What you feel? (gonorrhea symptoms)
This section will talk about the most common gonorrhea symptoms, or what you might possibly feel. In most health conditions, symptoms (“what you feel”) usually precede signs (“what you see”), though gonorrhea symptoms and signs might appear at the same time.
It is important to know the potential symptoms for gonorrhea so they can be addressed (tested and treated) early; this can stop the spread of the condition and prevent advanced gonorrhea health complications.
It is important to mention that most gonorrhea-positive people are not symptomatic, but we are covering symptoms here for those who are. Just knowing the symptoms is not enough for establishing a gonorrhea diagnosis, but it helps to direct testing and early treatment.
In this section on symptoms (“What I feel”), you will first see the table with a summary of symptoms for vaginal, penile, oral, and rectal gonorrhea. The tables are followed by FAQs that people often ask and practical answers from our STD expert doctor.
Penile and vaginal gonorrhea symptoms
This table summarizes penile and vaginal gonorrhea symptoms. It is divided into five parts:
- Common symptoms: symptoms experienced by MOST infected people
- Unusual symptoms: symptoms experienced by SOME infected people (but are not common or specific for gonorrhea)
- Most reliable symptoms: symptoms that are most specific for the condition and explain the pathophysiology disease process the best
- When symptoms appear: approximate timetable of when symptoms first appear
- Chance of not having symptoms: explains the chance of not having symptoms
*Pay attention to the much higher chances of females not having symptoms compared to males
Common
Symptoms | Unusual
Symptoms | Most Reliable
Symptoms | When symptoms
appear | Chance of not
having symptoms |
|---|
- Pain with urination
- Frequent urination
- Painful sex (females)
| - Testicular pain (male)
- Lower abdominal pain
- Joint pain (usually with advanced and untreated gonorrhea)
- Occasional systemic symptoms of: fatigue, fever, chills
| - Pain and burning with urination
- Frequent urination
- Painful sex (females)
(These symptoms are not gonorrhea specific but are the most reliable.) | 1-14 days after initial exposure (2-5 days on average) | Male 1 in 10 gonorrhea- positive men have nosymptoms (10%)
Females 5 in 10 gonorrhea- positive women have no symptoms (50%) |
Oral and rectal gonorrhea symptoms
This table summarizes oral and rectal (anal) gonorrhea symptoms. It is divided into five parts:
- Unusual Symptoms: symptoms experienced by SOME infected people (not common or specific for gonorrhea)
- Most reliable symptoms: symptoms that are most specific for the condition that explain the pathophysiology disease process the best
- When symptoms appear: approximate timetable of when symptoms first appear
- Chance of not having symptoms: explains the chance of not having symptoms
Please pay attention to the very high chance of asymptomatic cases with oral and rectal gonorrhea
| Common
symptoms | Unusual
Symptoms | Most reliable
symptoms | When symptoms
appear | Chance of
not having
symptoms |
|---|
Oral | - Throat pain or discomfort
- Dry throat
| N/A | All symptoms are non-specific and can be caused by other respiratory tract infection conditions | 7-21 days after exposure | In 90% of cases oral gonorrhea has no symptoms |
Rectal | - Itch around the anus
- Anal/rectal soreness
- Painful bowel movement
- Constipation
| Tenesmus (crampy rectal pain, feeling of incomplete emptying of the bowels) | All symptoms are non-specific and can be caused by other conditions and infections | 5-10 days after exposure | In 84% of cases rectal gonorrhea has no symptoms |
Frequently Asked Questions
Here we summarize real patients’ questions, grouped by topic, and Dr. Fuzayloff’s answers to them. “Dr. F” (his patients’ name for him) has been an STD doctor for over two decades in Midtown Manhattan, NYC.
Common gonorrhea symptoms 
Common symptoms mean:
- Most symptomatic people have those symptoms with a disease.
- It explains and follows the expected pathophysiology process for the disease.
Common gonorrhea symptoms for both genders:
Gonorrhea mostly causes urethritis. When infected, about 90% of males and over 50% of females might have it.
What are urethritis symptoms?
- Frequent need to urinate
- Burning, painful sensation around the opening of the urethra (the tube that transports the urine) when urinating
- Discharge
Why mostly urethritis?
- This is how the infection enters the body.
- Once in contact with the surface of the urethra (mucosa), Neisseria gonorrhoeae (the bacteria that causes gonorrhea) damages it causing inflammation.
