Chlamydia and gonorrhea are both sexually transmitted infections (STIs) caused by bacteria. They can be contracted through oral, genital, or anal sex.
The symptoms of these two STIs overlap, so if you have one of these conditions, it’s sometimes hard to be sure which one it is without having a diagnostic test at a doctor’s office.
Some people with chlamydia or gonorrhea may have no symptoms. But when symptoms occur, there are some similarities, such as an abnormal, bad-smelling discharge from the penis or vagina, or a burning feeling when you pee.
Chlamydia is more common than gonorrhea. According to a 2017 report, over 1.7 million cases of chlamydia were reported in the United States, while just over 550,000 cases of gonorrhea were documented.
Read on to learn about how these two STIs are different, how they’re similar, and how you can reduce your risk for these infections.
Both men and women can get chlamydia or gonorrhea and never develop any symptoms.
With chlamydia, symptoms may not appear for a few weeks after you’ve contracted the infection. And with gonorrhea, women may never experience any symptoms at all or may only show mild symptoms, while men are more likely to have symptoms that are more severe.
A couple of the most telltale symptoms of these STIs overlap between the two (for both men and women), such as:
- burning when you pee
- abnormal, discolored discharge from the penis or vagina
- abnormal discharge from the rectum
- pain in the rectum
- bleeding from the rectum
With both gonorrhea and chlamydia, men may also experience abnormal swelling in their testicles and scrotum, and pain when they ejaculate.
You may also develop symptoms that affect your throat if you engage in oral sex with someone who has one of these conditions. This can cause mouth and throat symptoms, including sore throat and a cough.
With chlamydia, women may experience more severe symptoms if the infection moves upward to the uterus and fallopian tubes. This can cause pelvic inflammatory disease (PID).
PID can cause symptoms such as:
- feeling sick
- vaginal bleeding, even if you’re not having a period
- intense pain in your pelvic area
Seek emergency medical help if you think you may have PID.
With gonorrhea, you may also notice rectal symptoms like itching, soreness, and pain when you defecate.
Women may also notice heavier bleeding during their periods and pain during sex.
Both conditions are caused by an overgrowth of bacteria. Chlamydia is caused by an overgrowth of the bacteria Chlamydia trachomatis.
Gonorrhea is caused by an overgrowth of bacteria called Neisseria gonorrhoeae.
Both STIs are caused by bacterial infections that are transmitted through unprotected sexual contact, meaning sex without using a condom, dental dam, or another protective barrier between you and your partner during vaginal, anal, or oral sex.
It’s also possible to contract the infection through sexual contact that doesn’t involve penetration. For example, if your genitals come into contact with the genitals of someone who’s contracted the infection, it’s possible to develop the condition.
Both STIs can also be contracted through protected sex with a condom or other barrier if you don’t use protection properly, or if the barrier breaks.
Either STI can be contracted even if you aren’t showing visible symptoms. Both STIs can also be transmitted to a child at birth if the mother has either condition.
You’re at increased risk for developing these and other STIs if you:
- have multiple sexual partners at one time
- don’t properly use protection, such as condoms, female condoms, or dental dams
- regularly use douches which can irritate your vagina, killing healthy vaginal bacteria
- have contracted an STI before
Sexual assault can also increase your risk of both chlamydia or gonorrhea.
Get tested for STIs as soon as possible if you’ve recently been forced to have non-consensual oral, genital, or anal sex. If you’re in the United States, you can also call the Rape, Abuse, and Incest National Network (RAINN) for support from people who can help without revealing any of your personal information or details of your experience.
Both STIs can be diagnosed using similar diagnostic methods. Your doctor may use one or more of these tests to ensure that the diagnosis is accurate and that the right treatment is given:
- physical examination to look for symptoms of an STI and determine your overall health
- urine test to test your urine for the bacteria that cause chlamydia or gonorrhea
- blood test to test for signs of bacterial infection
- swab culture to take a sample of discharge from your penis, vagina, or anus to test for signs of infection
Both STIs are curable and can be treated with antibiotics, but you’re more likely to contract the infection again if you’ve had either STI before.
Treatment for chlamydia
Chlamydia is usually treated with a dose of azithromycin (Zithromax, Z-Pak) taken either all at once or over a period of a week or so (typically about five days).
Chlamydia can also be treated with doxycycline (Oracea, Monodox). This antibiotic is usually given as a twice-daily oral tablet that you need to take for about a week.
