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No one wants to think about contracting sexually transmitted infections and diseases. Yet, they’re extremely common—many men and women will experience one at some point in their lifetimes. Many STIS, gonorrhea included, rarely show any obvious symptoms. So, understanding how to prevent these conditions, along with how they are diagnosed and treated, is one of the best ways to avoid any long-term problems.
What is gonorrhea?
Gonorrhea is a sexually transmitted disease (STD) that affects both men and women. Caused by the bacteria Neisseria gonorrhoeae, more than 550,000 cases were reported in 2017 alone across the United States. Most commonly spread through sexual contact, some people who carry the infection show no symptoms. Others may experience symptoms including, but not limited to, a burning sensation during urination or abnormal discharge from the penis or vagina. Fortunately, most cases of gonorrhea are curable with antibiotics, although some studies show the bacteria are becoming increasingly resistant to treatment, which makes prevention even more essential.
How is gonorrhea diagnosed?
Gonorrhea (or systemic gonococcal infection) is transmitted through sexual activities, including oral, anal, or vaginal sex, with a person carrying the infection. Risk of contracting the infection increases if you participate in unprotected sex with no condom.
It is essential for sexually active people to get regularly screened and tested for STDs and STIs. “Not everyone with gonorrhea will have symptoms. In fact, more than half of infected persons may show no symptoms and be unaware of the infection. This is the reason that sexually active individuals, especially young ones and multiple partners, should have testing done frequently,” says Amir G Nasseri, MD, FACOG, an obstetrician-gynecologist (OB-GYN) that specializes in STI treatment and diagnosis at Her Choice Women’s Clinic in Santa Ana, California.
Although many infected people show no symptoms of a gonorrhea infection, there are some signs that could lead to diagnosis. These symptoms include:
In men
- Sore throat
- Increased frequency or urgency to urinate
- Swelling or redness on the head of the penis
- Discolored discharge from the penis
- Tender or swollen testicles
- Conjunctivitis
In women
- Sore throat
- Discolored or excessive vaginal discharge
- Pain during sex
- Sharp pain in the lower abdomen
- Increased urgency of urination
- Stinging or pain while urinating
- Conjunctivitis
Given many of the symptoms are similar to those of other infectious diseases, like chlamydia, it can make them more difficult to identify. This is why symptoms alone are rarely enough to diagnose gonorrhea.
RELATED: Chlamydia treatment and medication
It’s unlikely you’ll need to visit a specialist to diagnose and treat gonorrhea, as your family doctor or general practitioner can perform necessary tests and prescribe treatment. In the United States, you may find state-funded health clinics that provide free testing and treatment for gonorrhea.
When you do go to see your doctor, here are some questions that might help make an accurate diagnosis:
- Are you taking any medications?
- What is your medical history?
- Are you sexually active?
- Do you have unprotected sex?
- Have you been exposed to any STDs?
- What symptoms have you experienced?
- When did these symptoms start?
- Are your symptoms continuous or sporadic?
As uncomfortable as it can be to speak with a doctor about personal issues, it’s important to be open and answer questions honestly. They’re there to help, and the more information they have, the better treatment they can provide so you can get back to your healthiest self.
Some questions you may want to ask your doctor include:
- What tests do I need?
- Should my partner also be tested?
- Will the tests uncover any other sexually transmitted diseases or infections like chlamydia?
- When can I start having sex again?
- What are the treatment options available?
- Can I prevent this going forward?
- What are the risks of leaving any STDs untreated?
After a thorough discussion of your medical history, it’s likely your doctor will perform a physical examination to check for any abnormalities and rule out other causes and infections.
In order to diagnose gonorrhea, your healthcare provider will likely perform a simple few tests:
- Fluid swabs from potentially infected areas including the penis, vagina, and mouth
- A urine test to check for any bacteria (specifically gonorrhea)
Test results are usually available in 24 hours to three days. After an infection is confirmed, your doctor will prescribe a treatment plan and schedule any necessary follow-ups.
Gonorrhea treatment options
After you’re diagnosed with gonorrhea, your doctor will explain the different treatment options available. This sexually transmitted disease can be cured with antibiotics. The most common treatment is a single antibiotic injection of ceftriaxone and a single dose of oral azithromycin, according to the Centers for Disease Control and Prevention (CDC) treatment guidelines.
Currently, there are no at-home treatments to cure gonorrhea. It is strongly advised that you get care from a doctor.
If left untreated, gonorrhea can cause long term health complications. In women, it is one of the leading causes of pelvic inflammatory disease (PID). This occurs when the infection moves up from the vagina to the reproductive tract, and into the ovaries, uterus, and fallopian tubes. PID can cause damage to the reproductive system, as well as severe abdominal pain. It may cause infertility or ectopic pregnancies.
A pregnant woman infected with gonorrhea can pass the infection onto a newborn.
Both men and women can also experience blood infections from untreated gonorrhea, resulting in heart valve damage, arthritis, and inflammation of the spinal cord. These conditions are rare, and avoidable by seeking diagnosis and treating gonorrhea with antibiotics as soon as possible.
Gonorrhea medications
Two drug classes that are most popularly prescribed to cure and treat gonorrhea are cephalosporin and macrolide antibiotics.
Cephalosporin antibiotics
Cephalosporins are part of a class of antibiotics called beta-lactams that kill bacteria. Ceftriaxone, commonly known by its brand name Rocephin, is the most commonly used drug in this class to treat gonorrhea. Usually taken as a single dose, a doctor will inject it either into a vein (IV) or large muscle (IM) like the buttock. Some side effects include tenderness at the injection site, shortness of breath, diarrhea, rash, nausea, or vomiting. If you experience any of these side effects or otherwise do not feel well after taking ceftriaxone, contact a doctor immediately.
