Gonorrhea is a common bacterial infection spread through sexual contact, and it remains one of the most frequently reported infections in the United States. It can affect the genitals, rectum, and throat, and many infections, especially in women, cause no symptoms at all, letting the infection spread unnoticed. That silence can sound worrying, but gonorrhea is easy to detect with a simple urine or swab test, and a single dose of antibiotic treatment clears it in almost all cases. Because an untreated infection can lead to more serious problems over time, getting tested when it makes sense protects both you and your partners. This guide explains what gonorrhea is, its symptoms, causes, how it is diagnosed with a urine or swab test, the treatments available, and the latest research.
What is gonorrhea?
Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae, which grows on the moist mucous membranes of the body. It most often infects the cervix, urethra, rectum, and throat, and it can also infect the eyes, which is most serious when a newborn is exposed to it during birth. Because the bacteria can live in more than one body site at a time, a person can be infected in several places without realizing it.
Gonorrhea remains one of the most commonly reported infections in the United States, with the highest rates among people ages 15 to 24. Reported cases fell by about 10 percent in 2024 compared with 2023, the third consecutive annual decline, though the combined toll of chlamydia, gonorrhea, and syphilis still topped 2.2 million cases that year. The infection responds well to treatment, but rising antibiotic resistance means testing and prompt care remain essential.
Symptoms of gonorrhea
Many gonorrhea infections cause no symptoms at all, especially in women, which is exactly what allows the infection to spread without either partner realizing it. When symptoms do occur, they commonly include a burning feeling during urination and an unusual discharge from the vagina or penis. Women may also notice bleeding between periods, while men can develop pain or swelling in one testicle. An infection in the rectum can cause discharge, itching, soreness, or pain during bowel movements, though it often causes no symptoms either, and a throat infection picked up through oral sex is usually silent as well, which is one more reason screening matters more than waiting for symptoms to appear.
Left untreated, gonorrhea can lead to more serious problems. In women, the infection can travel upward into the reproductive organs and cause pelvic inflammatory disease, which raises the risk of infertility, ectopic pregnancy, and chronic pelvic pain. In men, it can cause epididymitis, a painful inflammation near the testicles that can rarely affect fertility. In rare cases the bacteria enter the bloodstream and cause a disseminated infection that can affect the joints and skin and, without treatment, become life-threatening. Gonorrhea also makes it easier to acquire or transmit HIV, which is one more reason clinicians often test for HIV at the same visit.
What causes gonorrhea and its risk factors
Gonorrhea spreads through vaginal, anal, or oral sex with a partner who has the infection; ejaculation is not necessary for it to pass from one person to another. A pregnant person can also pass the infection to their baby during childbirth, which is why prenatal screening is routine. Because the bacteria can infect the throat and rectum as well as the genitals, exposure through any type of sex can lead to infection at that site.
Risk rises with younger age, having a new or more than one sex partner, inconsistent condom use, and a personal history of gonorrhea or another sexually transmitted infection. Rates are also notably higher among gay and bisexual men. Because gonorrhea and chlamydia spread the same way and often occur together, testing for one usually means testing for the other, and understanding the symptoms and treatment of chlamydia rounds out the picture for anyone diagnosed with either infection.
How gonorrhea is diagnosed
Gonorrhea is diagnosed with a nucleic acid amplification test, or NAAT, which detects the bacteria’s genetic material and is the most sensitive method available. It can be run on a urine sample or on a swab from the cervix, vagina, urethra, rectum, or throat, and many clinics now let patients collect their own swab, which makes testing easier and less invasive. Culture, an older method that grows the bacteria in the lab, is still used at some sites and is essential whenever a sample needs further testing to see which antibiotics will still work against it.
| Test | What it tells you |
|---|---|
| NAAT (nucleic acid amplification test) | Detects gonorrhea genetic material from a urine sample or swab; the most sensitive and most widely used test |
| Culture | Grows the bacteria from a swab sample; needed to check which antibiotics will still work against it |
| Test of cure | A repeat test 7 to 14 days after treatment; recommended specifically for throat infections, which are more likely to fail treatment |
| STI co-testing | Testing done at the same visit for chlamydia and other infections, since risk factors and exposure often overlap |
CDC recommends annual gonorrhea and chlamydia screening for all sexually active women under 25, and for older women with risk factors, while sexually active gay and bisexual men should be tested at least once a year, and every three to six months if their risk is higher. Because a full sexual health visit commonly checks for several infections at once, reviewing a urine culture test shows how that kind of sample is processed in the lab, while recognizing the symptoms and causes of herpes and understanding an HIV test result help make sense of a fuller panel. Once results are back, knowing how to read the flags and reference ranges on a lab report makes it easier to see what a result means and what to ask your clinician next.
