What Is the Difference Between Chlamydia and Gonorrhea?

If you get tested for a sexually transmitted disease and your results come back positive for either chlamydia or gonorrhea, you might wonder, “What is the difference between chlamydia and gonorrhea?” Testing positive can bring complicated emotions and fear, but the most important thing to know is that both of these infections are treatable.

Both chlamydia and gonorrhea are bacterial infections, and symptoms can vary from person to person. Some people experience severe symptoms, while others may experience minimal or no symptoms at all. Transmission of these sexually transmitted diseases (STDs) generally occurs during unprotected sexual contact, although gonorrhea is more likely to spread during non-penetrative contact than chlamydia.

Prevention, regular testing, and antibiotic treatment are essential to reduce transmission of chlamydia and gonorrhea, but there are some important differences to note, too. Keep reading to learn about what differentiates chlamydia from gonorrhea, what treatment involves, and when to get tested.

What Is Chlamydia?

Chlamydia is the name of the disease caused by infection of the Chlamydia trachomatis bacterium. Complications from severe or untreated chlamydia infection include inflammation of the cervix (cervicitis), rectum (proctitis), and urethra (urethritis), which can lead to additional complications.

In women especially, chlamydia can cause:

• Ectopic pregnancies
• Tubal factor infertility
• Pelvic inflammatory disease (PID)
• Chronic pelvic pain
• trachomatiscan also lead to lymphogranuloma venereum (LGV), another STD that causes proctitis in men who have sex with men.

Chlamydia Transmission

Women and assigned female at birth (AFAB) people are at higher risk of contracting chlamydia, as are men who engage in anal or oral sex with other men. Chlamydia infection spreads by contact with sexual fluids from someone with the infection to a partner through mucus membranes, including the vagina, anus, mouth, and in rare cases, eyes.

Besides unprotected sexual contact with bodily fluids, you can also contract chlamydia by touching fluids with a hand or sex toy and transferring the bacterium to other parts of the body. To prevent the spread of chlamydia, you should always practice safe sex and use condoms or dental dams correctly by putting the condom on before coming into contact with bodily fluids or by using a condom on sex toys and cleaning them thoroughly between uses.

Chlamydia Symptoms

Between 50% and 80% of people infected with chlamydia are asymptomatic, meaning they never experience symptoms severe enough to notice that they have chlamydia. However, even asymptomatic patients can develop severe complications without a diagnosis and treatment. Long-term effects of chlamydia can include infertility and pregnancy complications, among other serious conditions.

For patients who do exhibit symptoms, symptoms of chlamydia include:

Symptoms of chlamydia in women and AFAB patients:

• Abnormal vaginal discharge, including color, consistency, or odor
• Sore throat
• Burning sensation during urination
• Bleeding between periods
• Sores or inflammation around the infection site (vagina, rectum, mouth, throat, or eyes)
• Rectal pain, discharge, or bleeding in rectal chlamydia infection

Symptoms of chlamydia in men and assigned male at birth (AMAB) patients:

• A discharge from the penis
• Sore throat
• Burning sensation during urination or pain during ejaculation
• Swelling or pain in one or both testicles
• Sores or inflammation around the infection site (rectum, mouth, throat, or eyes)
• Rectal pain, discharge, or bleeding in rectal chlamydia infection

Symptoms of eye infection by chlamydia include conjunctivitis, which can come with swelling, redness, and discharge around the eye. Additionally, pregnant patients can pass chlamydia to their babies during birth, sometimes leading to conjunctivitis or pneumonia. Patients with chlamydia are also at a higher risk of contracting other STDs.

Treatment for Chlamydia

To treat a chlamydia infection, your doctor will prescribe antibiotics (usually doxycycline) for you to take for seven days. In the past, doctors could prescribe a single dose of azithromycin, especially for pregnant patients. However, the bacterial strain that causes chlamydia is developing a resistance to azithromycin.