Up until 2012, cephalosporin was prescribed orally for gonorrhea. But according to a Morbidity and Mortality Weekly Report (MMWR), the CDC updated it's sexually transmitted diseases treatment guidelines to replace oral doses with combination therapy with a single intramuscular dose of ceftriaxone 250 mg plus either a single dose of azithromycin 1 g orally or doxycycline 100 mg orally twice daily for 7 days.
Cephalosporin antibiotics are the first-line treatment for gonorrhea, as the bacteria have developed antibiotic resistance to most other options.
Macrolide antibiotics
Another class of antibiotics commonly used to treat gonorrhea are macrolide antibiotics, specifically azithromycin (brand name Zithromax). Macrolides work by stopping the growth of bacteria. Taken as a tablet along with a ceftriaxone injection, a single dose is often all that is required to treat gonorrhea. If you vomit within an hour of taking your azithromycin tablet, contact your doctor immediately to determine if you require another dose. Like all drugs, there is the risk of side effects. Some side effects include, but are not limited to, nausea, headache, and diarrhea. More severe side effects can include rash, swelling, or vomiting. If you experience any of these or other side effects after taking this medication, seek out medical help immediately.
Tetracycline antibiotics
Like macrolide antibiotics, tetracycline antibiotics are taken as a single dose tablet in conjunction with an antibiotic injection of ceftriaxone. It, too, stops the growth of bacteria. The generic drug doxycycline is used to treat gonorrhea, with brand name Vibramycin also available. Side effects include headache, nausea, and rash.
What is the best medication for gonorrhea?
There are a few antibiotics available to treat gonorrhea, but only your doctor will be able to determine which option is best for you. Your healthcare provider will make an evaluation based on your medical condition, medical history, and medications you may already be taking that could interact with gonorrhea medication. Your physician will also monitor your response to treatment in case any adjustments need to be made.
| Best medications for gonorrhea | ||||
|---|---|---|---|---|
| Drug name | Drug class | Administration route | Standard dosage | Common side effects |
| Rocephin (ceftriaxone sodium) | Cephalosporin antibiotics | Injection | Single-dose 250 mg injected either intravenously or intramuscularly | Nausea, diarrhea, swelling at the injection site |
| Zithromax (azithromycin) | Macrolide antibiotics | Oral tablet | Single-dose 1 g tablet taken in conjunction with a single dose of ceftriaxone | Diarrhea, vomiting, headache |
| Vibramycin (doxycycline) | Tetracycline antibiotics | Oral tablet | 100 mg oral tablet taken twice daily for 7 days in conjunction with a single dose of ceftriaxone | Nausea, vomiting, diarrhea |
Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.
What are common side effects of gonorrhea medication?
As with any medication, there is always a risk of side effects. There are many similar side effects across the different classes of antibiotics used to treat gonorrhea. Although rare, the most common side effects are:
- Headache
- Nausea
- Vomiting
- Stomach pain
- Indigestion
- Bloating
Other serious side effects of antibiotics include:
- Fever
- Rash
- Shortness of breath or trouble breathing
This is not a full list of all potential side effects. You should always speak to a healthcare professional about the risks before starting a new medication.
If you think you may be experiencing side effects from your antibiotics, seek medical advice immediately.
How to treat gonorrhea at home
Currently, there are no at-home remedies to treat gonorrhea, so we strongly advise you seek professional medical advice to avoid long term damage. Although some people may claim garlic and apple cider vinegar can cure gonorrhea, these are old wives’ tales that should be ignored.
That said, there are a few things you can do to avoid either getting gonorrhea in the first place or contracting the infection again.
How to prevent gonorrhea
Here are some ways you can prevent gonorrhea:
- Abstain from sexual intercourse
- Always use condoms when engaging in sexual activity, be it vaginal, anal, or oral
- Engage in sexual activities only with partners that have tested negative for the infection
- If you are sexually active, get tested regularly for sexually transmitted diseases and infections so they can be treated and prevent spreading to sexual partners
Due to increased exposure, you are at increased risk of contracting the infection if you participate in unprotected sex with multiple partners.
RELATED: Why you should get the HPV vaccine even in your 30s or 40s
Frequently asked questions about gonorrhea
What is the best treatment for gonorrhea?
Gonorrhea can be cured with antibiotics prescribed by your doctor. Your healthcare provider will be able to advise on the best course of medication based on your medical history and condition.
Which antibiotic is best for gonorrhea?
Per CDC recommendations, many doctors prescribe dual therapy, including an injection of ceftriaxone, plus a tablet of either azithromycin or a treatment course of doxycycline. The CDC recommends a single dose of azithromycin, which has been shown to be effective. Only your doctor can determine which antibiotic is best for you based on your medical history and condition.
How can I get rid of gonorrhea fast?
Speak to your doctor, who will prescribe the most appropriate treatment of antibiotics. Gonorrhea should clear up quickly with effective antibiotic treatment.
How long does it take for gonorrhea to clear up?
Symptoms can clear up within 1-2 days of taking antibiotics; however, it may take up to two weeks for any pain in your pelvis of testicles to dissipate. It is recommended you are retested one week after taking antibiotics to confirm you are clear of the infection.
Can gonorrhea go away on its own?
It is unclear if gonorrhea can go away on its own. If left untreated, it can cause painful complications and severe, permanent damage to reproductive organs. It can, however, be cured with antibiotics.
What happens if you don’t treat gonorrhea?
If left untreated, gonorrhea can cause permanent damage to both male and female reproductive organs, leading to infertility. It can also cause severe abdominal pain.