Sofie Wise

Shannon Chapman

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About Author — Shannon enjoys breaking down technical subjects and giving others the tools to make informed decisions. Her interests include behavioral economics, sustainable living, meditation, and healthy cooking.

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Antibiotics for Gonorrhea: Understanding Treatment

Gonorrhea is a sexually transmitted disease (STD) that affects both women and men. It is caused by a bacterial infection that is transmitted by having oral, anal, or vaginal sex with a person who already has Gonorrhea. The infection is spread through semen and vaginal fluids, but it can infect the eyes, mouth, and throat in addition to the penis, urethra, and anus. Treatment requires Gonorrhea antibiotics, but some strains of Gonorrhea have become antibiotic resistant. Learn more about what antibiotics are used to treat Gonorrhea.

Recognizing the Symptoms of Gonorrhea

Sometimes, someone with gonorrhea does not show any symptoms. It is unclear how common it is, with some estimates being the majority of men and women to only 10% of men and 40% of women show no symptoms. The key signs of Gonorrhea can appear within one or two weeks after having sex with a partner with Gonorrhea. Even with no symptoms, it is still possible to transmit the disease and damage the reproductive system.

There are some differences in how Gonorrhea presents in men vs women, but in general the most common reported symptoms in both men and women are:

  • Gonorrhea discharge – For women and men, this includes abnormal discharge from the vagina or penis that may be green, yellow, or white.
  • Burning sensation while urinating Also called dysuria, this symptom is common with other STDs and is an important sign to get tested.
  • Painful, burning and swollen glands in throat – This is a very common sign of a Gonorrhea infection from oral sex.

Women can also have painful periods, bleeding between periods, pain during sex, abdominal pain, or a fever. Men can also have a less common symptom of swelling or pain in either or both testicles. Gonorrhea can infect one or both eyes causing discharge, conjunctivitis (itchy, red eyes), or sensitivity to light. Gonorrhea can also spread or infect the anus causing:

  • Discharge
  • Bleeding
  • Rectal pain
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Diagnosing Your Gonorrhea

Gonorrhea can be diagnosed by several different laboratory tests. They can either use a urine sample to test for the bacteria or a cotton swab from the infected area. The Gonorrhea test most often uses a swab from the cervix for women and the urethra for men, but can also include a swab of the anus or other potentially infected areas. This swab is used for a culture or antigen for testing, both of which can identify if Gonorrhea is present. A doctor may also conduct a physical exam to examine symptoms and check for other STDs. Gonorrhea and Chlamydia are very similar, so it is important to test for both to ensure you receive the right treatment. A doctor may ask:

  • How often do you have unprotected sex?
  • Do you have a new partner or multiple sexual partners?
  • Do you exhibit any symptoms like discharge, pelvic pain, or pain when urinating?

These questions can be used to determine if you have a STD, and answering yes increases the likelihood that you may have contracted one. Getting tested for a STD can be scary and intimidating, but remember you are taking charge of your health and can have peace of mind knowing if you do or do not have a STD and what you can do about it.

Common Antibiotics Used for Gonorrhea Treatment

Gonorrhea is curable. Once you have been tested, your doctor can give prescribe Gonorrhea antibiotics, a course of oral tablets, for you. When taking antibiotics, your infected area and symptoms should improve within one or two days, but you may still be contagious. Make sure to take the full course of the antibiotics. The infection should clear after one to two weeks. You should never stop taking antibiotics until the recommended course is finished, even if you think the infection cleared or you are feeling better. If you do not finish the antibiotics, the infection can come back and be resistant to the antibiotics you were taking. It is important to always receive a prescription based on your information for antibiotics and to never take antibiotics meant for someone else. Medical professionals choose specific antibiotics based on numerous factors including age, medical history, current health, and many more. Taking antibiotics prescribed to someone else can have serious health consequences.

These common Gonorrhea antibiotics include:

  • Azithromycin – Azithromycin is not related to penicillin and is a very common Gonorrhea medication. It is also less prone to producing gastrointestinal side effects than those in the penicillin family. Azithromycin for gonorrhea is often taken as one dose. This medicine, along with doxycycline, cures up to 95% of cases of Chlamydia.
  • Ceftriaxone – Often prescribed alongside azithromycin for Gonorrhea infections with higher levels of bacteria. This drug, along with azithromycin, is more responsive to current strains of gonorrhea in the US.
  • Doxycycline – This is the second most common antibiotic for Gonorrhea, but it should not be taken by women who are pregnant or planning to become pregnant as it can lead to birth defects. It is often given as one dose a day for a week. It also makes you more sensitive to sunlight, so you should take extra precautions to stay out of the sun and wear sunscreen if you are on this medication.
  • Erythromycin – This antibiotic is only used as medicine for gonorrhea for babies who have contracted the STD during birth from an infected mother.

