Chlamydia and Gonorrhea: Symptoms, Testing and Treatment

Chlamydia and gonorrhea are bacterial sexually transmitted infections that often cause no symptoms. Both can infect the cervix, urethra, rectum, or throat; gonorrhea can also infect the eyes and rarely spread through the bloodstream. Testing the body sites exposed during sex, prompt guideline-based treatment, and partner care prevent complications and reinfection.

How the infections spread

Chlamydia and gonorrhea spread through vaginal, anal, or oral sex when infected secretions contact susceptible tissue. Penetration and ejaculation are not required. An infection can pass during birth and cause serious newborn eye or respiratory disease.

They do not spread through toilet seats, ordinary hugging, swimming pools, or sharing food. Condoms and other barriers reduce risk when used correctly for the entire sexual contact but do not make testing unnecessary after a known exposure.

A past infection does not create reliable immunity. A person can be infected again, including by a partner who was not treated or by a new exposure.

Symptoms by anatomical site

Cervix and urethra

Possible symptoms include unusual vaginal or penile discharge, burning when urinating, bleeding between periods or after sex, pain during sex, and lower abdominal discomfort. Testicular or epididymal infection can cause one-sided pain and swelling. Symptoms may be mild or absent.

Untreated cervical infection can ascend and cause pelvic inflammatory disease, or PID. PID may be subtle, yet inflammation can scar the fallopian tubes and increase the risk of infertility, chronic pelvic pain, and ectopic pregnancy. Early treatment reduces further damage but cannot reverse established scarring.

Rectum

Rectal infection is frequently asymptomatic. When present, symptoms can include pain, discharge, bleeding, itching, a sensation of incomplete emptying, or painful bowel movements. Rectal chlamydia can occur even when a person does not report receptive anal sex because infection may spread from a nearby genital site.

Throat

Throat infection is usually asymptomatic and may cause a mild sore throat. Pharyngeal gonorrhea is harder to eradicate than infection at some other sites and is important in resistance surveillance. A routine strep or respiratory test does not test for these STIs.

Eyes and bloodstream

Eye exposure can cause marked redness, pain, swelling, and heavy discharge. Gonorrhea can damage the cornea quickly, so urgent specialist assessment is needed. Rare disseminated gonococcal infection can cause fever, small pustular skin lesions, migrating joint pain, tenosynovitis, or a hot swollen joint and may require hospital care.

Who should consider testing?

Test after a partner diagnosis, compatible symptoms, condomless exposure, a new or multiple partners, or sexual assault, and according to routine screening guidance for age, pregnancy, sexual practices, and local prevalence. CDC recommends annual chlamydia and gonorrhea screening for sexually active women under 25 and older women at increased risk; recommendations for men, transgender people, and people with multiple anatomical exposure sites depend on population and practice.

During pregnancy, early testing and repeat testing for selected risks protect both parent and infant. Tell the clinic about pregnancy or possible pregnancy so collection, treatment, and follow-up are appropriate.

A cervical cancer screening test is not a general STI screen. A normal pelvic examination also does not exclude an asymptomatic infection.

Testing must match the exposure site

Nucleic acid amplification tests, or NAATs, detect genetic material and are usually the most sensitive routine tests. Depending on anatomy and laboratory validation, samples may be self-collected vaginal swabs, clinician-collected cervical or vaginal swabs, first-catch urine, rectal swabs, or throat swabs.

Tell the clinician which body sites had contact so the right samples are offered. A negative urine test can coexist with throat or rectal infection because those sites were not sampled. A blood test does not routinely diagnose uncomplicated chlamydia or gonorrhea.

Testing too soon after an exposure can miss infection, while NAAT performed too soon after treatment can detect residual genetic material. The clinic should advise the correct timing based on exposure, symptoms, test, and treatment.

Culture grows live gonorrhea bacteria and allows susceptibility testing. It is especially important when treatment failure is suspected, after a concerning test-of-cure result, or in resistance surveillance. A NAAT alone cannot show which antibiotic will work.

What happens after a positive result?

Treatment should begin promptly with the regimen recommended for the organism, body site, pregnancy status, allergy history, local resistance, and current national guideline. Chlamydia treatment is usually oral; uncomplicated gonorrhea treatment in the US usually requires a clinic-administered injection. Global recommendations differ, and resistance changes over time.

