Gonorrhea often causes no symptoms but can lead to pelvic inflammatory disease, infertility, and disseminated infection. Rising antibiotic resistance makes prevention, screening (especially for sexually active people under 25 or with risk factors), partner treatment, and adherence to current treatment guidelines critical to control the disease and protect newborns.

Why Gonorrhea still matters

Gonorrhea, caused by the bacterium Neisseria gonorrhoeae, remains a common sexually transmitted infection (STI). Public attention has often focused on HIV, but gonorrhea continues to cause serious reproductive and systemic complications - and rising antibiotic resistance has made prevention, screening, and timely treatment more important than ever.

Symptoms and who is affected

Many people with gonorrhea have no symptoms. Because asymptomatic infection is common, regular screening should be part of routine care for sexually active people at higher risk.

Typical symptoms

  • Men: urethral discharge and painful or burning urination are common when symptoms appear.
  • Women: symptoms can be mild or absent; when present, they may include vaginal discharge, painful urination, and pelvic pain.
Left untreated, infection can spread from the initial site to the reproductive organs and beyond.

Complications to watch for

Untreated gonorrhea can lead to pelvic inflammatory disease (PID) in women, which increases the risk of infertility, chronic pelvic pain, and ectopic pregnancy. In men it can cause epididymitis and potential infertility. The bacteria can also disseminate (disseminated gonococcal infection, DGI) and cause joint pain, skin lesions, or, rarely, more severe organ involvement.

Newborns exposed during delivery can develop ophthalmia neonatorum (eye infection) that can lead to blindness if not prevented or treated. Many hospitals provide newborn eye prophylaxis to reduce this risk.

Current treatment and resistance concerns

Antibiotic resistance in N. gonorrhoeae is a major global concern. Current recommended therapy for uncomplicated urogenital, rectal, and pharyngeal gonorrhea is a single intramuscular dose of ceftriaxone (higher dose for higher body weight and specific clinical situations). Because resistance patterns change, clinicians follow local and national treatment guidelines and may perform test-of-cure or repeat testing in certain cases.

If chlamydial co-infection is possible, clinicians commonly treat for both infections according to up-to-date guidelines.

Prevention, testing, and public-health action

Prevention options include consistent condom use, limiting the number of sexual partners, and regular testing. Routine screening is recommended for sexually active women under 25 and for older individuals with risk factors; testing sites include urine tests and swabs of suspected infected sites.

Partner notification and treatment are essential to stop ongoing transmission. Public-health outreach, access to testing and treatment, and surveillance for antibiotic resistance are key strategies for controlling gonorrhea and protecting reproductive and neonatal health.

If you are sexually active and at risk, talk with your clinician about testing and vaccination where appropriate (for other STIs), and make STI screening a regular part of your care.

FAQs about Gonorrhea

How common is asymptomatic gonorrhea?
Many cases are asymptomatic, especially in women. Because infection can be silent, regular screening for people at risk is recommended.
What are the main complications of untreated gonorrhea?
Untreated infection can cause pelvic inflammatory disease (PID) in women, epididymitis in men, infertility, and sometimes disseminated infection affecting joints and skin. Newborns can develop eye infections if exposed during delivery.
What is the usual treatment for uncomplicated gonorrhea?
Current recommended therapy is a single intramuscular dose of ceftriaxone at the dose advised by clinical guidelines, with follow-up or test-of-cure in select situations. Clinicians also consider treatment for chlamydia when co-infection is possible.
How can I reduce my risk of getting gonorrhea?
Use condoms consistently, limit the number of sexual partners, get regular STI screening if sexually active, and ensure partners are tested and treated as needed.
Why is antibiotic resistance an issue for gonorrhea?
Neisseria gonorrhoeae has developed resistance to multiple antibiotic classes over time. Rising resistance limits treatment options and increases the importance of surveillance, correct therapy, and prevention efforts.