10 Common Gonorrhea Symptoms You Should Know About

Gonorrhea is one of the most common sexually transmitted infections (STIs) worldwide, affecting millions of people each year. Caused by the bacterium Neisseria gonorrhoeae, this infection can affect the genitals, rectum, and throat. What makes gonorrhea particularly concerning is that many people infected with this STI may not experience noticeable symptoms, allowing the infection to spread unknowingly and potentially cause serious health complications if left untreated.

Understanding the symptoms of gonorrhea is crucial for early detection and prompt medical attention. While some individuals may be asymptomatic, others experience distinct signs that indicate infection. The symptoms can vary significantly between men and women, and can also differ depending on which part of the body is infected. This comprehensive guide will walk you through the most common symptoms of gonorrhea, helping you recognize the warning signs and take appropriate action.

1. Painful or Burning Sensation During Urination

One of the hallmark symptoms of gonorrhea is a painful or burning sensation when urinating, medically known as dysuria. This symptom occurs because the bacteria infects the urethra, causing inflammation and irritation of the urinary tract. The burning sensation can range from mild discomfort to severe pain that makes urination extremely uncomfortable.

In men, this symptom typically appears within 2-14 days after exposure and is often one of the first noticeable signs of infection. Women may also experience this symptom, though it can be less pronounced or mistaken for a urinary tract infection (UTI). The pain usually occurs at the beginning of urination and may persist throughout the process. If you experience persistent pain or burning during urination, especially following unprotected sexual contact, it’s important to seek medical evaluation promptly.

2. Abnormal Discharge from the Genitals

Unusual discharge from the penis or vagina is another prominent symptom of gonorrhea. The characteristics of this discharge can help identify the infection, though medical testing is always necessary for confirmation.

In men: The discharge from the penis is typically thick, cloudy, and may appear white, yellow, or greenish in color. The amount can vary from a small drop to more substantial discharge. This usually begins within a few days to two weeks after infection and may be accompanied by crusting at the opening of the penis, particularly noticeable in the morning.

In women: Vaginal discharge may increase in volume and change in consistency or color. It may appear watery, creamy, or slightly green. However, because vaginal discharge can vary naturally throughout the menstrual cycle, this symptom is often overlooked or attributed to other causes, making gonorrhea harder to detect in women.

3. Testicular Pain and Swelling

Men with gonorrhea may experience pain, tenderness, or swelling in one or both testicles, a condition known as epididymitis. This occurs when the infection spreads from the urethra to the epididymis, the coiled tube at the back of the testicle that stores and carries sperm. The affected testicle may feel warm to the touch and appear visibly swollen.

Testicular pain associated with gonorrhea can range from a dull ache to sharp, severe pain that may worsen with movement or pressure. Some men may also notice swelling in the scrotum. This symptom should never be ignored, as untreated epididymitis can lead to serious complications, including abscess formation, chronic pain, and potentially infertility. Any unexplained testicular pain or swelling warrants immediate medical attention to rule out gonorrhea and other serious conditions.

4. Pelvic or Lower Abdominal Pain in Women

Women with gonorrhea may experience pain in the lower abdomen or pelvic region. This symptom often indicates that the infection has spread beyond the cervix to the upper reproductive organs, including the uterus, fallopian tubes, and ovaries—a serious condition called pelvic inflammatory disease (PID).

The pain may be constant or intermittent, ranging from mild cramping to severe, debilitating discomfort. Some women describe it as a deep, dull ache in the pelvic area, while others experience sharp pains. The pain may worsen during sexual intercourse, bowel movements, or menstruation. Additional symptoms accompanying pelvic pain may include fever, nausea, and abnormal vaginal bleeding. Pelvic inflammatory disease can cause permanent damage to the reproductive system, leading to chronic pelvic pain, ectopic pregnancy, and infertility, making prompt medical evaluation essential.

5. Bleeding Between Periods or After Intercourse

Abnormal vaginal bleeding is a significant symptom of gonorrhea in women that should not be ignored. This may manifest as spotting or bleeding between menstrual periods, heavier periods than usual, or bleeding after sexual intercourse. The bleeding occurs due to inflammation and irritation of the cervix caused by the bacterial infection.

