Symptoms

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

Males may also notice:

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

Females may also experience 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 person may have a throat infection, but they might not notice any 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 pinkeye.

Diagnosis

A person might receive a diagnosis of gonorrhea if they see a doctor because they have had symptoms or because they suspect that they have been exposed to the infection.

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, or throat.

A person using a home 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 provider, if possible.

If one person has a diagnosis of gonorrhea, their sexual partner or partners should also receive testing.

Treatment

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

It cannot repair any problems that the infection has already caused, so it is important to receive treatment as soon as possible.

The Centers for Disease Control and Prevention (CDC) recommend a single dose of 250 milligrams of intramuscular ceftriaxone (Rocephin) and 1 gram of oral azithromycin (Zithromax). These are different types of antibiotics.

The CDC urge people to take all the medication that a doctor prescribes and to avoid sharing it with anyone else.

However, Neisseria gonorrhoeae, the bacteria that cause gonorrhea, have developed resistance to nearly all the antibiotics that doctors have traditionally used to treat it.

This 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 healthcare provider. They may need further testing to determine whether the treatment is working.

A person should also attend any follow-up appointments and avoid having sex until a healthcare provider 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 on to the baby during delivery, so the newborn will usually 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. They can also result from a more serious condition, such as meningitis or bacteremia.

Causes

N. gonorrhoeae bacteria are responsible for gonorrhea. These bacteria 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. Males do not need to ejaculate to transmit or contract gonorrhea.

It can also pass to a baby during delivery.

All sexually active people can develop gonorrhea. In the U.S., it is most common among adolescents and young adults.6

There are a number of severe complications of gonorrhea. For this reason, it is important to receive treatment as soon as possible.

In females, gonorrhea can lead to:

• PID
• chronic pelvic pain
• infertility
• ectopic pregnancy, which can be a medical emergency

Further complications of the infection can occur during pregnancy and delivery. Without treatment, it causes an increased risk of preterm labor or stillbirth.

Gonorrhea can also pass to the newborn, who can develop a joint infection, loss of vision, or bacteremia — a life threatening blood infection — as a result.

In males, gonorrhea can lead to epididymitis, which can cause problems with fertility.

In everyone, untreated gonorrhea can lead to a disseminated gonococcal infection. This 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

People with gonorrhea also 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.

Prevention

Ways of avoiding 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