Gonorrhea in Women: What You Need to Know

Medically reviewed on May 19, 2023 by Amy Harris, MS, RN, CNM. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• What Causes Gonorrhea?
• How Is Gonorrhea Spread from Person to Person?
• Gonorrhea: Symptoms and Signs in Women
• Gonorrhea: Diagnosis and Treatment
• Gonorrhea: Risks and Complications
• Regular STI Testing Is a Critical Part of Sexual Health for Sexually Active Women
• Check for Gonorrhea with Everlywell
• Related Content

Gonorrhea is a very commonsexually transmitted infection (STI) that infects least 87 million people each year. [8] Gonorrhea does not discriminate based upon gender, although it occurs more commonly in sexually-active people between the ages of 15 and 49. [1,8]

A gonorrhea infection can be tricky to catch and therefore can go undiagnosed for longer in women and those people assigned female at birth (AFAB). Gonorrhea symptoms in women, especially early on in the infection tend to be mild, and and are often mistaken for a bladder infection or UTI, prolonging the time to diagnosis and treatment. [1]

Unfortunately, the longer the delay to treatment, the greater the risk of long term health consequences such as male and female infertility, pelvic inflammatory disease in women, joint infections, and transmission to the baby if a woman becomes infected with gonorrhea while pregnant. [2]

Gonorrhea is curable, but early diagnosis and treatment are the way for you to avoid these serious, and potentially life-altering complications. Healthy sexual practices, knowing which signs and symptoms to look for, and how to treat and prevent spreading Gonorrhea to your sexual partners will safeguard sexual well-being.

What Causes Gonorrhea?

Gonorrhea is a shorthand for an infection caused by Neisseria gonorrhoeae. This type of fast-growing bacteria that attacks the mucous membranes or the tissues lining your reproductive and urinary systems. It can infect other areas of the body, like the mouth or anus. [1]

As one of the more common STDs, gonorrhea is highly contagious. [1]

How Is Gonorrhea Spread from Person to Person?

How do you get gonorrhea? Turns out there are several different ways to spread the bacteria responsible for gonorrhea infections. Most commonly, gonorrhea spreads through sexual activity such as: [1]

• Penetrative vaginal sex
• Anal sex
• Oral sex

Even without penetrative sex, gonorrhea can be contracted if an individual comes into contact with bodily fluids, like semen or vaginal discharge, during sexual activity. You can also spread gonorrhea even if you or your partner do not ejaculate.1 Pregnant women can also pass gonorrhea on to their baby in-utero or during labor if they’re infected. [1,4]

What Can You Do to Reduce Your Chances of Getting Gonorrhea?

While there are effective treatments for gonorrhea, you are better off trying to avoid getting gonorrhea in the first place. That’s where prevention comes in.

To prevent spreading or contracting gonorrhea, be sure to:

• Use a latex condom – Sexually active individuals should always use a condom. Condoms help to limit both partners’ contact with bodily fluids that may carry gonorrhea.1 Make sure to use a condom for any type of intercourse (anal and vaginal) and change condoms between sexual acts.
• Get tested regularly – By committing to regular screenings for STDs/STIs, you’ll be more aware of your sexual health status. That way you will find out if you have any STIs even if you don’t have any symptoms. Earlier detection helps reduce the chances that you’ll infect your sexual partners or develop long-term complications from your gonorrhea infection. The Centers for Disease Control recommend yearly STI screening for sexually active women younger than 25 and for older women at increased risk of infection. Men having sex with men should also be screened at least once a year for Gonorrhea and other STIs. [9]
• Practice abstinence and/or monogamy – Some people may choose to practice abstinence or limit the number of sexual partners. The fewer sexual partners you have, the less likely it is you’ll transmit or contract the infection. [1]

Gonorrhea: Symptoms and Signs in Women

In women, gonorrhea most commonly impacts: [2]

• Urethra
• Vagina
• Cervix

Initially, gonorrhea may present with mild symptoms or no observable signs at all. If an infected individual does exhibit symptoms, they may notice: [2]

• Pain or burning when they urinate
• Excessive vaginal discharge
• Spotting or light bleeding between menstruation or after having penetrative sex
• Pain in the belly or pelvic area
• Pain with intercourse (for women and those AFAB)

If gonorrhea infects other mucus membranes in the body, like the eyes or rectum, other symptoms may appear. These gonorrhea symptoms include: [2]

