Gonorrhea is one of the most common sexually transmitted infections (STIs) in Canada. It is a bacterial infection that affects the urethra, cervix, rectum, throat, and sometimes the eyes. Many people who have gonorrhea do not know it, because they feel no symptoms at all. However, without treatment, gonorrhea can lead to serious health problems.

What Is Gonorrhea?

Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. It spreads through unprotected vaginal, anal, or oral sex with an infected person. A pregnant person can also pass gonorrhea to their baby during childbirth.

Anyone who is sexually active can get gonorrhea. However, Health Canada notes that women and people with a cervix face a higher risk of complications if the infection goes untreated. Gonorrhea does not give you immunity. You can get it again, even after a successful course of treatment.

It is important to know that an infected person can pass gonorrhea to others even when they have no symptoms at all. This is why regular STI testing matters, especially if you have more than one sexual partner.

How Does Gonorrhea Spread?

Gonorrhea spreads through direct sexual contact with an infected person. This includes vaginal, anal, and oral sex. It does not spread through casual contact, such as hugging, sharing food, or touching doorknobs.

An infected person remains contagious until they complete treatment. In addition, a new exposure to gonorrhea after treatment will cause a new infection. Previous treatment offers no protection against future infections.

Who Is at Higher Risk?

Certain behaviours and circumstances increase your risk of getting gonorrhea. These include:

  • Having multiple sexual partners

  • Having a partner who has other sexual partners

  • Having unprotected sex (without a condom)

  • Men who have unprotected sex with other men

  • Starting sexual activity before age 18

Furthermore, any child diagnosed with gonorrhea must be seen by a doctor right away. A healthcare provider will work to understand how the infection occurred and whether abuse may be a concern.

Gonorrhea Symptoms to Watch For

Almost half of all people with gonorrhea have no symptoms at all. When symptoms do appear, they usually show up within two to five days of infection. However, in some cases, symptoms may not appear for up to 30 days.

Gonorrhea can also spread beyond the genitals. When it spreads to other parts of the body, it is called disseminated gonococcal infection. Symptoms of this form include skin rashes, joint pain, and swollen tendons.

Symptoms in Women

In women, early gonorrhea symptoms are often mild. They can easily be mistaken for a bladder infection or vaginal infection. As a result, many women do not seek care right away. Symptoms may include:

  • Unusual vaginal discharge (yellowish or with an odour)

  • Painful or frequent urination

  • Bleeding between periods or after sex

  • Irregular or heavier-than-normal periods

  • Pelvic pain or pain during sex

  • Genital itching or burning

  • Swollen and painful Bartholin glands (located at the vaginal opening)

  • Anal itching, pain, bleeding, or discharge

  • Sore throat, difficulty swallowing, or swollen lymph nodes in the neck (less common)

  • Red, irritated eyes (rare)

Symptoms in Men

Men tend to experience more noticeable symptoms, which often prompts them to seek care sooner. However, some men have mild or no symptoms and unknowingly pass the infection to others. Symptoms may include:

  • Penile discharge (starting clear or milky, then becoming yellow, creamy, or blood-tinged)

  • Burning or pain during urination

  • Anal itching, pain during bowel movements, or bleeding

  • Sore throat (less common)

  • Red, irritated eyes (rare)

According to the Mayo Clinic’s overview of gonorrhea, symptoms in men are generally more pronounced, which leads to earlier diagnosis and treatment compared to women.

Potential Complications If Left Untreated

Gonorrhea that is caught and treated early causes no long-term problems. However, untreated gonorrhea can lead to serious complications. Therefore, waiting and hoping symptoms will go away on their own is never a good idea.

Complications in Women

In women, untreated gonorrhea can spread to the uterus and fallopian tubes, causing pelvic inflammatory disease (PID). PID can result in chronic pelvic pain, difficulty getting pregnant, or an increased risk of ectopic pregnancy (a pregnancy outside the uterus).

Complications in Men

In men, untreated gonorrhea can cause epididymitis, a painful condition affecting the tubes near the testicles. In rare cases, this can affect fertility. The infection can also spread to the bloodstream and joints, causing a serious condition called disseminated gonococcal infection.

The World Health Organization’s fact sheet on gonorrhea highlights that antibiotic-resistant strains of gonorrhea are a growing global concern, making early diagnosis and proper treatment even more critical.

When to See a Doctor

If you think you may have gonorrhea, do not wait. Visit your family doctor, a walk-in clinic, or a sexual health centre as soon as possible. Many provincial health plans in Canada cover STI testing, so cost should not be a barrier.

