Chlamydia vs. gonorrhea: What’s the difference?

Chlamydia and gonorrhea are both sexually transmitted infections (STIs). Bacteria cause both infections, and they share similar symptoms like unusual discharge from the genitals and a burning sensation when peeing.

Gonorrhea and chlamydia are two of the most common STIs in the United States. 

But the two conditions have key differences, including some differing symptoms and causes. They’re also treated differently, so knowing which one is affecting you can help you seek the proper treatment as quickly as possible.

Chlamydia

Chlamydia is a bacterial infection that’s transmitted through sexual contact. It’s the most common STI in the United States, with 1,644,416 cases reported in 2021, according to the Centers for Disease Control and Prevention (CDC). 

Causes

A type of bacteria called Chlamydia trachomatis causes chlamydia. A person can get chlamydia through sex or contact with vaginal fluids or semen. A pregnant person with chlamydia may also pass it on to their fetus. You can get chlamydia by:

• having sex without condoms or other barrier methods
• sharing sex toys
• exchanging or coming into contact with genital fluids

It’s a common myth that you can get STIs from using public toilets. The bacteria causing chlamydia and gonorrhea can’t survive long outside of the human body, so it isn’t possible to catch these STIs from a toilet seat.

Symptoms

The symptoms of chlamydia can vary depending on biological sex and include:

• unusual discharge from the penis or vagina
• pain when peeing
• in females:
  • stomach pain
  • bleeding after sex
  • bleeding between periods
• in males:
  • pain in the testicles and penis
  • swelling in the testicles and penis

But some people may not experience any symptoms. This is why it’s important to get STI testing frequently if you’re sexually active. It might also remain dormant in your body for months or years without showing up on a test.

Treatment

Another misconception about chlamydia is that it’s uncurable. But with the right treatment, it can go away completely. If you have chlamydia, you may be prescribed antibiotics. These include:

• doxycycline (Adoxa)
• azithromycin (Zithromax)

You shouldn’t have sex while you’re being treated for chlamydia. After taking the prescribed course of antibiotics, you should get retested in about 3 months.

It’s important to get promptly treated for chlamydia because it can lead to complications if left untreated, such as infertility or reactive arthritis.

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Gonorrhea

Gonorrhea is the second most common STI in the United States, where more than 500,000 cases are reported every year, and 710,151 cases were reported in 2021 alone. A person can get gonorrhea through sexual contact, and a pregnant person can pass it to the fetus when giving birth.

Causes

The bacteria Neisseria gonorrhoeae causes gonorrhea. You can get gonorrhea through:

• vaginal, anal, or oral sex without condoms or barrier methods
• contact with fluids from the vagina or penis

Like chlamydia, you can’t catch gonorrhea from a shared toilet seat.

Symptoms

Symptoms of gonorrhea include:

• discharge from the vagina or penis that’s yellowish or greenish
• pain when peeing
• in females, bleeding in between periods 
• itchiness and pain during bowel movements

Gonorrhea can be asymptomatic in some people, so it’s important that you get tested regularly for STIs if you’re sexually active. 

Treatment

Gonorrhea can be treated and cured. Your doctor will prescribe an antibiotic injection of 500 milligrams (mg) of intramuscular ceftriaxone (Rocephin). After receiving the shot, you’ll be required to test for gonorrhea 7–14 days after treatment. And then, you’re advised to get tested again 3 months after treatment. 

Some people may need to take a course of oral antibiotics — azithromycin or doxycycline — after getting the ceftriaxone shot.

It’s advised that people undergoing treatment for gonorrhea don’t have sex for the treatment duration.  

Key differences

Some key differences between the conditions include:

• Cause: The bacteria that cause these infections are different. Chlamydia trachomatis causes chlamydia. The bacteria Neisseria gonorrhoeae causes gonorrhea. 
• Symptoms: Both conditions cause discharge from the vagina or penis, but the characteristic of the discharge is different. People with gonorrhea experience a discharge that’s yellowish or greenish. People with chlamydia have discharge that’s white, yellow, or gray.  
• Treatment: Treatment for chlamydia and gonorrhea differ. While chlamydia requires a course of oral antibiotics, you’d need to get an injection and sometimes a course of oral antibiotics to cure gonorrhea. 

Prevention

Chlamydia and gonorrhea are infections transmitted through sexual contact and genital fluids. To prevent getting these infections, you can:

• use an external or internal condom when having sex, whether it’s vaginal, anal, or oral
• avoid sharing sex toys, and wash them every time after use
• get routine tests for STIs, even if you don’t have any symptoms
• have open discussions with your partners about STIs and get tested before having sex with a new partner

Remember, even if you’ve had these infections before, you can still get them again. Practicing sex with a condom or other barrier methods can help lower the chances of this happening.

Summary

Gonorrhea and chlamydia are two of the most common STIs in the United States. Both infections are caused by bacteria and can lead to similar symptoms, such as unusual discharge from the genitals and pain when peeing.

But differences between these two infections, such as certain symptoms and causes, are key in figuring out the right treatment. A doctor will be able to test to find out which you have.

If left untreated, both conditions, which are otherwise curable, can result in complications like infertility.

You can take precautions to prevent getting gonorrhea and chlamydia. These include using protection like internal or external condoms when having sex, not sharing sex toys, and getting routine STI tests.

Remember, regardless of what STI you have, you should tell the last person you had sex with and any sex partners from the last 2–3 months. They should also get tested, even if they have no symptoms, and might require treatment.

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