If you can’t take doxycycline due to pregnancy or a drug allergy, discuss other antibiotic treatment options with your doctor. Additionally, ask about expedited partner therapy (EPT) to get a second prescription to give to your partner. You and your partner(s) should not have sex while taking the antibiotics to prevent reinfection.

You and your partner(s) should also re-test three months after treatment to ensure that the antibiotics worked and that you test negative for chlamydia.

What Is Gonorrhea?

So what is the difference between chlamydia and gonorrhea? Gonorrhea is also a bacterial STD, caused by the bacterium Neisseria gonorrhoeae. The symptoms between chlamydia and gonorrhea are often similar, although men often experience symptoms of gonorrhea much more often, with only 6% of men being asymptomatic with gonorrhea compared to over 50% having no symptoms with chlamydia.

Gonorrhea can also lead to severe complications without treatment. Some conditions gonorrhea can cause include infertility, epididymitis, inflamed prostate, pelvic inflammatory disease (PID), and disseminated gonococcal infection (DGI), which is a condition that occurs when gonorrhea spreads to the bloodstream, leading to inflammation and possibly death.

Gonorrhea Transmission

Transmission of gonorrhea occurs when a person without the infection comes into contact with the bodily fluids of someone with the disease during sexual contact. It can infect mucus membranes in the urogenital area, rectum, mouth, throat, and eyes.

Chlamydia and gonorrhea are both most common in sexually active people between the ages of 15 and 24. For gonorrhea, the people most at risk of transmission include teenagers, young adults, and African Americans in underserved communities.

To prevent gonorrhea, you and your partner(s) should always use condoms or dental dams correctly, and use condoms on shared sex toys. Additionally, regular testing can help you learn if you or a partner has gonorrhea so you can seek expedited partner therapy (EPT) for treatment.

Gonorrhea Symptoms

How can you tell the difference between chlamydia and gonorrhea? Many symptoms between gonorrhea and chlamydia are similar, meaning the only way to know for sure is to get a multi-panel test that tests for several types of infections at once, like a 10-panel STD test at Rapid STD Testing.

Symptoms of gonorrhea in women and AFAB patients:

• Changes in vaginal discharge, including white or yellow coloration
• Pain during sex
• Bleeding between periods
• Burning or pain during urination
• Pain in your lower abdomen

Symptoms of gonorrhea in men and AMAB patients:

• Discharge from the penis (yellow, white, or green in color)
• Pain and swelling in the testicles
• Burning or pain during urination

Additionally, you may experience a sore throat, scratchiness, itching, or trouble swallowing if you have a gonorrhea infection of the throat. An infection of the anus or rectum could include symptoms of itching, anal discharge, or pain during bowel movements.

Treatment for Gonorrhea

Gonorrhea treatment requires antibiotics, often a shot of ceftriaxone. If you’re allergic to ceftriaxone or any of its ingredients, other treatment options are available. The alternative usually includes a shot of gentamicin plus a dose of azithromycin that you take orally.

Some strains of gonorrhea are developing a resistance to treatment by antibiotics. This makes prevention and taking all of your antibiotics for gonorrhea treatment essential. Stopping your antibiotics early allows the bacteria to spread in your system, becoming too strong for normal treatment options. “Super gonorrhea” may continue to evolve stronger resistance to antibiotics if you don’t take your full regimen of antibiotics.

Diagnosing and Treating Chlamydia and Gonorrhea

Testing for chlamydia and gonorrhea often includes submitting a sample for a nucleic acid amplification test (NAAT). In AFAB patients, doctors collect a swab sample of the cervix or vagina, or collect a urine sample. In AMAB patients, doctors or clinicians collect a sample from the urethra or get a urine sample.

Your healthcare provider can also swab any other affected area for samples, including the eyes, throat, or anus.

Are gonorrhea and chlamydia treated the same? Both STDs require antibiotic treatment, although doctors often use two different antibiotics to treat the different infections. You must take the full regimen of antibiotics as prescribed without skipping doses.