• A sore, swollen throat and lymph nodes
• Pain, sensitivity, or discharge around the eyes
• Itching or discharge around the anus
• Difficulty having a bowel movement (this may include anal bleeding)
• Swollen or painful joints

Gonorrhea: Diagnosis and Treatment

If you’re concerned that you may have been infected with gonorrhea or are experiencing any symptom above, it’s important to reach out to a healthcare provider immediately. They can diagnose you using the following methods: [2]

• Swab test – Your healthcare provider can examine cells from the vagina, urethra, mouth, or other areas to determine your diagnosis.
• Urine test – Because gonorrhea frequently infects the urinary system, your healthcare provider may take a urine sample and screen it for the presence of N. gonorrhoeae.

Today, you may also have the option of taking an at-home gonorrhea test to screen for the bacteria that causes gonorrhea. [2] This works similarly to a test you might take in a healthcare provider’s facility: you’ll follow the instructions in your test kit, retrieve a sample of cells from an area suspected of infection, and send it in a mail-safe receptacle to a lab that will process your results.

If an at-home test kit determines you’ve been infected, it’s best to schedule an appointment with your healthcare provider. They can help you determine the severity of your infection and the best course of treatment for optimal recovery. They can also help advise you about treatment options for your sexual partners.

To avoid getting gonorrhea again, abstain from sex until after you and your sex partner have completed treatment and after symptoms are gone.

How Is Gonorrhea Treated?

If gonorrhea is caught relatively early, you can cure it with antibiotics. The most commonly recommended medicines include: [7]

• Ceftriaxone (oral; single dose)
• Gentamicin (injection; single dose)

These are typically administered by taking a pill or by injection. [5] The exact medication your provider prescribes may depend on: [5]

• The location of your gonorrhea infection (cervix, urethra, rectum, or in your throat)
• If you have any other STIs
• If you have any allergies to certain antibiotics
• Potential for antibiotic resistance
• Your ability to return for a follow-up visit or treatment

Unfortunately, many of the bacteria causing gonorrhea have become resistant to the antibiotics most commonly used to treat gonorrhea. This is called antimicrobial resistance, and unfortunately it is making successful treatment of gonorrhea more difficult. A test-of-cure – follow-up testing to be sure the infection was treated successfully – is not needed for genital and rectal gonorrhea infections at this time according to the CDC, but if your symptoms continue for more than a few days after receiving treatment, you return to a health care provider to be reevaluated. A test-of-cure is needed 7-14 days after treatment for people who are treated for a gonorrhea infection of the throat.

Gonorrhea and its associated symptoms will likely resolve in several days. [5] However, it’s critical to precisely follow the instructions and protocol recommended by your healthcare provider.Moreover, it’s extremely important to avoid engaging in sexual activity, including oral sex, while undergoing antibiotic treatment for gonorrhea or for at least one week after all sexual partners are treated and complete resolution of all symptoms, if you had any. [7] This helps make sure that you and your partner don’t repeatedly pass the infection back and forth to one another.

Gonorrhea: Risks and Complications

While the infection is curable, untreated gonorrhea can have lasting impacts on your health. Advanced gonorrhea can infect the joints and blood, which can have fatal consequences in the most severe cases. [4]

When undiagnosed and untreated, gonorrhea can put women at an elevated risk of developing the following conditions: [3]

• HIV – Having gonorrhea won’t automatically make you contract HIV, or human immunodeficiency virus, but it can make you more vulnerable to it. People who have both gonorrhea and HIV are able to pass both STIs more easily to their partners. [2]
• Pelvic inflammatory disease (PID) – PID is a condition that refers to the infection of the uterus, ovaries, and fallopian tubes. If bacteria from gonorrhea (or another STI) spreads to these organs, it can result in PID. [5] The more times someone has PID or the longer that PID goes untreated, the greater your risk for infertility. [2]
• Infertility – If an individual develops PID from gonorrhea and does not get treatment, they may be at risk of infertility.2 PID can lead to permanent damage and scarring of reproductive organs, putting you at risk for ectopic pregnancies, chronic pelvic pain, and having trouble getting pregnant. [2]
• Ectopic pregnancy – If gonorrhea or PID cause scarring of fallopian tubes (tubes connecting your ovaries to your uterus or womb, you are at greater risk for having an ectopic pregnancy. Ectopic pregnancy is a condition where a fertilized egg develops outside of the uterus, requiring surgery to remove the fetus. Without surgical intervention, it can lead to infertility or maternal death. [4]

