What Is Gonorrhea?

illustration of gonorrhea bacteria
Gonorrhea is a bacterial sexually transmitted disease.

Gonorrhea is one of the most common diseases passed from one person to another during sexual activity.

  • The overall rate of gonorrhea has decreased to the lowest rate ever recorded, according to the U.S. Centers for Disease Control and Prevention (CDC). However, gonorrhea is still the second most commonly reported notifiable disease in the United States. The CDC estimates that approximately 700,000 new gonorrheal infections occur yearly in the U.S., only about half of which are reported to the CDC. Roughly half of a percent of people between the ages of 18 and 35 have an infection with gonorrhea that they do not know about. New strains are more easily spread and are resisting treatment even with strong antibiotics.
  • Infection with gonorrhea is more common in certain groups of people. The highest reported infection rates occur in the following groups:
    • Adolescents and young adults
    • People (often poor) living in urban areas and Southern states
    • African Americans
    • Drug users

What Causes Gonorrhea?

Gonorrhea is caused by the Neisseria gonorrhoeae bacteria. The infection is transmitted from one person to another through vaginal, oral, or anal sexual relations.

  • Men have a 20% chance of getting the infection by having sexual relations with a woman infected with gonorrhea.
  • Women have a 50% chance of getting the infection by having sexual relations with a man infected with gonorrhea.
  • An infected mother may transmit gonorrhea to her newborn during vaginal childbirth.

What Are Gonorrhea Symptoms in Women and in Men?

Symptoms may appear within 2 to 10 days after exposure to an infected person -- even longer for women (up to 3 weeks).

Gonorrhea Symptoms in Women

  • It is important to note that infected women have no symptoms in 30% to 40% of cases. Thus it is possible to be infected with gonorrhea and not know about the infection.
  • Gonorrhea may cause pelvic inflammatory disease (a serious medical condition that can lead to infertility).
  • Infection and irritation of the cervix
  • The need to urinate often
  • Itching and burning of the vagina, usually with a thick yellow/green discharge
  • Infection and irritation of the vagina (this is how the infection usually appears in children who may be victims of sexual abuse)
  • Bleeding between menstrual periods

Gonorrhea Symptoms in Men

  • Pain or burning during urination in most men
  • Thick, yellow penile discharge 50% of the time
  • Inflammation and tenderness of a duct in the testicles
  • Inflammation and pain in the prostate gland

Gonorrhea Symptoms in Newborns

  • Irritation of the mucous membranes in the eyes (if not treated, can cause blindness)

Oral and Rectal Gonorrhea Symptoms

  • Gonococcal throat infection should be considered in people who complain of sore throat and have other signs of gonococcal infection. Throat infections from gonorrhea are transmitted through oral sex, but occur without any other symptoms in less than 5% of individuals infected with gonorrhea.
  • Rectal pain or discharge can be a sign of infection of the prostate and is transmitted through anal intercourse.

When to Seek Medical Care for Gonorrhea

When to call the doctor

Call your health care practitioner if you suspect gonorrheal infection and any of the following signs or symptoms are present:

When to go to the hospital

Gonorrhea can develop into more serious medical conditions if not treated. The infection may spread through the bloodstream and affect mucous membranes throughout the body. Symptoms of more serious disease can include joint pain and rash. Complications of gonorrhea can also include meningitis (inflammation of the brain) or perihepatitis (an infection involving the capsule surrounding the liver).

If you have any of the following serious symptoms, you need to go to a hospital's emergency department immediately for treatment with antibiotics (given through an IV).

How Is Gonorrhea Diagnosed?

In order to diagnose gonorrhea, the doctor will conduct a physical examination.

  • Tenderness for women in the area of the sex organs, and a pus-filled discharge from the vagina or penis, along with a high white-blood-cell count and fever could indicate an infection.
  • A sample of the discharge will be sent to the laboratory. The laboratory will put the specimen on a special bacteria plate to see if it will grow the gonorrhea bacteria. This usually takes at least 2 days to detect. The doctor may also order diagnostic tests to examine samples of the discharge under a microscope.
  • Most hospitals and clinics now have urine kits that will screen for gonorrhea. These tests are not as sensitive as genital cultures but are good tests for screening.

What Are the Medications and Treatment for Gonorrhea?

Previously, a class of antibiotics known as the fluoroquinolones (examples are ciprofloxacin [Cipro, Cipro XR], ofloxacin [Floxin], and levofloxacin [Levaquin]) was widely used in the treatment of gonorrheal infection. Because of increasing resistance of many tested samples of N. gonorrhoeae to the fluoroquinolone drugs, the CDC now recommends that only one class of antibiotics, the cephalosporins, be used to treat gonorrheal infections.

  • The health care practitioner may prescribe a single-dose injection of an antibiotic such as ceftriaxone (Rocephin) or a single-dose pill such as cefixime (Suprax).
  • If you are pregnant or younger than 18 years of age, the doctor will usually prescribe the shot instead of a pill.

Are There Home Remedies for Gonorrhea?

Gonorrhea can develop into more serious medical conditions if not treated. You must see a doctor for treatment, as there are no home remedies.

What Is the Follow-up for Gonorrhea?

  • Notify all sexual partners to be tested for infection. They should be treated or tested so the infection is not passed back and forth.
  • Be retested yourself for infection 72 hours after you finish all the antibiotics or if you think you've been reinfected.
  • Get tested for other sexually transmitted diseases, especially chlamydia and human immunodeficiency virus (HIV).

How to Prevent Gonorrhea

Is Gonorrhea Curable?

Treated with antibiotics, gonorrheal infections can be cured 95% to 99% of the time.

Complications if gonorrhea is not treated include:

  • Pelvic inflammatory disease (20% to 40% of women)
  • Chronic pelvic pain and sterility from tubal adhesions, which cause the Fallopian tubes to become blocked
  • Arthritis
  • Meningitis (inflammation of the brain) or perihepatitis (infection of the liver capsule)
  • Chlamydia, another sexually transmitted disease, often accompanies gonorrheal infections.

STDs in Men

  • Sexually transmitted diseases (STDs) can be spread (transmitted) by intercourse, kissing, oral-genital contact, and sharing sexual devices.
  • Aside from abstinence, the use of latex barriers, such as condoms, during intercourse and oral-genital contact (although not 100% effective) is the best means of preventing the spread of STDs.
  • Genital or oral ulcers are most often caused by herpes simplex, chancroid, syphilis, and lymphogranuloma venereum.
  • Syphilis infection can either produce no symptoms or can cause oral or genital ulcers, rash, fever, or a variety of neurological illnesses ranging from forgetfulness to stroke.
  • Chlamydia and gonorrhea can be transmitted alone or together and cause inflammation of the urethra (urethritis), which the patient experiences as burning on urination and a penile discharge (dripping).