Gonorrhea can cause cervicitis (inflammation of the cervix), which makes the cervical tissue more fragile and prone to bleeding, especially during or after sexual activity. Some women may also notice bleeding after gynecological examinations. While abnormal vaginal bleeding can have various causes, when combined with other symptoms such as unusual discharge or pelvic pain, it strongly suggests a possible STI. Any unexplained vaginal bleeding should be evaluated by a healthcare provider to determine the underlying cause and receive appropriate care.

6. Rectal Symptoms and Discomfort

Gonorrhea can infect the rectum through anal intercourse or, in some cases, through the spread of bacteria from the genital area. Rectal gonorrhea often produces no symptoms, but when symptoms do occur, they can be quite uncomfortable and concerning.

Common rectal symptoms include:

• Anal itching or irritation
• Rectal discharge that may be thick, mucus-like, or contain pus
• Pain or discomfort during bowel movements
• Rectal bleeding or spotting
• Soreness around the anal area
• Constipation or feeling of incomplete bowel evacuation

These symptoms are sometimes mistaken for hemorrhoids or other common rectal conditions, which can delay proper diagnosis and treatment. Both men and women can develop rectal gonorrhea, and it’s important to inform your healthcare provider about all types of sexual contact to ensure appropriate testing and care.

7. Sore Throat and Oral Symptoms

Gonorrhea can infect the throat through oral sexual contact with an infected partner, resulting in pharyngeal gonorrhea or gonorrhea throat. This form of the infection is often asymptomatic, but when symptoms do appear, they can mimic common throat conditions, making diagnosis challenging without proper testing.

Symptoms of gonorrhea throat may include:

• Persistent sore throat that doesn’t improve with typical remedies
• Redness and inflammation of the throat and tonsils
• Difficulty or pain when swallowing
• Swollen lymph nodes in the neck
• White spots or patches on the tonsils
• Hoarseness or changes in voice

Because these symptoms are similar to those caused by viral or bacterial infections like strep throat, pharyngeal gonorrhea is frequently misdiagnosed or overlooked. The infection can persist in the throat for months without treatment and can be transmitted to others through kissing or oral sex. If you have a persistent sore throat and have engaged in oral sexual activity, it’s important to request specific testing for gonorrhea.

8. Eye Infection and Discharge

Though less common, gonorrhea can infect the eyes, causing a condition called gonococcal conjunctivitis or ophthalmia. This typically occurs when infected genital or rectal fluids come into contact with the eyes through touching or rubbing. Newborns can also develop eye infections if exposed to gonorrhea during childbirth from an infected mother.

Symptoms of gonococcal eye infection include:

• Redness and swelling of the eye and eyelids
• Thick, purulent (pus-like) discharge from the eye, which may be yellow or green
• Crusting of the eyelids, especially after sleep
• Eye pain or discomfort
• Sensitivity to light
• Blurred vision or vision changes

Gonococcal conjunctivitis is a serious condition that requires immediate medical attention, as it can cause permanent eye damage and vision loss if not treated promptly. The infection can spread rapidly and affect the deeper structures of the eye, including the cornea. If you develop eye symptoms along with other signs of gonorrhea or after potential exposure, seek urgent medical care.

9. Joint Pain and Swelling

In rare cases, gonorrhea bacteria can enter the bloodstream and spread throughout the body, causing a serious condition called disseminated gonococcal infection (DGI). One of the primary manifestations of DGI is joint pain and swelling, known as septic arthritis or gonococcal arthritis.

This condition typically affects one or more joints, most commonly the knees, ankles, wrists, and elbows. The affected joint becomes painful, swollen, warm to the touch, and difficult to move. The pain is often severe and may be accompanied by fever and general feelings of illness. Some people may also develop a skin rash with small red or purple spots or pustules, particularly on the extremities.

Disseminated gonococcal infection is more common in women than men and can occur even when genital symptoms are minimal or absent. This serious complication requires immediate medical attention and aggressive treatment to prevent permanent joint damage and other severe health consequences. Any unexplained joint pain, swelling, and fever, particularly in sexually active individuals, should be evaluated promptly.

