Gonorrhea is an STI that is caused by the bacteria Neisseria gonorrhoeae. It is an especially serious problem for women because it can damage the female reproductive organs.

In 2014, gonorrhea affected more than 162,000 women in the United States.¹ Gonorrhea most often affects women ages 15 to 24. But, gonorrhea is becoming more common in older women too.¹

Gonorrhea is spread through:

• Vaginal, oral, or anal sex. Gonorrhea can be spread even if there are no symptoms. This means you can get gonorrhea from someone who has no signs or symptoms.
• Genital touching. A man does not need to ejaculate (come) for gonorrhea to spread. Touching infected fluids from the vagina or penis and then touching your eyes can cause an eye infection. Gonorrhea can also be passed between women who have sex with women.
• Childbirth from woman to her baby

Most women with gonorrhea do not have any signs or symptoms. If you do get symptoms, they are often mild and can be mistaken for a bladder or vaginal infection.

Signs or symptoms of gonorrhea depend on where you are first infected by the gonorrhea bacteria.

Signs and symptoms in the genital area can include:

• Pain or burning when urinating
• More vaginal discharge than usual
• Vaginal discharge that looks different than usual
• Bleeding between periods
• Pain in the pelvis or abdomen

Signs and symptoms in other parts of the body include:

• Rectum/anus: anal itching, pus-like discharge, bright red blood on toilet tissue, or painful bowel movements
• Eyes: pain, itching, sensitivity to light, pus-like discharge
• Throat: sore throat, swollen glands in your neck
• Joints (such as your knee): warmth, redness, swelling, or pain while moving

Gonorrhea can cause serious health problems, even if you do not have any signs or symptoms.

• If you are 24 or younger and have sex, you need to get tested for gonorrhea. Gonorrhea is most common in women between ages 15 and 24.² You need to get tested if you have had any symptoms of gonorrhea since your last negative test result or if your sex partner has gonorrhea.
• If you are older than 24, you need to get tested if, in the past year or since your last test, you:²
  • Had a new sex partner
  • Had your sex partner tell you they have gonorrhea
  • Have had gonorrhea or another STI in the past
  • Traded sex for money or drugs in the past
  • Do not use condoms during sex and are in a relationship that is not monogamous, meaning you or your partner has sex with other people

You also need to get tested if you have any symptoms of gonorrhea.

Testing is very important, because women with untreated gonorrhea can develop serious health problems. If you are tested for gonorrhea, you also need to get tested for other STIs, including chlamydia, syphilis, and HIV.

There are two ways that a doctor or nurse tests for gonorrhea:

• A urine test. This is the most common. You urinate (pee) into a cup. Your urine is then tested for gonorrhea.
• A swab test. Your doctor or nurse uses a cotton swab to take a fluid sample from an infected place (cervix, rectum, or throat). The fluid is then tested for gonorrhea.

A Pap test is not used to detect gonorrhea.

Your doctor or nurse will give you antibiotics to treat gonorrhea. The antibiotics are usually a pill you swallow.

Although antibiotics can cure gonorrhea, they cannot fix any permanent damage done to your body. For this reason, it is important to get tested and to take the antibiotics as soon as possible.

For the antibiotics to work, you must finish all of the antibiotics that your doctor gives you, even if the symptoms go away. Do not share your antibiotics for gonorrhea with anyone. If symptoms do not go away after treatment, see your doctor or nurse. It is possible to get gonorrhea again if you have sex with someone who has gonorrhea. Tell your recent sex partner(s) so they can be tested and treated.

Gonorrhea that is not treated can cause serious health problems in women:³

• Pelvic inflammatory disease (PID), an infection of a woman's reproductive organs. PID can lead to chronic pelvic pain, pregnancy problems, and infertility, meaning you can't get pregnant. Untreated gonorrhea is a common cause of PID.
• Higher risk of getting HIV or spreading HIV
• Although it does not happen very often, gonorrhea can cause widespread infection in other parts of the body, such as the blood, joints, heart, or brain. This can lead to death.

