Cases surged at the end of 2020, with a 111% increase since 2009. An estimated 677,769 new cases were reported in 2020. After chlamydia, it is the second most common STD in the United States.
This article reviews how gonorrhea is transmitted as well as its prevention, signs, and treatment.
How Is Gonorrhea Spread?
Gonorrhea spreads through contact with an infected body part, most commonly through oral, vaginal/penile, or anal sex. However, you can contract gonorrhea during non-intercourse sexual intimacy or unwashed sex toys.
All genders who engage in sexual activity can get gonorrhea. The infection can develop in the throat, the reproductive organs, the urethra (where urine leaves the body), and the rectum.
Gonorrhea and Kissing
Until recently, there was little evidence that you could get gonorrhea by kissing someone. In the 1970s, several case reports suggested deep kissing could cause oropharyngeal (throat) gonorrhea, but the science was limited.
In 2019, a small study of 3,677 men who identified as gay, bisexual, or who have sex with men showed that people could pass oral pharyngeal gonorrhea through deep kissing. There is no evidence to suggest that quick, casual kisses on the lips are of concern.
This study created a lot of discussion on the topic, but the small study doesn’t provide enough data, and scientists have not come to any one conclusion.
Until there is further research, it may be best to assume gonorrhea can be transmitted this way and stay up to date with screening, testing, and other prevention strategies.
Prevention
STD prevention starts with screening and testing at your healthcare provider’s office. There are at-home STD tests available, but you must notify your healthcare provider if you receive a positive test result.
The following are ways to help prevent gonorrhea:
Limit your number of sexual partners or abstain from sexual activity Limit sexual activity to a monogamous relationship with an uninfected partner Do not have sex if you or your partner have symptoms Use barrier devices such as condoms, finger cots, and dental dams Clean sex toys after every use Receive regular screening and testing
The Centers for Disease Control and Prevention (CDC) recommends yearly screening for sexually active people under 25 or high-risk individuals over 25. Risk increases with:
A new sex partner or multiple sex partnersSex partners who have sex with othersMales who have sex with males Recent sexual contact with someone outside the United StatesA sex partner who has an STDA diagnosis of another STD
Signs of Gonorrhea
Gonorrhea does not produce symptoms as often in females as in males. When females do have symptoms, they include:
Abnormal vaginal dischargeVaginal itchingPainful urinationPain with sexual intercourseVaginal bleeding outside of her periodLower abdomen (belly) or pelvic (between the hips) painRectal pain or dischargePain with bowel movements (poop)Constipation
The most common signs of gonorrhea for males include:
Penile discharge or itchingPainful urinationTesticular painRectal discharge or painConstipation
Oral or pharyngeal gonorrhea causes an infection in the throat. It can cause a fever, swollen lymph nodes, a red, scratchy, sore throat, and difficulty swallowing, but it is typically asymptomatic (no symptoms).
Treatment
Healthcare providers treat gonorrhea with antibiotics; however, the type of antibiotic has changed over the years. This is because the bacteria have become resistant to the antibiotics that previously cured them.
If you continue to have symptoms after treatment, notify your provider. Your infection could be resistant to the antibiotics prescribed.
The most common treatment for uncomplicated gonorrhea is Rocephin (ceftriaxone). Healthcare providers give it as a one-time shot in the muscle (IM). It’s a 500 milligrams (mg) dose for teenagers and adults weighing less than 330 pounds or 1000 milligrams (1 gram) for those over 330 pounds.
Some may be allergic to ceftriaxone, or it may also be unavailable. Providers can use Garamycin (gentamicin)—240 milligrams IM, if this happens. It is given in addition to either:
Zithromax, Z-Pak (azithromycin) 2 grams orally in a single dose Pancef, Caricef (cefixime) 800 milligrams orally in a single dose
Restrain from sexual activities until:
Seven days after treatmentAll symptoms resolveAll sex partners are treated
If you receive treatment for gonorrhea, you should retest three months after treatment.
Most reinfections occur for the following reasons:
Sexually intimate partners do not receive treatment Partners don’t refrain from sexual intimacy for seven days after treatment or until symptoms are gone (passing the infection back and forth) Sex with a new, infected partner occurs
Summary
Gonorrhea, otherwise known as “the clap,” is a bacterial sexually transmitted disease (STD).
In the 1970s, a few studies suggested you could get gonorrhea through deep kissing. The science was limited, but this theory resurfaced in 2019 when scientists conducted another small study that indicated the same results. Though more research is necessary, it may be best to assume it’s possible and follow STD screening, testing, and prevention recommendations.
The majority of women who have gonorrhea don’t show symptoms. When they do, signs include abnormal vaginal discharge, painful urination or sexual intercourse, belly pain, and more. Men usually exhibit penile discharge or itching and painful urination among other symptoms.
Healthcare providers treat gonorrhea with antibiotics and monitor you to prevent reinfection.
A Word From Verywell
Many people with gonorrhea don’t show symptoms and are concerned about unknowingly getting or passing an STD through sexual intimacy or kissing. Talk openly with your healthcare provider about your sexual activity and concerns if this is your case because it is highly treatable.
