Symptoms of Gonorrhea

Symptoms occur, but only sometimes—leaving many people untreated

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Gonorrhea (sometimes called "the clap" colloquially) is one of the most common sexually transmitted diseases (STDs) in the United States - with more than 1.5 new cases occurring each year.

Despite its prevalence, many people are unaware they have gonorrhea. This is because many people, especially women, do not experience any symptoms associated with the infection. While men tend to experience more noticeable symptoms, they usually do not seek care early enough to prevent spread to other partners. When symptoms do appear, they typically include a discharge from the penis or vagina and pain while urinating or having sex.

Complications of untreated gonorrhea can range from infertility to inflammation of the organs - making it critically important to stay up to date on STD screening.

gonorrhea symptoms
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Initial Symptoms

Gonorrhea is transmitted during oral, vaginal, or anal sex, and if there are any early symptoms, they will generally involve the affected area (the genitals, rectum, or throat).

Females with this infection can develop:

  • Vaginal discharge
  • Burning or pain when urinating (dysuria)
  • Vaginal itchiness
  • Bleeding between periods
  • Lower abdominal pain or discomfort
  • Pain during sex (dyspareunia)

Females and Asymptomatic Gonorrhea

According to the Centers for Disease Control and Prevention (CDC), most females infected with gonorrhea will not have symptoms or the symptoms can be mistaken for a bladder or vaginal infection.

Males with this infection can develop:

  • A greenish-yellow discharge from the penis
  • Dysuria
  • Pain and swelling in the testicles or scrotum

Rectal gonorrhea may cause mild itchiness, discomfort, bleeding, or pain during defecation. These symptoms can be mistaken for hemorrhoids.

Timing of Gonorrhea Symptoms

If signs and symptoms of gonorrhea develop, they usually appear 10 to 14 days after exposure to the Neisseria gonorrhoeae bacterium.

Symptoms in Babies

In addition to sexual transmission, gonorrhea can be passed from a pregnant mother to baby. This usually doesn't happen while the baby is in the womb. The transmission can occur during delivery when the baby is exposed to the mother's genital secretions.

When this happens, the bacteria may be transferred to the newborn's eyes, causing ophthalmia neonatorum, a form of conjunctivitis (eye infection) characterized by eye redness, pain, and discharge. The condition is usually prevented by the routine administration of an antibacterial eye ointment in all babies at the time of birth.

If the infection isn't averted, babies will usually develop symptoms within two to five days. In addition to conjunctivitis, other common effects include scalp infection, respiratory inflammation, vaginitis, and urethritis. Complications include vision loss, meningitis, septic arthritis, and blindness.

Complications

If left untreated, gonorrhea can lead to serious complications affecting the female and male reproductive tract and, less commonly, the joints, skin, heart, and central nervous system.

Complications in Females

In females with untreated gonorrhea, the most common complication is pelvic inflammatory disease (PID), a potentially serious infection of the female reproductive tract. Symptoms will often appear immediately after a menstrual period and, in some cases, this is the first sign of infection. PID is characterized by pain in the pelvis and lower abdomen, as well as nausea, vomiting, fevers, chills, cramping, and a foul-smelling discharge.

Infertility

An infection can sometimes cause scarring in the fallopian tubes, leading to complete tubal blockage and infertility. If only a partial blockage occurs, an egg can still be fertilized but may be unable to pass from the ovaries to the uterus. This would result in an ectopic (tubal) pregnancy in which a miscarriage is inevitable and can place the mother's life at risk if a rupture and hemorrhage occur.

Complications in Males

An untreated infection can cause damage and blockage of the epididymis (the narrow tube that stores sperm in the scrotum) in males.

Gonorrheal epididymitis may be identified by dysuria, a foul-smelling discharge, painful ejaculation, and swollen lymph nodes in the groin. The blockage of one or both tubes can lead to infertility.

Gonococcal Conjunctivitis

If infected body fluids get into your eyes, a condition known as gonococcal conjunctivitis may occur, causing redness, pain, swelling, and a profuse discharge of the eyes.

If left untreated, the infection can cause scarring and perforation of the cornea, leading to vision loss and blindness. In rare cases, the infection can cause the cornea to "melt," binding the eyeball partially or completely to the eyelid.

Disseminated Gonococcal Infection (DGI)

In rare cases, a gonorrheal infection can spread through the bloodstream and infect distant organs. This is referred to as disseminated gonococcal infection (DGI), a complication that occurs in around 3% of people who have gonorrhea.

People with an impaired immune system, including organ recipients and people with inadequately treated HIV, are at the highest risk for disseminated gonococcal infection.