Follow your doctor’s dosage instructions carefully. It’s important to take the full dosage for the prescribed number of days so that the antibiotics can clear the infection. Not completing the round of antibiotics can cause you to become resistant to that antibiotic. This can be dangerous if you contract the infection again.
If you’re experiencing symptoms, they should begin to fade a few days after you start treatment.
Avoid sex until your doctor tells you that the infection has fully been cleared by the antibiotics. It can take two weeks or more for the infection to clear up, and during that time, you can still transmit the infection.
Treatment for gonorrhea
Your doctor will likely prescribe ceftriaxone (Rocephin) in the form of an injection into your buttock.
The CDC previously recommended ceftriaxone plus azithromycin, but the guidelines were changed because the bacteria causing gonorrhea are becoming increasingly resistant to azithromycin.
Using both antibiotics helps clear the infection better than using only one treatment alone.
As with chlamydia, don’t have sex until the infection clears, and be sure to take your entire dose.
Gonorrhea is more likely than chlamydia to become resistant to antibiotics. If you contract the infection with a resistant strain, you’ll need treatment with alternative antibiotics, which your doctor will recommend.
Some complications of these STIs can happen to anyone. Others are unique to each sex due to differences in sexual anatomy.
Gonorrhea has more severe possible complications and is more likely to cause long-term problems like infertility.
In both males and females
Complications that may be seen in anyone include:
- Other STIs. Chlamydia and gonorrhea both make you more susceptible to other STIs, including human immunodeficiency virus (HIV). Having chlamydia can also increase your risk of developing gonorrhea, and vice versa.
- Reactive arthritis (chlamydia only). Also called Reiter’s syndrome, this condition results from an infection in your urinary tract (your urethra, bladder, kidneys, and ureters — the tubes that connect the kidneys to your bladder) or intestines. Symptoms of this condition cause pain, swelling, or tightness in your joints and eyes, and a variety of other symptoms.
- Infertility. Damage to reproductive organs or to sperm can make it more challenging or, in some cases, impossible to become pregnant or to impregnate your partner.
- Testicular infection (epididymitis). Chlamydia or gonorrhea bacteria can spread to the tubes next to each of your testicles, resulting in infection and inflammation of testicle tissue. This can make your testicles swollen or painful.
- Prostate gland infection (prostatitis). Bacteria from both STIs can spread to your prostate gland, which adds fluid to your semen when you ejaculate. This can make ejaculation or peeing painful, and cause fevers or pain in your lower back.
- Pelvic inflammatory disease (PID). PID happens when your uterus or fallopian tubes contain an infection from the bacteria. PID requires immediate medical attention in order to prevent damage to your reproductive organs.
- Infections in newborns. Both STIs can be transmitted to a baby during birth from vaginal tissue that contains an infection from the bacteria. This can result in complications like eye infections or pneumonia.
- Ectopic pregnancy. These STIs can cause a fertilized egg to become attached to tissue outside the uterus. This type of pregnancy won’t last until birth and can also threaten the mother’s life and future fertility if it’s not treated.
The only way that you can completely prevent yourself from catching chlamydia, gonorrhea, or another STI is by abstaining from sexual activity.
But there are also plenty of ways you can reduce your risk of contracting or transmitting these infections:
- Use protection. Both male and female condoms are effective in helping to reduce your risk from infection by either bacteria. Using proper protection during oral or anal sex can also reduce your risk of infection.
- Limit your sexual partners. The more sex partners you have, the more you risk exposing yourself to an infection. And because these STIs may not cause noticeable symptoms, sex partners may not know they have the condition.
- Get regularly tested. Whether you’re having sex with multiple people or not, regular STI tests can help you remain aware of your sexual health and ensure that you’re not unknowingly transmitting an infection to others. Regular testing can also help you identify an infection even if you’re not experiencing any symptoms.
- Don’t use products that affect your vaginal bacteria. Healthy bacteria in the vagina (called vaginal flora) helps fight off infections. Using products like douches or scented odor-reduction products can upset the balance of vaginal flora and make you more susceptible to infection.
Both chlamydia and gonorrhea can be transmitted in the same ways, and both can easily be treated using antibiotics.
Both are also preventable if you take precautions during sex, such as using protection and limiting the number of people you have unsafe sex with at any given time.
Regular STI testing, for both you and your sexual partners, can also help reduce the risk of transmitting an infection if you or a sexual partner develop an STI.
If you suspect an STI or have been diagnosed with one, stop all sexual activity and get treatment as soon as possible. If you’re diagnosed, tell anyone you’ve had sex with to get tested just in case.
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