Gonorrhea is easy to treat. But you need to get tested and treated as soon as possible.

If you have gonorrhea:

• See a doctor or nurse as soon as possible. Antibiotics will treat gonorrhea, but they will not fix any permanent damage to your reproductive organs.
• Take all of the antibiotics. Even if symptoms go away, you need to finish all of the antibiotics.
• Tell your sex partner(s) so they can be tested and treated. If they are not tested and treated you could get gonorrhea again.
• Avoid sexual contact until you and your partner(s) have been treated and cured. Even after you finish your antibiotics, you can get gonorrhea again if you have sex with someone who has gonorrhea.
• See your doctor or nurse again if you have symptoms that don't go away within a few days after finishing the antibiotics.

For pregnant women, untreated gonorrhea raises the risk of:

• Miscarriage
• Premature birth (babies born before 37 weeks of pregnancy). Premature birth is the most common cause of infant death and can lead to long-term health and developmental problems in children.⁴
• Low birth weight
• Water breaking too early. This can lead to premature birth.

Babies born to infected mothers are at risk for:

• Blindness. Treating the newborn's eyes with medicine right after birth can prevent eye infection. The U.S. Preventive Services Task Force strongly recommends — and most states require by law — that all babies be treated with medicated eye ointments soon after birth.⁵
• Joint infection
• Life-threatening blood infection

Treatment of gonorrhea as soon as it is found in pregnant women will lower the risk of these problems for both mother and baby. Your baby will get antibiotics if you have gonorrhea or if your baby has a gonorrheal eye infection.

The best way to prevent gonorrhea or any STI is to not have vaginal, oral, or anal sex.

If you do have sex, lower your risk of getting an STI with the following steps:

• Use condoms. Condoms are the best way to prevent STIs when you have sex. Because a man does not need to ejaculate (come) to give or get gonorrhea, make sure to put the condom on before the penis touches the vagina, mouth, or anus. Other methods of birth control, like birth control pills, shots, implants, or diaphragms, will not protect you from STIs.
• Get tested. Be sure you and your partner are tested for STIs. Talk to each other about your test results before you have sex.
• Be monogamous. Having sex with just one partner can lower your risk for STIs. After being tested for STIs, be faithful to each other. That means that you have sex only with each other and no one else.
• Limit your number of sex partners. Your risk of getting STIs goes up with the number of partners you have.
• Do not douche. Douching removes some of the normal bacteria in the vagina, and may increase your risk of getting STIs.
• Do not abuse alcohol or drugs. Drinking too much alcohol or using drugs increases risky behavior and may put you at risk of sexual assault and possible exposure to STIs.

The steps work best when used together. No single step can protect you from every single type of STI.

Yes. It is possible to get gonorrhea, or any other STI, if you are a woman who has sex only with women.

Talk to your partner about her sexual history before having sex, and ask your doctor about getting tested if you have signs or symptoms of gonorrhea.

For more information about gonorrhea, call the OWH Helpline at 1-800-994-9662 or contact the following organizations:

• National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), CDC, HHS
  Phone Number: 800-232-4636
• National Institute of Allergy and Infectious Diseases (NIAID), NIH, HHS
  Phone Number: 866-284-4107 (TDD: 800-877-8339)
• American Sexual Health Association
  Phone Number: 800-227-8922
• Planned Parenthood
  Phone Number: 800-230-7526

1. Centers for Disease Control and Prevention. (2015). 2014 Sexually Transmitted Disease Surveillance, Table 15.
2. U.S. Preventive Services Task Force. (2015). Screening for Chlamydia and Gonorrhea.
3. Centers for Disease Control and Prevention. (2015). Gonorrhea - CDC Fact Sheet.
4. Centers for Disease Control and Prevention. (2014). Preterm Birth.
5. U.S. Preventive Services Task Force. (2015). Ocular Prophylaxis for Gonococcal Ophthalmia Neonatorium: Preventive Medication.