Testing and Treatment for Chlamydia

You can get tested at a clinic or doctor's office, or you can collect your own sample to submit for testing using a home testing kit. At Rapid STD Testing, you can get same-day STD testing for chlamydia.

Testing for chlamydia often takes several days for the clinic or office to send the samples to a laboratory and get results through secure channels to protect patient privacy. These methods are often slow, meaning it could take up to a week to get results.

If you test positive for chlamydia or are waiting for test results but have symptoms, your doctor can prescribe antibiotics with a high efficacy against chlamydia. Treatment options for chlamydia include:

• Seven days’ worth of doxycycline
• Three days’ worth of azithromycin (if you are pregnant or allergic to doxycycline)
• Other antibiotics such as amoxicillin or erythromycin if the strain of chlamydia is resistant to azithromycin or if you are pregnant, breastfeeding, or allergic to doxycycline

Testing and Treatment for Gonorrhea

 Testing for gonorrhea is the same process as testing for chlamydia, although some patients may not realize they need testing for several weeks or even months after infection. This is because gonorrhea can remain dormant before a patient presents with symptoms. Unfortunately, this makes it easier for infected patients to spread gonorrhea before they realize they’re carrying the disease.

How long can gonorrhea stay dormant? Some people may have the disease for around six months before symptoms develop (if they develop symptoms). Upon diagnosis, your doctor may prescribe:

• A 500mg or 1g shot of ceftriaxone
• A 240mg shot of gentamicin plus 2g of azithromycin (taken orally) if allergic to ceftriaxone or any of its ingredients
• Doxycycline to treat coinfection with chlamydia

You should not have sex with your partner(s) until both you and they finish all antibiotics as prescribed to treat either chlamydia, gonorrhea, or coinfection by both STDs/STIs.

Prevention Against Chlamydia and Gonorrhea

The best way to avoid chlamydia and gonorrhea is abstinence. However, this isn’t a realistic safe sex measure for most people. Instead, using a condom or dental dam properly every time you have sex is the best option, even when using sex toys with a partner. Be sure to replace the condom when switching between partners for sex toy use or when engaging in sexual activity with multiple partners.

Other ways to prevent infection by chlamydia and gonorrhea include:

• Avoiding sexual contact with a partner who has an active infection
• Avoiding sexual contact with symptoms of an infection
• Limiting the number of sexual partners you have at any given time
• Open communication about your STD history and sexual health with your partners
• Getting yourself and your partners tested for chlamydia and gonorrhea
• Ensuring any new partner tests negative for chlamydia and gonorrhea before engaging in sexual activity with them

Risk Factors for Chlamydia and Gonorrhea

Chlamydia and gonorrhea share some common risk factors, and complications from these infections can lead to infertility, arthritis, tenosynovitis, or dermatitis. AFAB (assigned female at birth) people may develop pelvic inflammatory disease (PID), while AMAB (assigned male at birth) people can develop inflamed testicles or prostates. 

You should also understand the risk factors for contracting chlamydia or gonorrhea. People at higher risk for contracting either disease include:

• AFAB people
• People between the ages of 15 and 24
• African Americans
• People in underserved communities

Additionally, people who test positive for either STD are at higher risk for reinfection after treatment and coinfection by other STDs, including HIV.

Get Tested and Look for Local Treatment With Rapid STD Testing

What is the difference between chlamydia and gonorrhea? Both are STDs caused by bacteria, but different bacterial strains. Many symptoms between the two are similar, but there are some differences depending on the location of the infection. Treatment for both involves antibiotics, but the most common prescription for each is different.

At a Rapid STD Testing clinic, you can get a multi-panel rapid STD test to test for several common or dangerous infections, including chlamydia, gonorrhea, herpes, and HIV. Use our Find a Lab tool to discover a location near you, or order tests online to test at home by mail.