Gonorrhea:
Symptoms, Testing, and Treatment

Gonorrhea symptoms in men and women, how testing works, antibiotic treatment, and why prompt care matters.

What Is Gonorrhea

Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. It is one of the most common STIs in the United States. The CDC reports about 650,000 new infections each year. The bacteria mainly infect the mucous membranes of the reproductive tract. In women, this includes the cervix, uterus, and fallopian tubes. In both men and women, the urethra can be infected. Gonorrhea can also infect the throat, rectum, and eyes.

Gonorrhea is especially concerning because many infected people -- especially women -- have no symptoms. They may pass the infection to partners without knowing. Untreated gonorrhea can lead to serious complications. These include pelvic inflammatory disease (PID), infertility, and disseminated gonococcal infection (when the bacteria spread through the bloodstream to the joints and other organs).

The good news: gonorrhea is curable with the right antibiotics. Early detection through routine STD screening is essential. This is especially true for sexually active people under 25, men who have sex with men, and anyone with new or multiple sexual partners.

Symptoms in Men

Men with gonorrhea are more likely than women to develop noticeable symptoms. Still, about 10 to 15 percent of infected men have no symptoms. Symptoms usually appear 1 to 14 days after exposure. Most men notice signs within 2 to 5 days.

Common symptoms of urethral gonorrhea in men include:

• A white, yellow, or greenish purulent discharge from the penis
• Burning or pain during urination (dysuria)
• Swollen or tender testicles (epididymitis), which is less common but can occur if the infection ascends
• Urethral itching or irritation
• Increased urinary frequency

Rectal gonorrhea in men who have sex with men is often symptomless. When symptoms occur, they may include anal discharge, itching, soreness, bleeding, or painful bowel movements. Pharyngeal (throat) gonorrhea is usually symptomless but may sometimes cause a sore throat. If you have any of these symptoms, prompt evaluation and treatment through a gonorrhea consultation can prevent complications and reduce further spread.

Symptoms in Women

Gonorrhea in women is often symptomless. When symptoms do occur, they may be so mild they're mistaken for a bladder infection or a vaginal yeast infection. Up to 50 percent of women with gonorrhea have no symptoms at all. That's why routine screening is critical for early detection. When symptoms do appear, they usually develop within 1 to 14 days of exposure.

Symptoms of gonorrhea in women may include:

• Increased or abnormal vaginal discharge, which may be watery, creamy, or slightly green
• Burning or pain during urination
• Bleeding between menstrual periods or after sexual intercourse
• Pelvic or lower abdominal pain
• Painful intercourse (dyspareunia)

The silent nature of gonorrhea in women makes it especially dangerous. Untreated cervical gonorrhea can spread up to the uterus and fallopian tubes, causing pelvic inflammatory disease. PID can lead to chronic pelvic pain, ectopic pregnancy, and tubal factor infertility. Pregnant women with gonorrhea can also pass the bacteria to the newborn during delivery. This can cause gonococcal ophthalmia neonatorum, a serious eye infection. Regular STD screening is the most reliable way to catch silent infections early.

How Gonorrhea Spreads

Gonorrhea spreads through sexual contact with an infected partner. The bacteria spread through vaginal, anal, and oral sex. They can infect the genitals, rectum, and throat. Any sexually active person can get gonorrhea. Having the infection once doesn't protect you from getting it again. Reinfection is common, especially when sexual partners aren't treated at the same time.

Key facts about gonorrhea transmission:

• The bacteria are transmitted through contact with infected genital, rectal, or pharyngeal secretions
• Ejaculation does not need to occur for transmission to happen
• A pregnant woman can pass gonorrhea to her baby during vaginal delivery
• Gonorrhea is not spread through casual contact such as hugging, sharing food, or using toilet seats
• Condoms, when used correctly and consistently, significantly reduce the risk of transmission

Gonorrhea often occurs alongside other STIs, especially chlamydia. Providers often recommend testing for both at the same time. People diagnosed with gonorrhea should notify recent sexual partners so they can be tested and treated. This helps break the chain of transmission.

Testing and Diagnosis

Gonorrhea is diagnosed through lab testing. The most common test is a nucleic acid amplification test (NAAT) -- a highly accurate DNA-based test. NAATs are the gold standard because they're very sensitive and specific. Testing is simple. It can be done on a urine sample or a swab from the infected site (cervix, urethra, rectum, or throat).

Who should be tested for gonorrhea:

• All sexually active women under age 25, annually
• Women 25 and older with risk factors such as new or multiple partners
• Men who have sex with men, at least annually and more frequently based on risk factors
• Anyone with symptoms suggestive of gonorrhea
• Sexual partners of individuals diagnosed with gonorrhea
• Pregnant women at their first prenatal visit if at risk

Gonorrhea can infect multiple body sites. So for patients with relevant exposure history, providers may recommend throat and rectal testing on top of urogenital testing. Results are usually available within 1 to 3 days. A telehealth provider at InnoCre can order gonorrhea testing at a lab near you and review the results with you promptly.

Treatment

Gonorrhea is curable with the right antibiotics. The current CDC STI Treatment Guidelines (2021, re-affirmed 2024) recommend a single intramuscular injection of ceftriaxone as first-line therapy. The dose is 500 mg for patients under 150 kg, or 1 g for patients 150 kg or more. This applies to uncomplicated urogenital, rectal, or pharyngeal gonorrhea. The single-dose regimen achieves high cure rates and helps ensure treatment is completed.

Important treatment considerations include:

• Because gonorrhea and chlamydia frequently co-occur, providers may add doxycycline 100 mg twice daily for 7 days if chlamydia has not been ruled out
• All sexual partners from the preceding 60 days should be evaluated and treated to prevent reinfection
• Patients should abstain from sexual activity for 7 days after treatment and until all partners have been treated
• A test of cure (repeat testing 7 to 14 days after treatment) is recommended for pharyngeal gonorrhea and for any case treated with an alternative regimen
• Retesting at 3 months is recommended for all patients to check for reinfection

Through a telehealth gonorrhea consultation, your provider can develop a treatment plan, order the appropriate medication, and coordinate follow-up testing to confirm the infection has cleared.

Antibiotic Resistance Concerns

Neisseria gonorrhoeae has shown a striking ability to develop resistance to nearly every class of antibiotic used against it. Over the past several decades, gonorrhea has become resistant to sulfonamides, penicillins, tetracyclines, and fluoroquinolones. More recently, it has shown reduced susceptibility to cephalosporins and azithromycin. The CDC classifies antibiotic-resistant gonorrhea as an urgent public health threat.

This pattern of escalating resistance has significant clinical implications:

• Ceftriaxone injection remains the last reliably effective first-line treatment option
• Dual therapy with azithromycin was previously standard but was removed from guidelines after rising azithromycin resistance
• Treatment failures, while still rare, have been documented globally and are being closely monitored
• Self-treating with leftover antibiotics or incorrect regimens accelerates resistance and may not cure the infection

For these reasons, it's critical to follow current evidence-based treatment guidelines. Complete the full prescribed regimen, and return for test-of-cure when recommended. If symptoms continue after treatment, contact your provider right away. This may signal a resistant strain that needs a different therapy. Responsible antibiotic use is essential to keep the remaining treatment options effective.

Getting Tested Online

Telehealth offers a private, convenient path to gonorrhea testing and treatment. Many patients feel more comfortable discussing sexual health concerns from home than in a waiting room. In a virtual visit, a provider can evaluate your symptoms, assess your risk factors, and order lab testing at a facility near you -- no in-person office visit needed first.

At InnoCre Telehealth, our providers offer confidential gonorrhea evaluation and treatment for patients in Maryland, Washington, and Delaware. Here is how the process works:

• Schedule a same-day telehealth visit and discuss your symptoms or concerns with a board-certified provider
• Your provider orders a gonorrhea NAAT test at a local laboratory, often combined with screening for chlamydia and other STIs
• Visit the lab for a simple urine sample or swab collection -- no appointment needed at most locations
• Results are reviewed with you, typically within 1 to 3 days, and treatment is prescribed if positive
• Follow-up retesting is coordinated to confirm the infection has cleared

Early detection and treatment are the most effective ways to prevent gonorrhea complications and stop further spread. If you have been exposed to gonorrhea, are experiencing symptoms, or are due for routine STD screening, book a same-day telehealth visit to take the first step toward care.

Frequently Asked Questions