Gonorrhea

Gonorrhea is the second most common bacterial sexually transmitted infection (STI) in the United States. It is caused by the bacteria Neisseria gonorrhea.1

Gonorrhea leads to infection of the lining of the reproductive tract (the mucus membranes). This can cause inflammation of the cervix, uterus, and fallopian tubes in the female reproductive tract. It also causes inflammation of the anus and urethra (tube that carries urine out of the body) in both men and women.1

Gonorrhea is most common in young, sexually active people. It is hard to estimate just how common gonorrhea is because it is often asymptomatic. This means it may not have any symptoms.1

Transmission

Gonorrhea can be transmitted through semen and vaginal fluid at any point during oral, vaginal, or anal sex. Ejaculation does not need to occur. It can also be transmitted through sex toys if shared between partners and not properly cleaned.

It is not transmitted by other forms of contact like sharing utensils, sharing towels, kissing, or hugging.1

How is gonorrhea related to HIV?

Gonorrhea has a link to HIV. Both conditions can often occur together. There are several reasons why this might happen.

HIV and gonorrhea share similar risk factors. These include having multiple sexual partners and not using condoms regularly. Sores or blisters that come along with certain STIs cause breaks in the protective barrier of the skin. This makes it easier for HIV, gonorrhea, and other STIs to be transmitted.1-3

Having an STI like gonorrhea along with HIV can impact how both conditions are transmitted. For example, untreated gonorrhea alongside HIV makes it more likely that a person will transmit HIV to their partner. The risk of HIV transmission is thought to be even higher if a person’s HIV is not suppressed with medicine. It is also possible for gonorrhea and HIV to be transmitted at the same time.1-3

There are often shared barriers to healthcare, testing, and treatment that can lead to HIV and gonorrhea occurring together. These include:1-3

Trouble accessing healthcare and feelings of stigma may decrease a person’s ability or desire to see their doctor. This can lead to decreased testing, prevention measures, and treatment.

Signs and symptoms

Most people with gonorrhea may have no symptoms at all. If a person does have symptoms, it may take 1 to 2 weeks (or more) for them to appear.1

A person may have different symptoms based on what area of the body is affected, such as:1

  • Cervix, vagina, and uterus – Pain with urination, yellow or green mucus-like vaginal discharge, bleeding between periods, or heavier bleeding during periods
  • Urethra – Yellow-green watery discharge with painful urination
  • Testicles – Swelling and tenderness of 1 or both testicles
  • Rectum – Anal discharge, pain, itching, soreness, trouble having bowel movements, or bleeding

Other areas of the body that can be affected by gonorrhea include the eyes, joints, blood, and throat. These are less common than the reproductive tract.1

Testing for gonorrhea

Diagnosing and treating gonorrhea is very important. Untreated gonorrhea can move upward through the female reproductive tract and cause pelvic inflammatory disease (PID). PID can lead to severe pain, problems with fertility, and ectopic pregnancies, which can be dangerous or life-threatening. Advanced PID might also affect the liver. It is also possible for a person who is pregnant to transmit gonorrhea to their baby during birth.1-4

Because gonorrhea is often asymptomatic, it is possible for a person to have gonorrhea for a long time without knowing. This is why it is often recommended that young, sexually active people and those who are pregnant regularly get tested for gonorrhea and other STIs.1-4

Other people at high risk for gonorrhea may also benefit from frequent testing. This includes those with multiple sexual partners or who do not regularly use condoms.1-4

What is the test like?

Urine tests and simple swabs of the vagina, cervix, rectum, or urethra can all detect gonorrhea. These tests can be done at your doctor’s office, through your local health department, and sometimes even at home.1-4

How is gonorrhea treated?

Once a person is diagnosed with gonorrhea, they will take antibiotics to cure the infection. It is possible to get gonorrhea again even after treatment. Waiting to have sex until after treatment is done can prevent re-infection.1-4

When a person is diagnosed with gonorrhea, their sexual partners should also be tested. All partners with gonorrhea need to finish treatment to prevent reinfection. Many doctors’ offices or health departments can help notify partners in a safe and anonymous way.1-4

Gonorrhea is also often transmitted alongside chlamydia. When 1 is detected, it is common to be treated for both to be safe. Chlamydia is also treated with antibiotics.1-4

Prevention

Using condoms consistently can reduce the risk of getting gonorrhea. This includes using a new condom after each sexual act and for the entirety of sex.1-3

Talking to your doctor about your risk and regular testing can be helpful. Regular testing in those at risk, even when symptoms are not present, can help detect silent infections and reduce the risk of transmission.1-4

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Written by: Casey Hribar | Last reviewed: February 2021