Female specific gonorrhea symptoms:
Gonorrhea might affect the vagina including the cervix area of the uterus (the cervix is the anatomical part that connects the vagina to the uterus). If the cervix is affected by gonorrhea, a woman may experience vaginal and lower abdominal pain during intercourse.
Gonorrhea symptoms progression
Most initial gonorrhea symptoms appear at the same time. Moreover, symptoms and signs can appear at the same time or very close to each other.
When the incubation period ends (2-5 days on average), symptomatic people start to experience urethritis symptoms of burning, pain with urination, and a frequent need to urinate. At the same time or shortly after, urethritis symptoms are usually followed by gonorrhea signs of discharge (more on this in the ‘signs’ section).
Untreated (advanced) gonorrhea symptoms
When the disease is left untreated for some time (from a few weeks to many months), complications may occur that are gender specific.
Women
If left untreated, the infection may start to spread and affect the cervix (the anatomic area connecting the vagina to the uterus). Women start to experience lower abdominal pain and discomfort during sex.
- About 20% of these women develop pelvic inflammatory disease (PID), which is caused by the inflammation of the uterus, fallopian tubes, and ovaries.
- Up to 25% of women with long-term PID develop infertility, chronic pain, and pregnancy complications.
Men
Untreated men may develop epididymitis (inflammation of the tube inside the testicles where sperm is stored). This is characterized by swelling and pain at the back of one (more common) or both testicles.
- Unlike PID in woman, epididymitis rarely leads to infertility.
Asymptomatic gonorrhea chance
The chance of gonorrhea not causing symptoms depends on the anatomic area it effects:
- Penile gonorrhea is asymptomatic in 10% of cases.
- Vaginal gonorrhea is asymptomatic in 50% of cases.
- Rectal gonorrhea is asymptomatic in 84% of cases.
- Oral gonorrhea is asymptomatic in 90% of cases.
Oral and rectal gonorrhea symptoms: specificity
- There are no gonorrhea specific reliable symptoms with oral and rectal gonorrhea.
- Most symptoms that occur with gonorrhea can be seen with other infections and conditions.
- To suspect oral or rectal gonorrhea, a doctor considers the combination of symptoms and disease history (what preceded it, any new sexual partner, etc.)
Gonorrhea symptoms and their significance in terms of establishing a diagnosis
Most gonorrhea symptoms are very non-specific. This means that other conditions such as chlamydia, trich, mycoplasma, UTI and others can be presented with similar symptoms. To be helpful, gonorrhea symptoms need to be analyzed in the right context:
1. How soon after contact did the symptoms develope? (It has a longer incubation period than UTI but is shorter than chlamydia.)
2. New sexual partner? (The chance of STDs is higher than non-STD conditions with a new partner.)
3. How risky was the contact? (e.g., intercourse with a prostitute or stripper increases the chances)
4. Person’s age (STDs are statistically more common among younger people.)
5. Sexual orientation (Often more common among homosexuals.)
6. Gender (Often more common in females.)
Gonorrhea diagnosis cannot be established based on the symptoms alone. None of the symptoms are specific enough to gonorrhea to assume the correct diagnosis. Other sexually transmitted diseases can give similar symptoms. Symptoms only help with early treatment and testing.
Gonorrhea symptoms timing for different anatomic areas
The incubation period is the time between getting infected and having symptoms or signs. The gonorrhea incubation period depends on the anatomic area it effects: penile, vaginal, oral, or rectal. There is a shorter incubation period for genital gonorrhea compared to oral and rectal.
The table below summarizes this information:
| Exposed area | Incubation period |
|---|
Male genitals (penis)
Female genitals (vagina and cervix)
Oral area
Rectal area | 1-14 days
2-7 days
7-21 days
5-10 days |
Gonorrhea symptoms resolution
If gonorrhea symptoms resolve without treatment, it can mean two things:
- The immune system cleared the gonorrhea.
- The gonorrhea is staying dormant without giving symptoms.
Since there is no way of knowing if the disease is gone, testing (or treatment) is necessary. If gonorrhea is left untreated, even without having symptoms, it can mean:
1. The infected person will continue to pass gonorrhea to sexual partners.
2. In 3% of cases, it can slowly progress and cause serious complications such as:
- Infertility in women (due to inflammation of the fallopian tubes and further scarring)
- Septic arthritis (infected joints)
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