Gonorrhea is the most common STD among teens and young adults of 15-24 years age group. Without any clear symptoms, testing is the best way to diagnose and treat it.
Gonorrhea is a sexually transmitted disease caused by bacteria that mainly spread among sexually active adults.
The infection can transfer with vaginal, anal, and oral sex. Cases of spread from kissing have also been observed.
CDC and state health agencies regularly track STDs. The 2022 data show over 650k known cases of gonorrhea.
More than half-a-million cases annually occur in the US. Over twenty million infections occur worldwide every year.
Gonorrhea is a bacterial infection.
It is caused by the bacterium Neisseria gonorrheae and belongs to the same family that also cause meningitis, sepsis, etc.
Sometimes Neisseria gonorrheae is also called "gonococcus" or "GC" (which doesn't mean gonorrhea and chlamydia, although both are often tested together).
Neisseria are gram-negative bacteria that appear as double dots when seen on a microscope.
It has special affinity to mucous and binds to the outer (epithelial) cells of different organs.
It is very easy to get re-infected for gonorrhea because the bacteria have several ways to fight the immune system.
Gonococcus or Neisseria gonorrheae are highly adaptive bacteria that tend to attach to the mucous and other linings of the body.
Gonorrhea can spread in many ways during intercourse.
Most common is from men to women - the chance of getting infected during intercourse is more than 50 percent.
The chance of women infecting men is about 20 percent.
Gonorrhea can also spread with anal intercourse but the rate of such transmission is not yet known.
In cases of oral sex, both partners can transfer to each other but rate of spread from men to women is higher.
Gonorrhea has been shown to spread from men to men and during anal-oral contacts.
Some studies have also shown that gonorrhea can spread through kissing.
Gonorrhea can also transfer from a mother to the baby, mainly during the delivery (and not through the placenta).
The STI gonorrhea often has no symptoms. Or they may be mild and not easily noticed. One may ignore them as normal bladder, urine infections.
Gonorrhea symptoms are difficult to ignore, whenever they appear, and often require a visit to the doctor or emergency room.
However, even without symptoms, gonorrhea can cause serious health problems.
In both and women, symptoms of gonorrhea are mostly seen around the genital and rectal areas.
The first symptoms often appear in men, in the form of irritation during peeing.
Sometimes they appear as sore throat, giving the term oropharyngeal gonorrhea or "gonorrhea throat."
It is very rare to see any symptoms of gonorrhea in women.
The incubation period of the bacteria causing gonorrhea varies from one day to two weeks. However, symptoms in women normally develop in about 10 days of infection.
Although most women don't show obvious vaginal symptoms of gonorrhea, almost 80 percent have some laboratory evidence of cervical infection when checked with a lab test.
Whenever visible, symptoms of gonorrhea in women often include:
Unexpected vaginal bleeding that is not due to menstrual cycle periods.
Higher than usual vaginal discharge.
Unusually frequent urge to urinate.
Discomfort during peeing - feeling of pain or burning during urinating.
Abdominal pain.
Gonorrhea symptoms in women appear both in the vaginal and rectal areas. Symptoms in the rectal area may include:
Itching.
Sore, red, or bleeding skin.
Unusual discharge or puss.
Problems with bowel movement.
Symptoms of gonorrhea can be so subtle that they can be easily ignored. However, unexplained sores, itching, bleeding, discharge in either of the sexual partners, sore throat over months should be first signs of a possible infection.
In mother to newborn transfer, red-eyes or conjunctivitis might appear.
Symptoms of red-eyes might appear in both women and men due to touching of eyes with infected hands.
It's recommended to regularly wash your hands if you suspect such an infection, especially during any discharge.
Because gonorrhea can easily pass from mother to the newborn, anyone who is pregnant and suspects an infection should immediately talk to their healthcare provider.
Similar to women, clearly visible symptoms of gonorrhea in men are also rare and may be easily missed.
The incubation period of the bacterium Neisseria gonorrheae varies from 1 to 14 days. However, symptoms in men might appear within 2-5 days of infection.
Men with gonorrhea symptoms commonly notice:
Pain during peeing - a feeling of burning when urinating.
Unusual discharge from penis with yellow, white or green color.
Sometimes men may see swelling in their testicles that may cause pain.
Rectal infection of gonorrhea in both men and women can cause itching with sore, red skin that may easily bleed or ooze a puss-like discharge.