DGI is often referred to as arthritis-dermatitis syndrome because it frequently causes inflammation of the joints (septic arthritis) and pus-filled lesions on the skin.

Very rarely, the infection can settle in the heart and cause endocarditis (inflammation of the heart valve), manifesting with symptoms of malaise, fever, chills, and a heart murmur. DGI can also cause meningitis (inflammation of the membranes surrounding the brain and spinal cord), triggering headaches, fever, fatigue, a stiff neck, and mental confusion.

When to See a Doctor

Most signs of gonorrhea are relatively non-specific and can be easily missed. Because of this, the best rule of thumb is to see a doctor and request an STD screen if you have had unprotected sex or any signs of infection, however mild. This is especially true if your sex partner is someone you don't know well or you think may have an STD.

Even if you have no symptoms and have not had unprotected sex, the CDC recommends sexually active males and females get tested for gonorrhea and other STDs once a year. If you're hesitant, remember that health professionals are not there to judge you. Their role is to provide you with treatment if needed, and guidance to reduce your future risk.

Gonorrhea Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

CDC Guidance on Screening and Treatment

In 2021 the CDC released updated guidance on screening and treatment for STDs - including gonorrhea. Annual screening is recommended for all sexually active women aged <25 years, for older women with increased risk, and all men who have sex with men. Gonorrhea is typically treated with antibiotics, namely ceftriaxone.

Frequently Asked Questions

  • How is gonorrhea treated?

    Gonorrhea is treated with antibiotics to cure the infection. However, any damage done by the infection prior to treatment may be permanent. As bacteria become increasingly drug-resistant, prevention is the best way to protect yourself.

  • How long can someone have gonorrhea and be unaware of it?

    Someone who has gonorrhea may not be aware of it until it causes complications, such as a secondary infection. For people who do experience symptoms, it can take up to 30 days for initial symptoms to appear.

  • Can gonorrhea heal without treatment?

    Whether or not gonorrhea can go away without treatment has not been extensively studied. The information we have suggests that gonorrhea can persist in the body if it's not treated. One study, for example, showed that 16 females did not experience resolved gonorrhea without treatment. Another study in males showed that they carried the disease for at least six weeks, but the study could not conclude whether it would have resolved on its own after that time.

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13 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. U.S. Centers for Disease Control and Prevention. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR. Published July 23, 2021.

  2. Centers for Disease Control and Prevention. Detailed STD Facts—Gonorrhea. Last reviewed July 22, 2021.

  3. Sherrard J, Barlow D. Gonorrhoea in men: clinical and diagnostic aspects. Genitourin Med. 1996;72(6):422-6. doi:10.1136/sti.72.6.422

  4. Mallika P, Asok T, Faisal H, Aziz S, Tan A, Intan G. Neonatal conjunctivitis - a reviewMalays Fam Physician. 2008;3(2):77–81. Published 2008 Aug 31.

  5. Office on Women’s Health, U.S. Department of Health and Human Services. Pelvic inflammatory disease fact sheet. Updated April 1, 2019.


  6. Ochsendorf FR. Sexually transmitted infections: impact on male fertility. Andrologia. 2008;40(2):72-5. doi:10.1111/j.1439-0272.2007.00825.x

  7. McAnena L, Knowles SJ, Curry A, Cassidy L. Prevalence of gonococcal conjunctivitis in adults and neonatesEye (Lond). 2015;29(7):875–880. doi:10.1038/eye.2015.57

  8. UpToDate. Disseminated Gonococcal Infection. Updated June 17, 2018.

  9. Shetty A, Ribeiro D, Evans A, Linnane S. Gonococcal endocarditis: a rare complication of a common diseaseJ Clin Pathol. 2004;57(7):780–781. doi:10.1136/jcp.2003.015628

  10. Centers for Disease Control and Prevention. Which STD tests should I get? July 22, 2021.

  11. Michigan Medicine. Gonorrhea. Updated February 26, 2020.

  12. Stupiansky NW, Van Der Pol B, Williams JA, Weaver B, Taylor SE, Fortenberry JD. The natural history of incident gonococcal infection in adolescent womenSexually Transmitted Diseases. 2011;38(8):750-754. doi:10.1097/OLQ.0b013e31820ff9a4

  13. Handsfield HH, Lipman TO, Harnisch JP, Tronca E, Holmes KK. Asymptomatic gonorrhea in men: diagnosis, natural course, prevalence and significanceN Engl J Med. 1974;290(3):117-123. doi: 10.1056/NEJM197401172900301

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