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What’s the Difference Between Chlamydia and Gonorrhea?

Chlamydia and gonorrhea are both common bacterial sexually transmitted infections, but they are caused by different bacteria. Because of this, they have different symptoms and treatment options.

What Causes Chlamydia and Gonorrhea?

Chlamydia and gonorrhea are both caused by an overgrowth of bacteria in the body. However, the bacteria that causes chlamydia is called Chlamydia trachomatis while the bacteria that causes gonorrhea is called Neisseria gonorrhoeae.

Chlamydia trachomatis is an extracellular organism. This means it does not invade your body’s cells. Instead, it lives in the cervix, the rectum, and other passages in the body, except for the genitals. It takes 7 to 15 days after exposure for any symptoms to develop.

Neisseria gonorrhoeae is an intracellular organism. That means it invades and infects the body’s cells, including cells in the genitals, cervix, and rectum. Its incubation period is much more varied than Chlamydia trachomatis, lasting between 2 and 30 days for symptoms to develop.

How Do You Get Chlamydia and Gonorrhea?

Chlamydia and gonorrhea are both usually transmitted during unprotected vaginal, anal, and oral sex. You can also get these infections if your genitals come in contact with the genitals of someone with chlamydia or gonorrhea, even if you don’t have sex with them. Someone with these conditions can pass on the infection, even if they aren’t showing any symptoms at the time. Expectant moms can also pass chlamydia and gonorrhea on to their babies during childbirth.

What Are the Symptoms of Chlamydia and Gonorrhea?

You can get chlamydia or gonorrhea and show no symptoms at all. Women are less likely to develop symptoms after being infected with gonorrhea than men. If they do get symptoms, they also tend to be much milder. Men and women are just as likely to show chlamydia symptoms. These may develop weeks after infection. Chlamydia and gonorrhea share many of the same symptoms, including:

  • Burning sensation in genitals, especially when urinating.
  • Unusual or discolored genital or rectal discharge.
  • Pain or bleeding from the rectum, if contracted during anal sex.
  • Pain during ejaculation.
  • Swollen testicles and scrotum.
  • Sore throat, if contracted during oral sex.
  • Cough, if contracted during oral sex.
  • Conjunctivitis.
  • Sensitivity to light.

Chlamydia shares its most common symptoms with gonorrhea, although these symptoms are usually much milder than they are in gonorrhea cases. Gonorrhea also has some unique common symptoms. These include:

  • Itching, soreness, or painful bowel movements.
  • Painful sex, for women.
  • Heavy periods.

If left untreated, both these sexually transmitted infections can cause some more serious side effects. These include:

  • Infertility.
  • Infected testicles and prostate glands.
  • Pelvic inflammatory disease: This condition can cause irregular vaginal bleeding, pelvic pain, fever, and general unwellness.
  • Ectopic pregnancies.

In addition, untreated chlamydia can also trigger reactive arthritis which makes your joints and eyes swell and feel tight or painful. It can also cause adhesions to form on your fallopian tubes.

All these serious symptoms sound scary, but they only occur if these conditions are left untreated. Getting regular STI screenings to detect these conditions will ensure you treat your infections soon enough that you never have to worry about these complications.

How Common Is Chlamydia and Gonorrhea?

Chlamydia is the most commonly reported bacterial sexually transmitted infection in the United States. In 2018, the Centers for Disease Control and Prevention (CDC) received reports of approximately 1.76 million new cases of chlamydia. However, as some people do not know symptoms, it’s estimated that the actual number of new annual cases is closer to 2.86 million. Gonorrhea isn’t quite as common, with the CDC estimating there are approximately 820,000 new infections in the United States every year.

How Do You Prevent Chlamydia and Gonorrhea?

The same steps will reduce your risk of catching chlamydia and gonorrhea. Using condoms every time you have vaginal or anal sex will prevent you from catching one of these diseases from an infected partner. Using dental dams for oral sex will also reduce your risks.

Women should also avoid odor-reduction products including vaginal douches. These products kill off the vagina’s natural bacteria which can actually fight off infections like chlamydia and gonorrhea.

How Are Chlamydia and Gonorrhea Diagnosed?

Chlamydia and gonorrhea can both be diagnosed with blood or urine tests, even if you are not showing any symptoms at the time. The CDC recommends women under the age of 25 and older women with new partners, multiple partners, or infected partners undergo yearly STI screenings to test for chlamydia and gonorrhea. The CDC doesn’t recommend screening for men, but it certainly can’t do any harm if you are concerned about your risks.

If you do show symptoms of one of these STIs, it may be diagnosed during a physical exam. Your care providers may also take a swab culture of any genital or rectal discharge to confirm the diagnosis.

How Are Chlamydia and Gonorrhea Treated?

Since they are caused by different bacteria, chlamydia and gonorrhea require different treatment plans.
Chlamydia is usually treated with one of the following medications:

  • Azithromycin (Zithromax, Z-Pak): a single pill or course of daily pills taken over approximately one week.
  • Doxycycline (Oracea, Monodox): Two pills daily for approximately one week.

Since gonorrhea invades the cells, it requires a more aggressive treatment approach. You will usually receive both of the following treatments:

  • Ceftriaxon (Rocephin) injection.
  • Azithromycin (Zithromax, Z-Pak): a single pill or course of daily pills taken over approximately one week.

No matter which condition you have, you should follow your medical team’s advice carefully to resolve it. Take the full course of medications prescribed, even if you start feeling better, to ensure the infection is totally gone. If you don’t complete the antibiotics you may also develop an antibiotic resistance. This can make treating the condition difficult if you catch it again in the future.

You should also postpone sex until your infection has totally cleared up as you can still pass it on to your sexual partners, even if you aren’t showing symptoms anymore. They can then pass it back to you. If you follow your medical team’s treatment plan, both gonorrhea and chlamydia should clear up in one to two weeks.

Further Reading

Invasion of Human Mucosal Epithelial Cells by Neisseria gonorrhoeae Upregulates Expression of Intercellular Adhesion Molecule 1 (ICAM-1), National Center for Biotechnology Information, March 1999

Chlamydia – CDC Fact Sheet (Detailed), Centers for Disease Control and Prevention, October 2016

Gonorrhea – CDC Fact Sheet (Detailed Version), Centers for Disease Control and Prevention, November 2019

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