This page does not give drug names or doses. Do not use leftovers, share medication, or order an unverified “STI kit.” Inadequate treatment can leave infection at the rectum or throat and contributes to resistance. Tell the clinician about pregnancy, breastfeeding, severe allergy, kidney or liver disease, and all medicines.

Ask whether you are being treated for both infections or whether one was excluded. Broader testing commonly includes HIV and syphilis, and may include hepatitis or other STIs based on exposure and vaccination. People at ongoing HIV risk can discuss pre-exposure prophylaxis.

Sex and partner care

Avoid sexual contact until the treatment interval given by the clinic has passed, every prescribed dose is complete where applicable, symptoms have resolved, and recent partners have been treated. In CDC pathways this generally means seven days after single-dose treatment or until a seven-day course is completed, plus partner treatment. Follow the exact local instruction.

Recent partners should be notified confidentially so they can be evaluated, tested, and treated. In the US, CDC commonly uses the preceding 60 days and includes the most recent partner even when the last contact was earlier. Other public-health systems use different intervals and may offer anonymous notification.

Expedited partner therapy allows a clinician to provide medication or a prescription for selected partners without examining them first. It can reduce reinfection but is not legal everywhere and may miss pregnancy, allergy, PID, other STIs, or a site needing different treatment. Provider-assisted partner services are preferred when available.

If notifying a partner could lead to violence, coercion, homelessness, or another safety risk, tell the clinic. A public-health or domestic-violence service can help plan notification without direct confrontation.

Test of cure is different from retesting

A test of cure asks whether treatment eliminated the original infection. It is not routinely required for uncomplicated chlamydia in non-pregnant people when the recommended treatment was completed and symptoms resolved. CDC recommends a chlamydia test of cure during pregnancy, generally about four weeks after treatment, and in selected cases of adherence concern, persistent symptoms, or possible reinfection.

For gonorrhea, CDC does not routinely require test of cure after recommended treatment of uncomplicated genital or rectal infection. Pharyngeal gonorrhea is different: a test of cure is recommended 7–14 days after treatment. Persistent symptoms or suspected failure require culture and susceptibility testing and public-health consultation.

Retesting looks for repeat infection. CDC recommends retesting people treated for chlamydia or gonorrhea at about three months, regardless of whether they believe partners were treated. A new positive is more often reinfection than antibiotic failure.

When symptoms persist

Do not repeat the same treatment independently. Persistent burning, discharge, pelvic pain, testicular pain, rectal symptoms, or sore throat can reflect reinfection, non-adherence, resistance, another STI, PID, epididymitis, prostatitis, vaginitis, or non-infectious inflammation.

For possible gonorrhea treatment failure, clinicians obtain culture before retreatment when feasible and involve local public health because resistance has population implications. Avoid sex until the evaluation and new plan are complete.

Reducing future risk

Use condoms or barriers correctly from start to finish, test with new partners, share results, and agree on whether the relationship is exclusive. Vaccination prevents hepatitis A, hepatitis B, and HPV-related disease where recommended, but there is no routine chlamydia or gonorrhea vaccine yet.

Doxycycline post-exposure prophylaxis is recommended in the US only for defined groups through shared decision-making and monitoring; it is not a universal “morning-after” antibiotic. Do not self-start it from online advice.

Questions people often ask

Can I tell which infection I have from discharge?

No. Symptoms overlap and co-infection occurs. Laboratory testing identifies the organism and site.

Does a negative urine test rule out every STI?

No. It may not include the throat or rectum and does not test for all infections. Ask exactly what was tested.

Can I get chlamydia or gonorrhea from oral sex?

Yes. Either can infect the throat, and infection can transmit between throat and genital sites.

Why test again after successful treatment?

Because repeat exposure and untreated partners make reinfection common. Retesting is prevention, not an accusation.

Sources and evidence scope

This guide was researched using the 2024 WHO updated recommendations, current CDC information on chlamydia, CDC clinical guidance for chlamydial and gonococcal infections, CDC partner-therapy guidance, and CDC screening recommendations. Sources were checked on August 21, 2026. Treatment, resistance, screening, notification law, and partner services vary by country and region.