How to Differentiate Chlamydia and Gonorrhea

Chlamydia and gonorrhea are both sexually transmitted infections (STIs) that can infect the vaginal, oral, anal, urethral, and throat tissues. While some of the symptoms may be the same, many people are asymptomatic (experience no symptoms at all) with either infection.

It can be difficult to determine if you have chlamydia or gonorrhea by symptoms alone. To get effective treatment, STIs must be diagnosed by a healthcare provider.

Read on to learn more about the similarities and differences between these infections, risk factors, and prevention.

Similarities

Chlamydia and gonorrhea are not caused by the same pathogen (germ), but there are a number of similarities between the infections, including how they are transmitted and diagnosed, and their outcomes if they aren't treated.

Transmission

The bacterium that causes chlamydia (Chlamydia trachomatis) and the bacterium that causes gonorrhea (Neisseria gonorrhoea) can both be found in semen and vaginal fluids.

Transmission between people for either infection can occur during:

• Vaginal sex
• Oral sex
• Anal sex
• Childbirth (in which transmission occurs from pregnant person to a baby)

Diagnosis

Diagnostic tests for chlamydia or gonorrhea are very similar.

• To test for chlamydia in people with vaginas, a swab is used to collect a sample of the vaginal canal or the cervix. A urine sample could also be used.
• For people with penises, a swab of the urethra (the tube that allows urine and semen to exit the body) or a urine sample can be used.
• For anyone at risk of a chlamydia infection in the anus or throat, a rectal or throat swab can be taken.

The samples used to test for a gonorrhea infection are essentially the same.

For both infections, you may have the option to collect samples yourself. You will either use a swab to collect samples from the same areas that a healthcare provider would, or collect your own urine sample. Researchers have found that self-collection of samples provides accurate results.

Collecting samples at home and returning them to a clinic or mailing them to a lab to get results may also be an option.

Possible Impacts of Untreated Infections

While some people may have a chlamydia or gonorrhea infection without knowing it, it won't go away without being treated. Some of the long-term impacts of the two infections are similar.

Among other health concerns, some of the possible conditions that can occur if either infection is left untreated include:

• Infertility
• Pelvic inflammatory disease (PID)
• Pregnancy concerns, including preterm birth, in the case of chlamydia
• Inflammation or scarring in the genital area
• Arthritis that is associated with swelling in the joints (reactive arthritis in the case of chlamydia) and can spread to other parts the body (gonococcal arthritis is associated with gonorrhea)
  

Differences

While chlamydia and gonorrhea have a lot in common, there are a few differences between the two, mainly in symptoms and treatment.

Symptoms

A person who has a chlamydia or gonorrhea infection may not know they have it, because they have no symptoms. If symptoms are experienced, they may be slightly different depending on the type of infection.

Symptoms of chlamydia may include:

• Pain during sex
• Bleeding between menstrual periods
• Burning or pain during urination
• Swollen testicles
• Anal pain, bleeding, or discharge (for rectal infections)
• Vaginal discharge that may be yellow and have a strong smell
• Milky/watery discharge from the penis
  

Symptoms of gonorrhea may include:

• Atypical discharge from the penis or vagina that may be yellow, green, or white
• Bleeding between menstrual periods
• Burning or pain during urination
• Pain or swelling of the testicles

Gonorrhea can also infect the anus and throat. In the anus, symptoms may include itching around the area, discharge, or pain. Symptoms in the throat are rare and may only include a sore throat.

Treatment

Both infections are treated with antibiotics, though they are not the same medications.

Chlamydia is treated with doxycycline taken orally, two times a day for seven days. Alternative medications are also taken orally and may include a single dose of azithromycin or levofloxacin, once a day for seven days.

Gonorrhea treatments will vary. Some strains of gonorrhea are now resistant to some antibiotic medications that were previously effective.

For an infection in the urethra, cervix, throat, or rectum:

• A single shot of ceftriaxone will be given (the amount of the medication may vary depending on your weight).
• People with allergies to ceftriaxone may get a single shot of gentamicin and a single oral dose of azithromycin.
• If it's not possible to get a shot of ceftriaxone, then a single oral dose of cefixime may be administered.

If chlamydia infection hasn't been excluded, the person should also be treated for chlamydia with doxycycline.

Being tested for either infection right after completing treatment isn't necessary (unless the infection is in the throat or the person is pregnant). However, retesting at three months after treatment is recommended for everyone.

It's wise to avoid having sex until your treatment is completed and all your sexual partners have completed their treatment for chlamydia or gonorrhea. This reduces the risk for transmission to other people and being reinfected.

Expedited partner therapy may be available in some healthcare clinics if it's not possible for your partner(s) to easily get tested or treated. In this case, a healthcare provider gives a prescription to the patient who was diagnosed with chlamydia or gonorrhea so that they can give it to their partner(s) without their needing a medical visit.

Prevention

The only way to completely avoid the risk of getting an STI is to not have sex.

But if you are sexually active, there are a number of ways you and your partner(s) can reduce the risk of transmitting STIs, including:

• Getting vaccinated against human papillomavirus (HPV) and hepatitis B
• Using barrier methods during sex, such as condoms
• Getting tested regularly for STIs
• Talking with your partner(s) about how you will negotiate safer sex practices, sexual activities that may be higher risk, and your STI status
• Considering how many sexual partners you have (the chances of getting an STI increase with the number of partners you have)
  

Risk Factors and Populations With Higher Risk

Anyone who is sexually active may be at risk for getting or transmitting an STI. However, there are certain factors that may increase your risk for getting chlamydia, gonorrhea, or another STI.

There are certain populations of people who may be at a higher risk for STIs. These groups include:

• Young people ages 15–24 years old account for about half of the STIs in the United States.
• Men who have sex with men (MSM) have higher rates of STIs, including chlamydia and gonorrhea, than other populations.
  

Summary

Chlamydia and gonorrhea infections are similar in many ways, including how they are transmitted, diagnosed, and what happens if they are left untreated. However, there are some notable differences, such as certain symptoms and the specific treatments for each infection.

There are effective ways to reduce your risk of transmitting STIs, including by using condoms, getting tested for STIs regularly, and being familiar with your sexual partners.

A Word From Verywell

If you're sexually active, it's wise to know the symptoms and risk factors for sexually transmitted infections. Talk with your healthcare provider about how often you should be tested for STIs depending on your status. Testing will help you identify infections sooner and reduce the risk of transmitting them to others.