Gonorrhea
Gonorrhea is a common sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae.
Because it often causes no symptoms, practicing safe sex and undergoing timely screening are essential to prevent transmission and reduce the risk of serious complications.
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On this page
- What Is Gonorrhea?
- What Are the Symptoms of Gonorrhea?
- How Do You Diagnose Gonorrhea?
- How Do You Treat Gonorrhea?
What Is Gonorrhea?
Gonorrhea is one of the most common sexually transmitted bacterial infections worldwide. The bacterium responsible, Neisseria gonorrhoeae (also known as gonococcus), primarily infects the mucous membranes of the genital tract but can also affect the throat, rectum, and eyes.
In men, it most commonly affects the urethra, while in women it mainly infects the cervix and reproductive tract. If left untreated during pregnancy, the infection can be transmitted to the newborn during childbirth. However, thanks to routine neonatal preventive protocols, complications in newborns are now extremely rare in developed countries.
Complications
If left untreated, gonorrhea can cause serious reproductive health complications:
- In women: the infection may spread to the uterus and fallopian tubes, causing Pelvic Inflammatory Disease (PID). This increases the risk of infertility and ectopic pregnancy.
- In men: it may spread to the epididymis (epididymitis), causing painful inflammation that can affect fertility.
- In both sexes: in rare cases, the bacterium can spread through the bloodstream (disseminated gonococcal infection), causing skin lesions, joint pain, endocarditis, or meningitis.
How it spreads
Gonorrhea is transmitted through unprotected vaginal, anal, or oral sexual contact with an infected person.
Risk factors for gonorrhea
The risk of infection increases with:
- Having unprotected sex (without using condoms).
- Having a new sexual partner or multiple sexual partners.
- Having a partner with a known or suspected STI.
- A personal history of sexually transmitted infections.
- Not undergoing routine screening and testing when sexually active with different partners.
What Are the Symptoms of Gonorrhea?
Many people with gonorrhea, particularly women and a significant proportion of men, experience no symptoms and may unknowingly transmit the infection. When symptoms do occur, they usually appear within 2 to 14 days after exposure and vary depending on the site of infection.
Symptoms in women
Symptoms are often mild and may be mistaken for a urinary tract infection or a common vaginal infection. They may include:
- Increased or abnormal vaginal discharge (changes in color or consistency).
- Burning or pain during urination.
- Pain during or after sexual intercourse.
- Bleeding between menstrual periods (spotting).
- Genital itching or irritation.
Symptoms in men
Symptoms are generally more noticeable and typically affect the urethra:
- Abnormal urethral discharge (white, yellow, or green in color).
- Significant burning or pain during urination.
- Redness or swelling at the opening of the urethra.
- Pain or swelling in the testicles.
Rectal, throat, and eye infections
- Rectum: the infection may cause no symptoms or may result in itching, discharge, bleeding, and pain during bowel movements.
- Throat: infection may occur through oral sex and is usually asymptomatic or associated with a mild sore throat and redness.
- Eyes: usually through self-contamination by touch, gonorrhea can cause purulent conjunctivitis, pain, and sensitivity to light.
How Do You Diagnose Gonorrhea?
Because gonorrhea is frequently asymptomatic, diagnosis cannot rely solely on a clinical examination and requires specific laboratory testing.
A physician or specialist collects a biological sample, such as a urethral, cervical, rectal, or throat swab, or a urine sample, which is then analyzed using:
- Nucleic Acid Amplification Testing (NAAT): the most accurate and widely used molecular test for detecting the bacterium’s genetic material. It can also be performed on a urine sample.
- Bacterial culture and antimicrobial susceptibility testing: essential for isolating the bacterium and determining which antibiotics are effective, particularly in cases of suspected antibiotic resistance.
When a diagnosis of gonorrhea is confirmed, screening for other sexually transmitted infections, such as HIV, syphilis, and chlamydia, is recommended. Recent sexual partners should also be informed so they can undergo appropriate testing.
How Do You Treat Gonorrhea?
Gonorrhea is treated with targeted antibiotic therapy prescribed by a specialist. Because Neisseria gonorrhoeae has developed resistance to several commonly used antibiotics over time, the choice of medication and dosage must follow current clinical guidelines.
To ensure successful treatment and prevent reinfection:
- Complete the prescribed treatment: follow the prescribed dosage and duration exactly, even if symptoms improve or disappear.
- Avoid sexual activity: refrain from any sexual contact until treatment has been completed and recovery has been confirmed.
- Treat sexual partners: sexual partners should also be evaluated and treated to prevent reinfection.
Reviewed September 2026.