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JAMA Internal Medicine Patient Page
January 2019

I Am Worried About Gonorrhea: What Do I Need to Know?

JAMA Intern Med. 2019;179(1):132. doi:10.1001/jamainternmed.2018.4345

What Is Gonorrhea and How Is It Spread?

Gonorrhea is a sexually transmitted infection that can affect both men and women. The bacteria that cause gonorrhea spread from person to person through unprotected oral, vaginal, or anal sex. They are not spread by casual touching such as hugging or kissing. Gonorrhea can also spread from a pregnant woman to her baby.

You can reduce your risk of infection by avoiding intercourse, using condoms, limiting sexual partners, and getting tested if symptoms develop.

What Are the Symptoms and Complications of Gonorrhea?

Many people infected with gonorrhea do not develop symptoms. Men may notice painful urination, pain in the testicles, and/or pus-like discharge from the penis. Women may notice painful urination, vaginal discharge, or itching. Gonorrhea can also affect the rectum leading to pain with bowel movements, rectal discharge, or constipation.

Untreated gonorrhea in women can cause an inability to get pregnant, severe abdominal infections, and life-threatening complications during pregnancy for both mother and newborn.

Gonorrhea can also increase your chances of HIV infection.

Who Should Get Tested?

Cases of gonorrhea have been increasing rapidly in recent years, particularly in young women and men who have sex with men. Anyone who has symptoms of gonorrhea should get tested. Annual testing, even for those who do not have any symptoms, is recommended for some people:

  • Sexually active women younger than 25 years

  • All men and women with a new sex partner or multiple sex partners

  • Men who have sex with men (gay, bisexual, or any sexual contact with other men)

How Do I Get Tested?

Testing is available in physicians’ offices and urgent care clinics. You can find a free location near you at https://gettested.cdc.gov/.

Be open and honest with your doctor about your sexual practices. This may determine the type of testing that will be done. For many people, a urine sample is sufficient. If you have had oral or anal sex, special testing may be needed. Your doctor may also recommend testing for other sexually transmitted infections and a pregnancy test.

How Is Gonorrhea Treated?

Gonorrhea is generally treated with 2 different antibiotics (an injection and a pill). Gonorrhea is becoming more resistant to antibiotics, so you must take both antibiotics as instructed. It is extremely important to inform all your sexual partners of your infection. They need to be tested and treated if they are infected. If left untreated, they may develop complications, and you may be reinfected by them.

How Do I Inform My Sexual Partners?

If you feel comfortable, you can tell your sex partners yourself. You can also ask your doctor to ask the local health department to notify partners. You can also inform partners through anonymous websites such as http://www.InSpot.org.

What If My Partners Are Unwilling or Unlikely to Get Tested?

Tell your doctor. In some cases, your doctor may be able to prescribe medications for you to give directly to your partner, along with medication instructions and safe-sex counseling instructions.

What Should I Do After Treatment?

Do not have sex until a week after both you and your partner(s) are treated and your symptoms disappear. If your symptoms do not get better within 1 week after treatment, see your doctor. Even if your symptoms disappear completely, you should get retested in 3 months to make sure the gonorrhea is cured.

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Section Editor: Michael Incze, MD, MSEd.
The JAMA Internal Medicine Patient Page is a public service of JAMA Internal Medicine. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA Internal Medicine suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call (312) 464-0776.
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Article Information

Published Online: November 5, 2018. doi:10.1001/jamainternmed.2018.4345

Conflict of Interest Disclosures: None reported.