10. Asymptomatic Infection (No Visible Symptoms)

Perhaps the most concerning aspect of gonorrhea is that many infected individuals experience no symptoms at all, particularly in the early stages of infection. This is especially common in women, where up to 50% of infections may be asymptomatic, though men can also have no noticeable symptoms.

An asymptomatic infection means that the bacteria is present and active in the body, but produces no obvious signs or discomfort. During this time, the infected person can unknowingly transmit gonorrhea to sexual partners and may develop serious complications without realizing they need treatment. The infection continues to damage reproductive organs and other tissues silently.

This is why regular STI screening is crucial for sexually active individuals, especially those with multiple partners or those who engage in unprotected sex. Even without symptoms, gonorrhea can cause:

• Pelvic inflammatory disease in women
• Epididymitis in men
• Infertility in both sexes
• Increased risk of HIV transmission
• Disseminated infection affecting joints and other organs

Don’t wait for symptoms to appear before getting tested. Routine screening is the best way to detect and treat gonorrhea early, preventing complications and transmission to others.

Main Causes of Gonorrhea

Gonorrhea is caused exclusively by the bacterium Neisseria gonorrhoeae, which is transmitted through specific routes of infection. Understanding how gonorrhea spreads is essential for prevention and risk reduction.

Primary Transmission Routes:

Unprotected Sexual Contact: The primary cause of gonorrhea transmission is unprotected vaginal, anal, or oral sex with an infected partner. The bacteria lives in warm, moist environments and is transmitted through contact with infected genital fluids, including semen, vaginal fluids, and pre-ejaculatory fluid. Even brief contact can result in transmission.

Multiple Sexual Partners: Having multiple sexual partners or a partner who has multiple partners significantly increases the risk of exposure to gonorrhea. The more sexual partners you have, the higher your likelihood of encountering someone with an active infection.

Previous STI History: Having had gonorrhea or another sexually transmitted infection in the past increases your risk of contracting it again. Previous infection does not provide immunity, and reinfection is common, especially if sexual behaviors don’t change.

Mother-to-Child Transmission: Pregnant women with gonorrhea can pass the infection to their babies during childbirth as the infant passes through the infected birth canal. This can cause serious eye infections and other health problems in newborns.

Lack of Protection: Not using condoms or dental dams during sexual activity leaves individuals vulnerable to infection. Barrier methods are the most effective way to prevent the transmission of gonorrhea and other STIs during sexual contact.

Young Age: Sexually active teenagers and young adults (ages 15-24) have the highest rates of gonorrhea infection, likely due to a combination of biological factors, multiple partners, inconsistent condom use, and barriers to accessing sexual health services.

Prevention Strategies

Preventing gonorrhea involves a combination of safer sexual practices, regular testing, and open communication with partners. Here are the most effective strategies to protect yourself and others:

Use Barrier Protection Consistently: Proper and consistent use of condoms during vaginal, anal, and oral sex is one of the most effective ways to prevent gonorrhea transmission. Use latex or polyurethane condoms for penis-involved activities and dental dams for oral-vaginal or oral-anal contact. Make sure to use condoms from start to finish of any sexual activity, not just before ejaculation.

Get Regular STI Screening: Regular testing is crucial, especially for sexually active individuals under 25, those with multiple partners, or anyone with a new sexual partner. Annual gonorrhea screening is recommended for sexually active women under 25 and for men who have sex with men. More frequent testing may be appropriate depending on your sexual activity and risk factors.

Maintain Mutual Monogamy: Being in a long-term mutually monogamous relationship with a partner who has tested negative for STIs significantly reduces your risk of gonorrhea and other STIs. Both partners should be tested before beginning an exclusive sexual relationship.

Communicate with Sexual Partners: Have open, honest conversations with your partners about sexual health, STI testing history, and the use of protection. Ask about their STI status and share your own. This communication should happen before engaging in sexual activity.

Limit Number of Sexual Partners: Reducing the number of sexual partners decreases your overall risk of exposure to gonorrhea and other STIs. Being selective about partners and understanding their sexual health history is an important preventive measure.

