Gonorrhea

Gonorrhea is a common sexually transmitted infection (STI). It’s caused by bacteria called Neisseria gonorrhoeae and spreads through oral, anal, or genital sex.

In Canada, rates of gonorrhea are rising. Men who have sex with men are especially affected, with many cases found in the throat and rectum.

Why Gonorrhea Matters for HIV & Other STIs

• Rectal gonorrhea can make it easier to get HIV.
• Having gonorrhea once does not protect you—you can get it again.
• Many people don’t notice symptoms, so the infection spreads without anyone knowing.
  

Symptoms — What to Watch For

Most people with gonorrhea have no symptoms. But when symptoms do show, they depend on the site of infection:

• Urethra (penis, urine passage): discharge, burning when peeing, itching, pain
• Rectum: discharge, bleeding, pain during bowel movements, discomfort
  
• Throat: sore throat or no symptoms at all
  
• Eyes: pain, redness, discharge if infected fluids touch the eye
  

If you notice these signs, see a healthcare provider and get tested.

Getting Tested — It’s Key

Because gonorrhea often has no symptoms, testing is crucial. But here’s something important:

Many primary care providers only order a urine test. While useful, urine tests miss infections in the throat and rectum. Research in Canada shows that when clinics added swabbing for those sites, 70% of gonorrhea cases were found only in the throat or rectum—places a urine test alone would have missed (canada.ca).

That’s why swabbing is equally, if not more, important than urine testing. If you’ve had oral or anal sex, ask your provider to test those sites. Some clinics even offer self-swabs, which many people find more comfortable. Routine testing in all your holes is the best way to know your status!

Treatment

Gonorrhea is usually treated with antibiotics. Because resistance is a growing concern, a test-of-cure may be recommended—especially for throat infections, which can be harder to clear.

Taking care

• Use condoms for all kinds of sex (oral, anal, and vaginal).
  
• Some people use DoxyPEP (taking doxycycline after sex). It lowers the risk of some bacterial STIs but is less effective for gonorrhea, since gonorrhea often resists it.
  
• Avoid frequent rectal douching (more than 2–3 times per week). Over-douching may increase risk of infection.
  
• Talk openly with partners about STI testing and sexual health. Honesty helps reduce shame and keeps everyone safer.
  

Dealing with Stigma

STIs often come with shame or fear. But stigma can keep people from getting tested, treated, or talking to partners.

• Getting tested and treated is a sign of care for yourself and others.
  
• Having an STI does not make you “dirty” or “bad.”
  
• You don’t have to share your STI status with everyone you know. Choose who, when, and how to tell.
  

A sex-positive approach means recognizing that your sexuality is valid. You deserve health, safety, and pleasure without shame.

Gonorrhea is common and often silent. It matters because of its link to HIV and because untreated infections can spread quickly.

The good news? Testing, swabbing, condoms, treatment, and open conversations make a big difference. With the right tools and information, you can enjoy your sex life while protecting yourself and your partners. Check out ourFactsheet on Gonnorhea for more information.