All of these medications should be prescribed by a doctor who understands your medical history and potential complications. For example, if a doctor believes you may be at risk for the infection to spread and cause further complications, the doctor may prescribe antibiotics for longer than the typical dosage. Common side effects with all of these treatment are usually mild, but can include feeling worn down, diarrhea, stomach pain, and for women vaginal thrush.

Your and your sexual partner(s) should not have sex again until treatment is complete. You should wait at least one week after completing a prescribed single dose medication. You should finish all doses if you are prescribed a seven day treatment. In some cases, the infection may still be present, so you should wait until you and your partner(s) are sure the disease is no longer present.
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Antibiotic Resistant Gonorrhea or “Super Gonorrhea”

Gonorrhea is a very rapidly adapting STD. Current strains of Gonorrhea in the US that are being transmitted from person to person are already resistant to sulfonilamides, penicillin, tetracycline, and fluoroquinolines treatment. This resistance has occurred in the last 30 thirty years. Since antibiotic resistant strains of bacteria are already more common, if your symptoms continue after a few days of taking antibiotics, consult your doctor. They may switch you to a different strain of antibiotics. These antibiotic resistant strains, sometimes called “Super Gonorrhea” are responsive to other antibiotics listed above, but recommended treatment can change and new treatments are being developed. Thus, it is extremely important to consult a doctor before taking antibiotics.

Potential Chlamydia Complications

Because Chlamydia often has no symptoms, some people go untreated. Even with those who have symptoms; stigma, access, or other reasons get in the way of getting medical attention. Not receiving prompt and proper treatment can create serious health problems. Chlamydia that goes untreated can increase the likelihood of contracting another STD like Gonorrhea or HIV/AIDS or increasing the likelihood of transmitting that STD to someone else. It is also possible to develop reactive arthritis, or arthritis caused by the body’s reaction to an infection, because of Chlamydia. This can affect the joints, urethra, and eyes.

For women, Chlamydia that goes untreated can spread through your uterus to your fallopian tubes. Fallopian tubes connect the ovaries to the uterus and transport fertilized eggs during pregnancy. If untreated Chlamydia spreads to this area, the result is pelvic inflammatory disease (PID), affecting around 5% of women in the US.

Pelvic inflammatory disease, similar to Chlamydia, can have no symptoms or just some pelvic or abdominal pain initially. Unfortunately, PID can do permanent damage to a women’s reproductive system, including:

  • Long-term pelvic pain – PID can damage the fallopian tubes or other areas of the reproductive system inflaming them and causing chronic pelvic pain.
  • Infertility – As the infection spreads through the fallopian tubes, the damage can cause scars that prevent any sperm from reaching an egg.
  • Ectopic pregnancy – Sometimes, the sperm is able to get through and fertilize an egg, but the same damage and scarring can prevent the fertilized egg from reaching the uterus. This fertilized egg can implant in the fallopian tubes or elsewhere. Since these other areas are not designed to expand as the egg goes, they can rupture causing massive internal bleeding and even death. It is extremely important to call a doctor immediately if you experience any symptoms, such as heavy vaginal bleeding, dizziness or shoulder pain.
  • Premature birth – Even with the damage caused by the disease, it is still possible to conceive a child. Sometimes, PID can result in the birth occurring before the due date which can risk the health and development of the child.

For men, Chlamydia rarely leads to health problems. It is very rare for Chlamydia to cause infertility in men, but sometimes the infection can spread past the penis causing fever or pain. In addition, it is possible for Chlamydia to cause:

  • Nongonococcal urethritis – This is an infection of the urethra, the tube that carries urine, which causes inflammation, pain, and fever.
  • Epididymitis – This occurs when the epididymis is infected, the tube beside the testicle that carries sperm, which causes inflammation, scrotal pain, and fever.
  • Proctitis – This results in inflammation of the rectum.
  • Prostate gland infection – This is an infection of the prostate gland, which can cause fever, pain during sex or while urinating, and pain in the lower back.

Should any of these symptoms arise or if you suspect you may have a STD, it is very important to get tested. Even if you have no symptoms, as do the majority of those with chlamydia, you should be getting tested regularly so you do not unknowingly spread the disease. You can make an appointment with your primary care physician or see an urgent care in order to be tested.

Read more of our Gonorrhea Series: