According to the CDC, gonorrhea is a very common sexually transmitted disease (STD) that is particularly prevalent among young people ages 15-24 who have multiple sexual partners. Spread by vaginal, oral, or anal intercourse, gonorrhea symptoms can range from mild to severe. Symptoms may manifest differently in men and women.

It’s important to recognize the signs in order to get quick treatment, as it can cause severe and lasting damage if left unchecked. Let’s look into some of the most common symptoms of gonorrhea, its different impacts on men and women, and how it can be treated and prevented.

What Causes Gonorrhea?

This STD is bacterial in nature, caused by the easily-spread Neisseria gonorrhoeae bacterium. During unprotected sexual intercourse, the bacteria can be spread through contact with the mouth, anus, vagina, or penis of someone who is infected. Because it’s spread from semen, pre-cum, or vaginal fluids, the gonorrhea bacteria cannot be spread by contact like kissing, hugging, sneezing, or holding hands. It can take up to 30 days after infection for symptoms to manifest (if they do).

N. Gonorrhoeae targets the body’s mucous membranes. For women, this means the bacteria target the cervix, urethra, and fallopian tubes. In both men and women, gonorrhea can infect the rectum, urethra, throat, and eyes—anywhere with a vulnerable mucous membrane. Colloquially referred to as “the clap” or “the drip,” it can be asymptomatic in both genders.

How Gonorrhea Impacts Women

Around 80% of women with gonorrhea will present no symptoms. Even without symptoms, they can unknowingly spread the infection to their sexual partners. However, even without symptoms, doctors can easily diagnose gonorrhea by testing urine. In cases of oral or anal sex, physicians can diagnose the infection by collecting samples from the throat or rectum. Sometimes, swabs will be taken from the cervix during a consultation.

In approximately 20% of cases, women might demonstrate the following symptoms:

  • Pain or burning sensation when urinating.
  • Unusual-looking or greater amounts of vaginal discharge.
  • Bleeding between periods, unrelated to menstruation.
  • Unusual pain in the pelvis or abdomen.

Symptoms Outside Reproductive System

Women can also suffer symptoms outside of the reproductive system. For example, a bacterial infection in the eyes will cause pain, itching, and pa us-like discharge. It can also cause a sore throat and swollen glands if it attacks the mucous membranes in the throat. In some cases, gonorrhea symptoms will manifest in the rectum, causing painful bowel movements, itching, and bleeding or pus.

Serious Complications of Untreated Gonorrhea in Women

In many ways, the asymptomatic nature of gonorrhea infections in women can make it more dangerous for females. Because women often don’t know they are infected, they may not receive prompt antibiotic treatment. Mild symptoms can often be misattributed to a bladder infection or a UTI. Unchecked, gonorrhea can cause devastating consequences in women:

  • Pelvic Inflammatory Disease (PID). Left untreated, gonorrhea in women can to a serious infection of the reproductive system. For some, this can make it harder to get pregnant or cause infertility.
  • HIV risk. Untreated gonorrhea puts women at a higher risk of getting or spreading HIV.
  • Arthritis. A serious and rare complication, gonococcal arthritis occurs when the infection is spread via the person’s bloodstream to their joints. There, it causes inflammation and pain. Though rare, it is more common in women than in men. For both genders, gonorrhea that spreads to the blood or joints can be life-threatening.
  • Childbirth. If a pregnant woman has gonorrhea, she can spread the infection to her baby during childbirth. This can cause serious illness in the infant. Luckily, prompt treatment during pregnancy can usually protect the baby.

How Gonorrhea Impacts Men 

Due to the asymptomatic nature of gonorrheal infection in women, they can pass it unwittingly to men or other women. Unlike women, men generally demonstrate symptoms when they contract gonorrhea—only approximately 10 to 15% of men are asymptomatic. Although this causes discomfort in the moment, it means men will be more compelled to seek treatment.

Like women, men can have gonorrhea diagnosed with a urine test. Physicians can also swab the throat, rectum, or urethra. Commonly, men experience the following symptoms:

  • A burning sensation when urinating.
  • White, yellow, or green discharge from the penis.
  • If the infection impacts the rectum, they can also experience discharge, anal itching, bleeding, soreness, and painful bowel movements.

Serious Complications of Gonorrhea in Men

  • Epididymitis. Less commonly, the tube at the back of the testicles called the epididymis can become infected. This causes pain in the testicles and scrotum, and fluid build-up around the testicle. If this becomes serious enough, it can cause infertility in men.
  • HIV Risks. Like women, men who have had gonorrhea will have an increased risk of getting or transmitting HIV.
  • Arthritis. Men can also suffer from gonoccocal arthritis as a complication of gonorrhea. Join infection can also manifest in the form of a skin rash with pink, red, or purplish sores.

Is Gonorrhea More Harmful for Men or for Women?

It’s difficult to say definitively which gender suffers more as a result of gonorrhea. Though men are more likely to have obvious symptoms, this might actually work in their favor in the long run. This is because women are more likely to attribute mild symptoms of gonnorhea to something else, and might not get the speedy treatment they need.

In both men and women, untreated gonorrhea can have devastating consequences for reproductive health. PID can cause infertility in women, while rare cases of epididymitis in men can lead to sterility. Further complications caused by unchecked gonorrhea can be dangerous or even fatal for both genders.

Treatment is Generally Effective

Luckily, proper and quick treatment makes all the difference in STD cases. The N.Gonorrhoeae bacterium responds to antibacterial treatment as prescribed by a physician. Because gonorrhea quickly becomes resistant to antibiotics, treatments have changed over the years to respond accordingly. According to the CDC, the recommended treatment since 2015 has been to give a patient a shot of ceftriaxone along with an oral dose of azithromycin.

Doctor's office desk with copy space

Administered together, cetriaxone and azithromycin are considered effective. Because gonorrhea becomes antibiotic-resistant so quickly, it’s extremely important for those who are prescribed antibiotics to finish the entire course exactly as prescribed. It’s important not to share medication with anyone else, and to return to seek treatment if symptoms don’t resolve within a few days. After finishing the course of antibiotics, it’s key to wait seven days before resuming sexual activity.

Unfortunately, though antibiotics can eliminate the infection, they cannot cure some of the lasting damage caused by the bacteria, such as PID or infertility. Also, previous infection doesn’t mean a person is immune to the infection; every time a person gets gonorrhea, they should go into treatment.

Prevention is Key

Prevention of STD’s has always been an important health issue, but recent spikes in gonorrhea cases in the United States speak to the urgent need for prevention education. Between 2013 and 2017, gonnorhea cases increased by an incredible 67%. In 2017, there were approximately 555,000 diagnosed cases in the U.S., a worrying figure. Increasingly antibiotic-resistant bacterial strains make this a particular issue. Here’s how both genders can prevent transmission of gonnorhea (and other STD’s):

  • Use a condom during sexual intercourse (anal, vaginal, or oral).
  • If you have this STD, do not have sexual intercourse with another person until you have received treatment.
  • The CDC recommends limiting the number of sexual partners or practicing monogamy, if possible.
  • Remember that gonorrhea often presents no symptoms, so it’s key to get regularly tested for STD’s.

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