Gonorrhea, also known as “the clap,” is an extremely contagious sexually transmitted disease. It is the second most reported infectious disease in the United States (after chlamydia), according to the Centers for Disease Control and Prevention (CDC).

The gonorrhea bacteria gain access to the body through body fluids associated with sexual activity. Transmission can occur during any kind of sexual contact – vaginal, oral or anal. In men, gonorrhea infects the urethra, which is the tube that leads to the bladder. In women, the disease usually first infects the opening of the uterus (cervix) or the urethra.

Women are rarely symptomatic but, when they are, symptoms usually include abnormal vaginal discharge (possibly bloody) or pain while urinating. The symptoms for men may include discharge from the penis and a burning sensation during urination. Gonorrhea infection in the anal area may be caused by anal sex or contamination by bacteria from the genitals. Oral sex may cause gonorrhea of the throat.

If gonorrhea is left untreated, it can spread to other organs. In women, gonorrhea may spread into the upper reproductive organs, such as the uterus, fallopian tubes and ovaries. Inflammation at those sites can cause pelvic inflammatory disease (PID). In men, one of the most common complications is epididymitis, a condition that causes painful swelling of the scrotum. In rare cases, untreated gonorrhea may spread to other systems in the body and infect the heart, brain or joints.

Nonsexual transmission of gonorrhea may also occur. A pregnant woman with gonorrhea can transmit it to her infant during childbirth, frequently causing eye infections. In addition, an infected person can transmit the bacteria from their original infection site by touching that area and then touching another susceptible body part, such as the eyes.

Sexually active young people are at greatest risk for gonorrhea. More than three-fourths of the cases reported to the CDC occur in sexually active people under age 30. People who have unprotected sex, have multiple sexual partners or have sexual partners who have multiple sexual partners are most likely to contract gonorrhea.

Gonorrhea can be diagnosed with several tests such as a urine test that detects the bacterium’s genes, as well as gram stains and cultures that involve examining tissue samples taken from the infected area. After diagnosis, a patient’s sexual partners should be notified so they may be tested and, if necessary, treated for gonorrhea.

Antibiotics are the standard treatment for gonorrhea. They are usually given orally or by injection. Antibiotic eye drops or ointment and rarely silver nitrate eye drops are also given to newborn infants of gonorrhea-infected women shortly after birth to help prevent gonorrhea infection of the eye. 

Gonorrhea can be prevented by practicing safe sex, which includes limiting sexual partners, knowing the sexual history of partners and using latex condoms and dental dams during sexual activity.