What is it?

Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. It can infect the genitals, rectum, and throat. It is the second most commonly reported notifiable condition in the United States. Antibiotic-resistant strains are an increasing public health concern.

How it spreads

Gonorrhea spreads through vaginal, anal, and oral sex. It can infect the penis, vagina, cervix, anus, urethra, and throat. A pregnant person can pass it to their baby during delivery, potentially causing serious eye infection. Pre-ejaculatory fluid can also transmit the infection.

Symptoms

Many people with gonorrhea have no symptoms. When present, symptoms may include:

  • Burning when urinating
  • White, yellow, or green discharge from the penis or vagina
  • Painful or swollen testicles
  • Rectal pain or discharge

Throat infections are usually asymptomatic. Symptoms appear 1–14 days after exposure.

Testing

Gonorrhea is diagnosed with a NAAT test — a urine sample or swab of the affected area. Because gonorrhea often occurs with chlamydia, testing for both at the same time is recommended. The CDC recommends annual testing for sexually active women under 25 and for all people at increased risk.

Treatment

Gonorrhea is treated with a single injection of ceftriaxone. Due to increasing antibiotic resistance, follow-up testing 1–2 weeks after treatment is recommended to confirm cure. Avoid sex until treatment is complete and symptoms resolve. Sexual partners from the last 60 days should be tested and treated.

Prevention

Prevention steps:

  • Use condoms or dental dams consistently with every sexual encounter
  • Get tested regularly
  • Discuss STI testing with partners before sex

Gonorrhea can be re-acquired — a previous infection does not provide immunity. Reducing the number of sexual partners lowers risk.