Avoid Sharing Sex Toys: If you use sex toys, avoid sharing them with partners, or ensure they are thoroughly cleaned and covered with a new condom between uses and between partners.

Seek Prompt Treatment: If you test positive for gonorrhea or have been exposed to someone with the infection, seek medical care immediately. Complete the entire course of prescribed treatment and abstain from sexual activity until you and your partner(s) have been successfully treated and retested to confirm the infection is gone.

Notify Sexual Partners: If you’re diagnosed with gonorrhea, it’s essential to inform all recent sexual partners so they can get tested and treated if necessary. Many health departments offer partner notification services that can help with this process anonymously.

Pregnant Women Should Get Tested: All pregnant women should be tested for gonorrhea during their first prenatal visit. Those at increased risk should be retested during the third trimester to prevent transmission to the baby during delivery.

Frequently Asked Questions

How soon do gonorrhea symptoms appear?

Symptoms typically appear within 2 to 14 days after exposure, though some people may not develop noticeable symptoms for weeks or may remain asymptomatic. Men usually notice symptoms sooner than women, often within 2-5 days after infection.

Can gonorrhea go away on its own without treatment?

No, gonorrhea will not go away without proper medical treatment. The infection will persist and can lead to serious health complications, including infertility, pelvic inflammatory disease, and increased risk of HIV transmission. Antibiotic treatment prescribed by a healthcare provider is necessary to cure the infection.

What is the difference between gonorrhea symptoms in men and women?

Men are more likely to have noticeable symptoms, particularly painful urination and penile discharge. Women often have milder or no symptoms, which can include vaginal discharge, pelvic pain, and abnormal bleeding. Women are also at higher risk for developing serious complications like pelvic inflammatory disease due to delayed diagnosis.

Can you have gonorrhea without any symptoms?

Yes, many people with gonorrhea have no symptoms at all, especially women. Up to 50% of women and 10% of men with gonorrhea are asymptomatic. This is why regular STI screening is important for sexually active individuals, even when feeling perfectly healthy.

Can gonorrhea infect the throat?

Yes, gonorrhea can infect the throat through oral sexual contact with an infected partner. Throat infections often produce no symptoms but can cause persistent sore throat, difficulty swallowing, and throat redness. Pharyngeal gonorrhea requires specific testing and treatment.

How is gonorrhea diagnosed?

Gonorrhea is diagnosed through laboratory testing of samples collected from potentially infected areas. This may include urine tests or swabs from the urethra, cervix, rectum, or throat. Nucleic acid amplification tests (NAATs) are the most sensitive and commonly used diagnostic method. Results are typically available within a few days.

Can gonorrhea come back after treatment?

Yes, you can get gonorrhea again after successful treatment. Having gonorrhea once does not provide immunity against future infections. Reinfection is common, especially if sexual partners are not treated simultaneously or if safe sex practices are not followed. It’s important to get retested 3 months after treatment to check for reinfection.

Is gonorrhea more serious in women than men?

While gonorrhea can affect both sexes seriously, women face higher risks of complications due to the infection often being asymptomatic, leading to delayed diagnosis and treatment. Untreated gonorrhea in women can cause pelvic inflammatory disease, ectopic pregnancy, chronic pelvic pain, and infertility.

Can gonorrhea affect fertility?

Yes, untreated gonorrhea can lead to infertility in both men and women. In women, the infection can spread to the reproductive organs, causing scarring and blockage of the fallopian tubes. In men, it can cause epididymitis, which may affect sperm production and transport. Early detection and treatment can prevent these complications.

Should my partner get tested if I have gonorrhea?

Absolutely. All sexual partners from the past 60 days (or the most recent partner if longer than 60 days) should be tested and treated for gonorrhea, even if they have no symptoms. This prevents reinfection and stops the spread of the infection to others. Both you and your partner should avoid sexual contact until treatment is completed and follow-up testing confirms the infection is gone.

References:

• Centers for Disease Control and Prevention (CDC) – Gonorrhea Fact Sheet
• World Health Organization (WHO) – Sexually Transmitted Infections
• Mayo Clinic – Gonorrhea Symptoms and Causes
• NHS – Gonorrhoea
• Planned Parenthood – Gonorrhea