagnosis

Gonorrhea is found with a simple lab test.

Questions you may be asked

• Any discharge, burning, or pain
• Recent sex partners and condom use
• Oral or anal sex, so the right sites are tested
• Whether a partner has an STI

The exam

They may check your genitals, throat, and rectum.

Tests

Testing is quick:

• Urine test or swab: From the urine, vagina, throat, or rectum.
• Tests for other STIs: Including chlamydia, syphilis, and HIV.
• Culture: If symptoms don't go away after treatment, to check for drug resistance.

Treatment

Gonorrhea is cured with one shot of the antibiotic ceftriaxone. If chlamydia hasn't been ruled out, you may also get pills for it.

Self-care

• Don't have sex for 7 days after treatment, and until symptoms are gone
• Tell your partners from the past 60 days so they can be tested and treated
• Get retested in 3 months, even if your partners were treated
• Come back if symptoms last more than a few days after treatment

Medicines

Treatment is given by a healthcare professional.

If you're allergic to ceftriaxone or the shot isn't available, other antibiotics can be used. A throat infection may need a follow-up test to make sure it's gone.

How it compares

Prevention

You can lower your risk:

• Use condoms correctly every time
• Get tested regularly if you're sexually active; ask how often is right for you
• Get tested with new partners
• Limit your number of partners

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a sexual health clinic, an OB-GYN, or a urologist; your local health department can test for free or low cost.

Back to school, work, or sports

• You can go to school and work as usual.
• Don't have sex until you and your partners finish treatment and your doctor says it's OK.

Children, pregnancy, and older adults

• Pregnancy: Gonorrhea can pass to the baby at birth and cause a serious eye infection. Pregnant women are tested and treated.
• Men who have sex with men: Test the throat and rectum too, not just urine.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Some infections can pass to the baby during pregnancy or birth. Tell your provider if you've been exposed.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

Outlook

Gonorrhea is curable with the right treatment. Reinfection is common, so retest at 3 months.

Myths and facts

Getting ready for your visit

STI visits are private.

What to bring

• Your symptoms and when they started
• The kinds of sex you've had, so the right places are tested
• Any allergies to antibiotics

Questions to ask

• Which sites should be tested?
• How do I tell my partners?
• When can I have sex again?
• When should I get retested?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Gonorrhea