Treatment options for gonorrhea
Gonorrhea is treated with antibiotics, and cure rates for uncomplicated infection are high. Current guidance calls for a single 500 milligram injection of ceftriaxone into a muscle, a dose that was raised from 250 milligrams in 2020 as concern about resistance grew. If chlamydia has not been ruled out at the time of treatment, doctors typically add an oral antibiotic to treat that infection as well.
| Approach | Role |
|---|---|
| Ceftriaxone injection | A single 500 mg intramuscular dose; the recommended first-line treatment for uncomplicated gonorrhea |
| Additional antibiotic for chlamydia | Added when chlamydia co-infection has not been ruled out at the time of treatment |
| Partner treatment | Recent sex partners are tested and treated to prevent reinfection and further spread |
| Test of cure | Repeat testing 7 to 14 days after treatment, recommended specifically for throat infections |
Treating sex partners is a core part of care, since reinfection from an untreated partner is common and can undo successful treatment; anyone diagnosed with gonorrhea should let recent partners know so they can be tested and treated too. Because a growing share of Neisseria gonorrhoeae strains show reduced sensitivity to antibiotics, including early signs of reduced susceptibility to ceftriaxone itself, ongoing surveillance is used to catch resistant strains early, and anyone whose symptoms continue after treatment should be retested rather than assume the infection is gone. People treated for gonorrhea should avoid sex for seven days after finishing treatment and until their partners have completed treatment as well.
Living with gonorrhea and long-term outlook
With appropriate antibiotic treatment, gonorrhea clears completely in the large majority of cases, and most people have no lasting health effects. Because reinfection is common, especially when a partner goes untreated, the outlook is best when diagnosis comes early and both partners finish treatment before having sex again. Regular screening, rather than waiting for symptoms, is usually what catches the infection early enough to avoid complications such as pelvic inflammatory disease or epididymitis.
Living with the possibility of gonorrhea mostly comes down to ongoing prevention: using condoms consistently, talking openly with partners about testing, and getting screened on a regular schedule if you are sexually active, particularly if you are under 25, have a new or more than one partner, or are a gay or bisexual man. A gonorrhea diagnosis is common and treatable, and it says nothing about anyone’s character; treating it promptly and completing the full course of care protects both your own health and your partners’ health.
Latest scientific advances in gonorrhea research
Antibiotic resistance has made new gonorrhea treatments a public health priority, and two studies published in The Lancet in 2025 delivered the first new drug classes for gonorrhea in decades. According to PubMed-indexed research, a phase 3 trial of a single oral dose of the new antibiotic zoliflodacin found it cured 90.9 percent of uncomplicated genital gonorrhea infections, compared with 96.2 percent for the standard ceftriaxone-plus-azithromycin regimen, meeting the study’s threshold for non-inferiority (Luckey et al., 2025). What this means for you: this trial supported the drug’s approval in the United States as Nuzolvence, giving clinicians a needle-free oral option as older antibiotics become less reliable. A second phase 3 trial tested oral gepotidacin, taken as two doses ten to twelve hours apart, and found success in 92.6 percent of participants versus 91.2 percent for ceftriaxone plus azithromycin, meeting the same non-inferiority standard, though gastrointestinal side effects were somewhat more common (Ross et al., 2025). What this means for you: this study supported the approval of gepotidacin, sold as Blujepa, a second new oral option for people who cannot take the standard cephalosporin-based therapy, such as those with an allergy to it.
Prevention research has also advanced. According to PubMed-indexed research, a randomized trial of doxycycline taken after sex found that a single 200 milligram dose, taken within 72 hours of condomless sex, cut the combined rate of new gonorrhea, chlamydia, and syphilis infections by roughly two-thirds compared with standard care (Luetkemeyer et al., 2023). What this means for you: this trial is the evidence behind the doxycycline post-exposure prevention strategy, known as doxy-PEP, that CDC now recommends for gay and bisexual men and transgender women who have had a bacterial STI in the past year, although its effect against gonorrhea specifically is more modest than against chlamydia or syphilis, and researchers continue watching for signs of growing doxycycline resistance.