Seek Care Right Away If You Have

Some symptoms are a sign that the infection may be spreading. Seek immediate care if you experience any of the following:

In women:

  • Sudden, severe pelvic pain

  • Pelvic pain with vaginal bleeding or discharge and a fever of 38°C or higher

  • Painful, frequent urination or inability to urinate along with a fever

In men:

  • Penile discharge with a fever of 38°C or higher

  • Painful or frequent urination, or inability to urinate, along with a fever

  • Pain, swelling, or tenderness in the scrotum along with a fever

Also Book an Appointment If You Notice

Even without a fever, certain signs are worth a conversation with your healthcare provider. These include:

  • Unusual genital or anal rashes, sores, or swelling

  • Burning, pain, or itching when urinating for more than 24 hours

  • Any unusual penile or vaginal discharge

  • Pain during sex or bleeding after sex

  • Any known or suspected exposure to an STI

  • Red or irritated eyes after sexual contact

Walk-in clinics across Canada can test and treat gonorrhea without an appointment. You do not need a referral to be tested for STIs in most provinces.

Diagnosis and Treatment

A doctor diagnoses gonorrhea with a simple swab test from the affected area (urethra, cervix, throat, or rectum) or a urine sample. Results are usually available within a few days.

Gonorrhea is treated with antibiotics. Because antibiotic-resistant gonorrhea is becoming more common in Canada, treatment often involves a combination of two antibiotics given at the same time. Your doctor will advise you on the best approach based on current guidelines.

What Happens After Treatment?

You must avoid all sexual contact until you and your partner have both completed treatment and have no symptoms. In addition, you should notify any sexual partners from the past 60 days so they can also get tested and treated. If you feel uncomfortable doing this yourself, public health departments in most provinces offer confidential partner notification services.

It is also important to go back for a follow-up test if your symptoms do not clear up within a few days of finishing treatment. This helps confirm the infection is gone and rules out antibiotic resistance.

How to Reduce Your Risk

Using a condom correctly every time you have sex is the most effective way to reduce your risk of gonorrhea. Regular STI testing is also a key part of staying healthy if you are sexually active with more than one partner.

Open and honest conversations with your sexual partners about STI status and testing are important. Furthermore, getting tested together before starting a new sexual relationship is a responsible and caring choice.

Can you have gonorrhea and not know it?

Yes, this is very common. Nearly half of all people with gonorrhea have no symptoms at all. Because gonorrhea can be silent, regular STI testing is the only reliable way to know your status if you are sexually active.

How soon do gonorrhea symptoms appear?

Gonorrhea symptoms typically appear within two to five days of infection. However, in some cases, symptoms may not show up for up to 30 days — or not at all. This is why waiting for symptoms before getting tested is not a reliable approach.

Is gonorrhea curable?

Yes, gonorrhea is curable with the right antibiotics prescribed by a doctor. However, antibiotic-resistant strains are becoming more common, so it is important to complete the full course of treatment exactly as prescribed. Having gonorrhea once does not protect you from getting it again.

Where can I get tested for gonorrhea in Canada?

You can get tested for gonorrhea at your family doctor’s office, a walk-in clinic, or a sexual health centre. Most provincial health plans in Canada cover STI testing, so there is usually no out-of-pocket cost. No referral is needed at most walk-in clinics.

Can gonorrhea affect areas other than the genitals?

Yes, gonorrhea can infect the throat, rectum, and eyes in addition to the genitals. If the infection spreads through the bloodstream, it can also cause joint pain, skin rashes, and swollen tendons — a condition known as disseminated gonococcal infection.

Do both partners need to be treated for gonorrhea?

Yes, both partners must be treated for gonorrhea, even if one person has no symptoms. Treating only one partner means the other can re-infect them after treatment. All sexual partners from the past 60 days should be notified and tested.

Key Takeaways

  • Gonorrhea is a common and treatable bacterial STI spread through unprotected sexual contact.

  • Many people have no symptoms, making regular testing essential for sexually active Canadians.

  • Symptoms vary between men and women, and can affect the genitals, throat, rectum, and eyes.

  • Left untreated, gonorrhea can lead to serious complications, including infertility and pelvic inflammatory disease.

  • Treatment involves antibiotics — both partners must be treated at the same time to prevent re-infection.

  • You can get tested at your family doctor, walk-in clinic, or local sexual health centre — most provincial health plans cover the cost.

  • Using condoms consistently and getting regular STI checkups are the best ways to protect yourself and your partners.

This article is for general information only and does not replace professional medical advice. If you have concerns about gonorrhea or any other STI, please speak with your family doctor, a walk-in clinic provider, or a sexual health professional.