Causes and Risk Factors of Gonorrhea

Gonorrhea is a sexually transmitted infection caused by a bacteria called Neisseria gonorrhoeae. All sexually active people face a risk for gonorrhea.

According to the Centers for Disease Control and Prevention (CDC), more than 600,000 new cases of gonorrhea were reported in 2019—making it the second most common notifiable condition. The highest reported rates of infection are found to be among sexually active teens, young adults, and African Americans.

It is important to learn as much as you can about causes, risk factors, and ways to defend yourself against infection.

gonorrhea risk factors
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Common Risk Factors

Let’s take a look at some of the factors that contribute to the chances of acquiring gonorrhea and the action steps you can take to reduce those risks.

Sexual Activity

If you have unprotected, vaginal, oral, or anal sex with someone who’s infected with gonorrhea, you may acquire the infection. If your condom breaks during sex with an infected partner, your chances of contracting it may increase.

Although gonorrhea is transmitted through sexual activity, a male partner doesn’t have to ejaculate to spread the infection to another person. If the bacteria enter an opening in the body, including the vagina, penis, anus, or mouth, you can become infected.

If you've been diagnosed with gonorrhea in the past and took the medication to eradicate the infection, you can still get the infection again if you have unprotected sex with a partner who has it.

To decrease the likelihood that you’ll transmit gonorrhea to a sexual partner or acquire it from them, the CDC recommends the following testing schedule:

  • You should be tested at least yearly if you’re a sexually active man who is gay, bisexual, or who has sex with men.
  • If you’re a sexually active woman under the age of 25, you should be tested every year.
  • If you’re a woman 25 and older and at increased risk of infection, you should be tested every year. Risk factors include having a new sex partner, more than one sex partner, a sex partner with concurrent partners, or a sex partner who has an STI.


Testing isn't difficult or scary—an easy swab or urine test can yield accurate results.

Pregnancy

If you’re pregnant and have gonorrhea, it can pose potential risks to your pregnancy or you can pass the infection to your baby during childbirth. In this instance, the infection typically affects the baby’s eyes, lungs, and rectum.

Compromised Immune System

If you’re immunocompromised, including having a diagnosis of HIV/AIDs, you may be more at risk of acquiring and spreading the infection.

How It Doesn't Spread

Gonorrhea can’t survive outside of the human body, which means you can’t contract it from bed sheets, toilet seats, or clothing from a person who has the infection.

2:22

Click Play to Learn About the Symptoms of Gonorrhea

This video has been medically reviewed by Jamin Brahmbhatt, MD

Lifestyle Factors That Lower Risk

There are some risk factors of gonorrhea that you can address through your daily habits and behaviors.

Condoms

The only way to ensure you won’t become infected or spread gonorrhea is to abstain from having sex. However, that may not be realistic or practical for all individuals. If you decide to have sex—whether vaginal, anal, or oral—use a condom.

Unsure of how to properly use condoms to protect yourself from the transmission of STDs/STIs? There are helpful guides available for correctly using male condoms and female condoms. Paying attention to details like checking the expiration date or how you unroll a condom can make using them more effective.

Open Communication

While it might not always be an easy topic to discuss, maintaining open communication with your sexual partners about whether or not they’ve been tested for gonorrhea can help you protect yourself.

Ask your partner whether they’ve had recent STD/STI testing done and whether the tests were positive or negative. If your partner hasn’t been tested in a while, find out if they’d consider getting tested.

If your partner displays atypical symptoms like pain or burning upon urination, unusual discharge, or something else, refrain from sexual activities until they can be evaluated and treated accordingly by a healthcare provider.  

Stay the Course of Treatment

If you’ve been diagnosed with gonorrhea, it can be tempting to stop taking your medication as soon as you begin feeling better or your symptoms subside. But to fully eradicate the infection, stay the course of treatment your healthcare provider has prescribed for you.

To prevent infecting someone else, your healthcare provider will recommend that you abstain from sex for seven days after completing single-dose therapy and until all sex partners are treated.

Prioritize Annual Screenings

If you’re sexually active with a new partner, have multiple partners, or you’ve been with a partner who’s been diagnosed with gonorrhea, consider making routine screenings an ongoing part of your overall healthcare. Furthermore, practice safe sex to reduce the risk of contracting gonorrhea. When it’s caught early, gonorrhea is a curable infection. If it’s left untreated, it can lead to serious complications for both men and women.

Frequently Asked Questions

  • What causes gonorrhea?

    Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. It is spread by oral, vaginal, and anal sex. It can also be passed from mother to child during childbirth, which can cause a damaging eye infection known as gonococcal conjunctivitis.

  • What are the risk factors for gonorrhea?

    The two major risk factors for gonorrhea are sex without barrier protection and multiple sex partners. Barrier protection not only includes condoms but also involves dental dams used during oral-vaginal or oral-anal sex.

  • Who is at the highest risk of gonorrhea?

    Men who have sex with men (MSM) are at the highest risk of gonorrhea. This is because there is a higher prevalence of STDs in the MSM sexual networks. Issues such as homophobia and stigma also fuel risk-taking behaviors that increase a person’s vulnerability to STDs.

  • Can you get gonorrhea from kissing?

    No. Gonorrhea is not spread through casual contact, so you cannot get it from kissing, sharing utensils, toilet seats, coughing, sneezing, or hugging.

  • Can gonorrhea infection occur in the eyes?

    Yes, this can occur if genital secretions from an infected person get into the eye of an uninfected person. This usually happens when someone touches their eyes. This can cause gonococcal conjunctivitis, which manifests with symptoms of pink eye.

  • Can gonorrhea cause infertility?

    Yes. Untreated gonorrhea in females can lead to pelvic inflammatory disease (PID). Studies suggest that around 15% of people with PID will experience infertility, mainly due to the blockage of the fallopian tubes. Gonorrhea can also cause infertility in males due to complications of epididymitis (infection of the tubes that transport sperm).

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. National Overview - Sexually Transmitted Disease Surveillance, 2019.

  2. Centers for Disease Control and Prevention. Gonorrhea - CDC fact sheet (detailed version).

  3. Centers for Disease Control and Prevention. Gonorrhea - CDC Fact Sheet.

  4. Centers for Disease Control and Prevention. Sexually Transmitted Infections Treatment Guidelines, 2021.

  5. Centers for Disease Control and Prevention. CDC fact sheet: What gay, bisexual and other men who have sex with men need to know about sexually transmitted diseases.

  6. Planned Parenthood. Gonorrhea.

  7. Bodurtha Smith AJ, Holzman SB, Manesh RS, Perl TM. Gonococcal conjunctivitis: a case report of an unusual mode of transmission. J Pediatr Adolesc Gynecol. 2017;30(4):501-2. doi:10.1016/j.jpag.2016.11.003

  8. Tsevat DG, Wiesenfeld HC, Parks C, Peipert JF. Sexually transmitted diseases and infertility. Am J Obstet Gynecol. 2017;216(1):1-9. doi:10.1016/j.ajog.2016.08.008

By Jenny Lelwica Buttaccio, OTR/L
Jenny Lelwica Buttaccio, OTR/L, is a licensed occupational therapist and advocate for patients with Lyme disease.