What Is Usually the First Sign of Gonorrhea?

Pain or burning during urination is usually the first sign of gonorrhea, a bacterial infection transmitted sexually.

Gonorrhea is a sexually transmitted disease (STD) (also called a sexually transmitted infection, or STI) that affects both men and women. 

About 700,000 people are infected with gonorrhea each year in the U.S., and it is especially common among people aged 15 to 24 years.

What Are Symptoms of Gonorrhea?

Many people, especially women, have no symptoms at all. Many people do not know they have gonorrhea, so it is important to see a doctor for diagnosis at the first sign of gonorrhea. 

Symptoms of gonorrhea in both men and women include: 

If the urethra is infected:

• Pain or burning during urination 
• If the rectum is infected:
• Rectal discharge 
• Constipation
• Painful bowel movements
• Anal itching
• Soreness
• Bleeding

If the throat or mouth is infected:

• Usually causes no symptoms
• May cause sore throat

Symptoms of gonorrhea in women include: 

• Vaginal itching 
• Abnormal vaginal discharge
• Vaginal bleeding or spotting between periods

Symptoms of gonorrhea in men include: 

• Milky, yellow, or green discharge from the penis
• Pain and swelling in one testicle (less common)

Gonorrhea is caused by the Neisseria gonorrhoeae bacteria. Gonorrhea is spread from person to person during oral, vaginal, or anal sex.

Pregnant women with gonorrhea can pass the infection to their babies during childbirth.

The risk of getting gonorrhea is increased in people who have a new sexual partner, more than one sexual partner, or who have other sexually transmitted infections.

Gonorrhea is diagnosed with: 

• A swab of the vagina or cervix (in women)
• A urine sample (in men)
• A swab of the mouth or rectum

Treatment for gonorrhea is the same for women and men and involves a one-time antibiotic treatment with ceftriaxone given as a shot into the muscle.

Sexual partners should also receive treatment because it is possible to be reinfected with gonorrhea. Re-infection is common, and patients should be retested for gonorrhea three months after treatment of the initial infection. Sex should be avoided until both the patient and partner have been treated.

If untreated, gonorrhea can lead to serious complications, including:

• Pelvic inflammatory disease (PID) in women 
  • Scarring of the fallopian tubes 
  • Infertility 
  • Increased risk of ectopic pregnancy 
• Epididymitis in men, which can lead to infertility
• Bloodstream infection, accompanied by joint infection and arthritis
• Higher risk of infection with human immunodeficiency virus (HIV)
• During pregnancy
  • Miscarriage 
  • Premature birth
  • Passing the infection to the baby during delivery
    • Can cause conjunctivitis that can damage the baby's eyes and affect vision over time