Glossary of key gonorrhea terms
| Term | Definition |
|---|---|
| Neisseria gonorrhoeae | The bacterium that causes gonorrhea. |
| NAAT | A highly sensitive lab test that detects bacterial genetic material from a urine sample or swab. |
| Culture | A lab test that grows bacteria from a sample so doctors can see which antibiotics will work. |
| Ceftriaxone | The antibiotic given as a single injection to treat gonorrhea. |
| Pelvic inflammatory disease | An infection of the female reproductive organs that can follow untreated gonorrhea or chlamydia. |
| Disseminated gonococcal infection | A rare complication in which the bacteria spread through the bloodstream to the joints and skin. |
| Test of cure | A repeat test after treatment, mainly used to confirm that a throat infection has cleared. |
Frequently asked questions about gonorrhea
What is gonorrhea and how do you get it?
Gonorrhea is a common bacterial sexually transmitted infection caused by Neisseria gonorrhoeae. It spreads through vaginal, anal, or oral sex with someone who has the infection, and a pregnant person can pass it to their baby during birth. It can infect the genitals, rectum, and throat.
What are the symptoms of gonorrhea in men versus women?
In men, gonorrhea often causes pain during urination, discharge from the penis, and sometimes pain or swelling in one testicle. In women, it can cause painful urination, unusual vaginal discharge, and bleeding between periods, though women are more likely than men to have no symptoms at all. Rectal and throat infections can occur in either sex and often cause few or no symptoms.
Can you have gonorrhea with no symptoms?
Yes, many gonorrhea infections cause no symptoms, especially in women and in throat infections in either sex. This is exactly why the infection can spread without anyone realizing it, which is why routine screening, rather than waiting for symptoms, is recommended for people at risk.
How is gonorrhea tested or diagnosed?
Gonorrhea is diagnosed with a NAAT, a highly sensitive test that detects the bacteria’s genetic material from a urine sample or a swab of the affected site. Culture, which grows the bacteria in a lab, is used at some sites and whenever antibiotic-susceptibility testing is needed.
How is gonorrhea treated, and what antibiotics are used?
The standard treatment is a single 500 milligram injection of the antibiotic ceftriaxone into a muscle. If chlamydia has not been ruled out, doctors often add an oral antibiotic, and sex partners should also be tested and treated to prevent reinfection.
Is gonorrhea curable, and can you get it again?
Yes, gonorrhea is curable with the right antibiotic treatment, and most infections clear completely. Having gonorrhea once does not protect you from getting it again, so reinfection is common, especially if a partner is not treated at the same time or exposure continues.
Sources
- Centers for Disease Control and Prevention — About Gonorrhea — CDC, 2024 — cdc.gov
- Mayo Clinic — Gonorrhea: Symptoms and Causes — Mayo Clinic, 2023 — mayoclinic.org
- Centers for Disease Control and Prevention — Gonorrhea Treatment Guidelines — CDC Sexually Transmitted Infections Treatment Guidelines, 2021 — cdc.gov
- Luckey A, Balasegaram M, Barbee LA, et al. — Zoliflodacin versus ceftriaxone plus azithromycin for treatment of uncomplicated urogenital gonorrhoea: an international, randomised, controlled, open-label, phase 3, non-inferiority clinical trial — The Lancet, 2025 — doi.org/10.1016/S0140-6736(25)01953-1
- Ross JDC, Wilson J, Workowski KA, et al. — Oral gepotidacin for the treatment of uncomplicated urogenital gonorrhoea (EAGLE-1): a phase 3 randomised, open-label, non-inferiority, multicentre study — The Lancet, 2025 — doi.org/10.1016/S0140-6736(25)00628-2
- Luetkemeyer AF, Donnell D, Dombrowski JC, et al. — Postexposure Doxycycline to Prevent Bacterial Sexually Transmitted Infections — New England Journal of Medicine, 2023 — doi.org/10.1056/NEJMoa2211934
Further reading
- See how a related infection compares in this guide to chlamydia symptoms and treatment.
- Learn what a lab detects in a urine sample with this guide to understanding a urine culture.
- Compare symptoms across common infections in this guide to herpes symptoms and causes.
- Understand another infection often tested for at the same visit in this guide to interpreting an HIV test result.
- Build confidence reading test results with this guide to reference ranges, flags, and next steps on a lab report.
Understand your lab results with BloodSense
Gonorrhea care almost always starts with a single lab result: a positive or negative NAAT from a urine sample or swab. Because testing frequently covers chlamydia, HIV, and other infections in the same panel, a lab report from a sexual health visit can include several results at once, each with its own reference range and its own next step. BloodSense translates a full lab report into plain language, explaining what each result means and what questions to bring to your clinician, whether you are being screened for the first time, confirming that treatment worked, or reviewing results for several infections at once.