Sometimes sore throat from gonorrhea infection can last for several months.
Oropharyngeal gonorrhea has the symptoms of sore throat that might last 4-6 months with additional symptoms of fever, inflamed tonsils and lymph nodes.
If you notice any of these symptoms, see your healthcare provider. You can order an at-home STD test that checks for gonorrhea and other STDs.
Long term effects of gonorrhea can be serious and permanent, including:
Pelvic inflammatory disease or PID in women - which can lead to blocking of fallopian tubes, infertility, ectopic pregnancy (where the fetus forms outside the womb).
Higher risk of sepsis, although very rare.
Increase in risk of HIV infection.
In men, inflammation or narrowing of the tube that brings sperms out of the testicles.
In rare cases, swelling of the prostate gland, causing painful or weak, interrupted urine flow (the sound from such urination is the origin behind word "clap" for STDs).
In some rare but serious life-threatening cases, gonorrhea can spread to blood and joints.
Gonorrhea rarely has any symptoms, therefore testing is the best way to confirm an infection.
Who should get tested for gonorrhea?
Anyone who is sexually active should consider testing since symptoms may not always be visible.
The CDC suggests that gay and bisexual men should test every year.
A sexually active woman should also consider testing every year if she is under 25 years of age or had multiple partners or a partner with known case of STD infection.
Because it is so easy to transfer the infection or get re-infected, the CDC recommends testing both partners. Especially, in teenagers and young adults under 25 years of age.
Testing for gonorrhea is straightforward with an at home STD test.
A urine test for gonorrhea, chlamydia and trichomoniasis can be collected at home and mailed to a CLIA-certified lab.
Sometimes, a swab from throat or rectal area might be used to diagnose gonorrhea.
In rare case, a swab from a men's urethra or a women's cervix might be necessary. Your doctor may decide the best way to collect the sample before testing.
Gonorrhea is easily treatable with antibiotics.
Current guidelines for medical treatment of gonorrhea include a single dose of 500 mg Ceftriaxone. For anyone over 300 lbs, the amount is doubled.
Other options include 240 mg Gentamicin or 800 mg Cefixime.
However, gonococcus is highly adaptable, and resistant to develop antibiotic resistance, therefore the types of antibiotics used have changed over the years.
The chart below shows all the possible antibiotics used to treat Gonorrhea over the years.
The bacteria developed resistance to most of them.
Chart showing all the medicine used over the years to treat the STD gonorrhea and how the bacteria have developed resistance very quickly.
Once cured, it is recommended to also do another test after around 14 days with oral swab to confirm the elimination of Neisseria gonorrheae.
Gonorrhea in throat is also common. The bacteria are known to reside in the back of the throat where they constantly change.
More testing and intensive treatment might be needed for those with throat infection or a parallel infection of chlamydia.
It is extremely difficult to avoid gonorrhea infection since it can be passed on through vaginal, anal, or oral sex. Cases of infection with kissing have also been reported.
Proper use of condom and long term monogamous relationship with someone without an infection are probably the only way to prevent or reduce the risk of gonorrhea.
Regular screening for gonorrhea is important since infection with kissing has also been reported.
The bacteria can spread in many different ways between men and men, women and men, and even from a mother to the newborn.
Early detection through testing is crucial, as it allows for prompt treatment and reduces the risk of complications
Gonorrhea symptoms are very difficult to observe, therefore preventing the STD gonorrhea is absolutely critical.
To prevent reinfection, one should wait for at least a week before having sex again.
The CDC recommends to test after 3 months to previous infection and treatment to confirm full treatment.
As for any other STD, regular testing and communication with your partner about sexual health are essential for preventing any STD infection.
Early detection, treatment, and responsible sexual practices can help protect you and your partner's health.
Order a Chlamydia STD Test kit that checks for Chlamydia, Gonorrhea, and Trichomoniasis with a urine sample.
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Chlamydia - STD Symptoms, At Home Testing and Treatment - learn about one of the common STI in young adults.
Hormone Imbalance in Women - Role of Estrogen, Progesterone and Testosterone - learn about key hormones for living a full life.
Hormone Testing - Role of FSH and LH Hormone Levels - how the two key hormones change with age.
Testosterone and Aging - an in-depth summary of science behind the male hormone.
