Gonorrhea vs. Chlamydia

Chlamydia and gonorrhea are very similar. Moreover, they coexist 38% of the time. The differences in the signs and symptoms of these two conditions are so subtle that even experienced doctors will have doubts when they’re thinking about which is present.

Because of the strong similarity of the two conditions, it’s all the more important that the signs and symptoms be considered in context. The prevalence of the condition in the area, the incubation period (the amount of time before symptoms appear), differences in the symptoms and signs, and other things are all important.

Gonorrhea versus chlamydia: differences and similarities

Similarities	Differences
Both genders Painful urination Frequent urination Swollen groin lymph nodes Males Testicular pain Redness and swelling at the tip of the penis Females Lower abdominal pain Pain during sex Bleeding in between periods Bleeding during sex	Severity of symptoms Chlamydia symptoms are milder than gonorrhea symptoms Discharge color Chlamydia discharge is whitish or colorless and scanty, while gonorrhea discharge is a yellowish greenish color and abundant Penile itch Chlamydia causes an itching sensation around the penile opening

Similarities

Differences

Both genders

Painful urination
Frequent urination
Swollen groin lymph nodes

Males

Testicular pain
Redness and swelling at the tip of the penis

Females

Lower abdominal pain
Pain during sex
Bleeding in between periods
Bleeding during sex

Severity of symptoms

Chlamydia symptoms are milder than gonorrhea symptoms

Discharge color

Chlamydia discharge is whitish or colorless and scanty, while gonorrhea discharge is a yellowish greenish color and abundant

Penile itch

Chlamydia causes an itching sensation around the penile opening

Gonorrhea versus chlamydia in photographs

In the photos below, pay attention to the color and amount of the discharge.

Gonorrhea

Usatine RP, Smith MA, Mayeaux EJ Jr, Chumley M, Tysinger J: The Color Atlas of Family Medicine: www.accessmedicine.com

Chlamydia

Image source: https://www.kalcounty.com/hcs/stdtoolkit/chlamydia.html

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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.

I am a 22-year-old male with a penile discharge. Can I tell whether I have chlamydia or gonorrhea based on the discharge?

No, it’s difficult to say what condition you have based on the information provided because these two conditions can present very similarly. We need more information (characteristics of the discharge and when it appeared) to make the correct assumption. We need to compare two conditions based on the most obvious differences between them.

Discharge color and amount

Chlamydia, unlike gonorrhea, creates a scanty, transparent discharge. It must be squeezed to be visible. Gonorrhea discharge is greenish and produced in abundance (dripping).

When did the discharge appear?

It’s important to know when the symptoms started. The incubation period is much shorter for gonorrhea than for chlamydia, which means that with gonorrhea, symptoms appear much sooner after exposure. On average, with gonorrhea the symptoms appear within a week and with chlamydia they appear in two or three weeks.

Important to keep in mind

The symptoms and the presentation can be very similar
Chlamydia and gonorrhea often coexist (24% of males and 38% of females with gonorrhea are chlamydia-positive), which results in symptom overlap

The table below summarizes the most important differences that help practicing physicians make a diagnosis of chlamydia or gonorrhea.

	Chlamydia	Gonorrhea
Incubation period and symptoms’ appearance	7–21 days (2 weeks on average)	1–14 days (2–5days on average)
Discharge	Whitish (milky) or watery Scanty	Greenish or yellowish, thick, purulent(pus-like) Abundant

Although this information may help to rule out one of these infections, the exact diagnosis may be established only after proper testing (a swab or urine test).

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Gonorrhea vs. Chlamydia

Gonorrhea versus chlamydia: differences and similarities

Gonorrhea versus chlamydia in photographs

Frequently Asked Questions

I am a 22-year-old male with a penile discharge. Can I tell whether I have chlamydia or gonorrhea based on the discharge?

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