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Gonorrhea is the 2nd most common STI — here’s what you need to know

Microscopic image of gonorrhea
Gonorrhea is on the rise in the U.S. (Photo: Getty Images)

Cases of gonorrhea are skyrocketing in the U.S. after hitting a historic low in 2009. In 2020 (the most recent year data is available), more than 675,000 gonorrhea cases were reported to the Centers for Disease Control and Prevention, making it the second most common sexually transmitted infection behind chlamydia.

In fact, rates of reported gonorrhea have gone up 111% since 2009. But despite its prevalence, many people don’t know a lot about the infection. Here are important facts to keep in mind, just in case.

It’s not spread by kissing or sharing food.

Gonorrhea, which is caused by the bacterium Neisseria gonorrhoeae, spreads through sexual contact with the penis, vagina, mouth or anus of someone who is infected, the CDC explains. A person doesn’t need to ejaculate for gonorrhea to be spread. It can also be spread from mother to baby during childbirth, infectious disease expert Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security, tells Yahoo Life.

Having gonorrhea once doesn’t prevent you from getting it again: The CDC says that people who have had gonorrhea and been treated for it can be reinfected if they have sexual contact with someone with gonorrhea.

It’s not uncommon to have gonorrhea and chlamydia at the same time.

Research has shown that up to 50% of all teens and young adults who tested positive for gonorrhea at STD clinics, family planning centers and juvenile detention centers also had chlamydia. Adalja says this can happen simply because “individuals who have gonorrhea are also likely to have risk factors for chlamydia and vice versa.” And, he points out, “They are both transmitted in the same manner and have the same risks for acquisition.”

Many people with gonorrhea don’t have symptoms.

Most men and women with gonorrhea are asymptomatic — meaning, they don’t have symptoms, the CDC says. The reason for this likely comes down to individual immune responses, Adalja says. Some people’s immune systems don’t have a strong response to the bacteria and, as a result, don’t trigger symptoms, he explains.

Because many people with gonorrhea may go undiagnosed, “the true number of those who are asymptomatic is not known,” Dr. Nancy Phillips, associate professor at Rutgers Robert Wood Johnson Medical School and director of the Center for Vulvovaginal Health, tells Yahoo Life.

It can take about a week for symptoms to appear.

Again, many people with gonorrhea never show signs of the illness. But for those who do, Phillips says, “in general, symptoms occur within five to 14 days, but may be delayed for months, which may allow the infection to go undetected for quite some time,” she says.

When symptoms do show up, they’re a little different for men and women. Men might experience the following symptoms, the CDC says:

  • Pain while urinating

  • White, yellow, or green discharge from the penis

  • Testicular or scrotal pain

Women may have these symptoms, according to the CDC:

  • Pain while urinating

  • Increased vaginal discharge

  • Bleeding between periods

If someone with gonorrhea has a rectal infection, the CDC says symptoms can include:

  • Discharge

  • Anal itching

  • Soreness

  • Bleeding

  • Painful bowel movements

There’s a cure for gonorrhea.

Gonorrhea can cause permanent and serious health issues if it's left untreated. In women, the bacteria can spread to the uterus or fallopian tubes and cause pelvic inflammatory disease, which can lead to infertility, the CDC says. Men may also develop infertility from gonorrhea, although it’s rare.

Fortunately, gonorrhea can be treated. Treatment typically consists of a dose of the antibiotic ceftriaxone given once via injection, per the CDC. “If gonorrhea has spread upwards into the pelvis, hospital admission for IV antibiotics may be required,” Phillips says. And, she notes, it’s a good idea to be tested again two to four weeks after treatment to make sure the treatment worked and that you weren’t reinfected by a partner.

However, in January, health authorities in Massachusetts identified a new "concerning" strain of gonorrhea that shows some resistance to multiple antibiotics used to treat the STI. According to a statement released by the Massachusetts Department of Public Health, this marks the first time in the U.S. that a strain of gonorrhea showed a reduced response to five different types of antibiotics. The two cases identified in the state were ultimately cured after injections of the antibiotic ceftriaxone, which is the most commonly used treatment.

Gonorrhea can be prevented.

There are a few ways to lower your risk of getting gonorrhea. The Mayo Clinic recommends doing the following:

  • Use a condom if you have sex.

  • Limit your number of sex partners.

  • Be sure you and your partner are tested for sexually transmitted infections.

  • Don’t have sex with someone who has symptoms of an STI, including burning during urination or a genital rash or sore.

  • Consider annual gonorrhea screening, which is recommended for sexually active women younger than 25 and for older women at increased risk of infection. The CDC also recommends that all men 13 years and older who have sex with other men should get screened for gonorrhea each year.

If you had gonorrhea and were treated for it, the CDC recommends that you avoid having sex until you and your partner have completed treatment to lower your risk of getting reinfected.

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