Regular STI Testing Is a Critical Part of Sexual Health for Sexually Active Women

If you are sexually active, getting tested regularly, even if you don’t have any symptoms or think you might be at risk, can help keep you safety and free of gonorrhea. [2] There are three ways testing should be a part of your sexual wellness routine:

• Follow-up testing – If you’ve been infected with gonorrhea, follow-up testing is as important as undergoing initial treatment. While not required if you had a gonorrheal infection of your urethra, vagina, cervix, or anus, the CDC does recommend follow-up testing after a throat infection with gonorrhea.7 Because of antimicrobial resistance, the lack of symptoms, and how commonly partners can reinfect each other, many healthcare providers advise follow-up STI testing 3 months after finishing treatment.
• Partner STI testing – If you’re sexually active and have recently been infected with gonorrhea, your partner(s)’ STI status is as important as your own. For the sake of both your sexual health, it’s crucial they undergo screening, too (even if they don’t have any symptoms). [2]
• Regular STI testing –All persons who receive a diagnosis of gonorrhea should be tested for other STIs, including chlamydia, syphilis, and HIV, according to the CDC.7 It is possible to be re-infected with gonorrhea, even if you completed your prescribed treatment. [1] Moreover, it’s very common for an individual to contract gonorrhea and another STD, particularly chlamydia, at the same time.4 For this reason, many healthcare providers screen for or treat both infections simultaneously. [4]

Combining antibiotic treatment and regular sexual health testing can be your ticket to sexual health peace of mind.

What About Gonorrhea in Pregnancy?

All pregnant people should be screened in the first trimester of pregnancy and again in their third trimester if they are at high risk for a gonorrhea infection. If you are pregnant or recently gave birth, and have any gonorrhea symptoms or possible exposure to gonorrhea from a sexual partner, you should seek advice from your obstetrical healthcare provider immediately. Untreated gonorrhea infections during pregnancy has been linked to miscarriages, premature birth and low birth weight, premature rupture of membranes, and severe infections.10 If your baby gets an infection with gonorrhea in their eyes, it can put them at risk for vision problems and even blindness8 Fortunately, gonorrhea in infants can also be treated with antibiotics if caught early. [5]

Check for Gonorrhea with Everlywell

Because gonorrhea often arises with barely-noticeable symptoms, it’s one of several STIs that can be difficult to catch. By testing your sexual health status regularly, such as with an at-home gonorrhea test, you can help ensure both you and your partner(s) limit your risk of contracting or transmitting the infection.

Luckily, you can take control of your sexual health through Everlywell’s virtual care visits. Through our virtual care offering, you have access to licensed clinicians who can meet with you at your convenience to discuss your symptoms. Then, they can provide you with online STI treatment if needed.

Get proactive about your sexual health today.

Related Content

Gonorrhea: Signs and Symptoms

Gonorrhea and Chlamydia: Knowing the Difference

A Guide to Oral Gonorrhea: How It’s Caused, Symptoms, and More

References

1. Detailed std facts - gonorrhea. Centers for Disease Control and Prevention. URL. Published April 11, 2023. Accessed May 5, 2023.
2. Gonorrhea. Mayo Clinic. URL. Published April 14, 2023. Accessed May 5, 2023.
3. Gonorrhea. National Institute of Allergy and Infectious Diseases. URL. Accessed May 5, 2023.
4. What are some types of and treatments for sexually transmitted diseases (stds) or sexually transmitted infections (stis)? Eunice Kennedy Shriver National Institute of Child Health and Human Development. URL. Accessed May 5, 2023.
5. Treatment - Gonorrhoea. NHS choices. URL. Accessed May 5, 2023.
6. Antibiotic resistance. MedlinePlus. URL. Accessed May 5, 2023.
7. Gonorrhea treatment and care. CDC. URL. Published July 22, 2021. Accessed May 26, 2023.
8. Kirkcaldy RD, Weston E, Segurado AC, Hughes G. Epidemiology of gonorrhoea: A global perspective. Sexual health. URL. Published September 2019. Accessed May 5, 2023.
9. Chan PA, Janvier M, Alexander NE, Kojic EM, Chapin K. Recommendations for the diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis, including extra-genital sites. Med Health R I. 2012;95(8):252-254. URL.
10. STDs during pregnancy-a detailed fact sheet. CDC. URL. Published April 11, 2023. Accessed May 26, 2025.