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What is the Difference Between Chlamydia and Gonorrhea?

By Tamsen Butler
Updated Mar 03, 2024
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Chlamydia and gonorrhea are infections that are acquired primarily through sexual contact and affect the urinary tract and genitals. Despite these similarities, they are recognizably different diseases, with different symptoms, treatment, and complications. Chlamydia symptoms include the presence of a discharge and painful urination, while gonorrhea more often causes genital burning and itching. Treatment for both requires antibiotics, but different drugs are used.

Causes

Both of these diseases are caused by bacterial infections, but the species that cause them are not the same. Chlamydia is caused by Chlamydia trachomatis, while gonorrhea is caused by Neisseria gonorrhoeae. These infections are most common in people aged 15 to 24.

Symptoms

Often, it's not immediately obvious that a person has either of these infections, although symptoms are even less likely to occur in women. In the case of chlamydia, 50% of men and 80% of women do not show any signs. Almost all men have at least one symptom of gonorrhea, but only 50% of women have any at all. This means that women are less likely to be diagnosed with either disease, and they have a higher risk of developing complications.

Women and men tend to experience the symptoms of chlamydia differently. In women, they closely resemble those of a bladder infection, with painful urination and low fever, and sometimes a discharge from the vagina or rectum. Women are also likely to experience pain during sexual intercourse. These symptoms make correct diagnosis different, as the sufferer might assume a bladder infection is the cause, and that medical treatment is not necessary. Men with chlamydia typically experience a light-colored discharge from the penis or rectum, painful urination, and pain in the testicles.

Symptoms of gonorrhea in both men and women can include pain and itching of the genitals, painful burning urination, increased frequency of urination, and a sore throat. In men, a white, yellow, or green discharge from the penis may also occur, along with a red or swollen urethra and swollen testicles that are tender to the touch. For women, vaginal discharge, pain during sexual intercourse, pain in the lower abdomen, and fever may be caused by the infection.

Diagnosis

Chlamydia and gonorrhea are diagnosed using similar methods. In each case, a urine sample, or a sample of the genital discharge, is processed in a laboratory using a polymerase chain reaction. In this technique, bacterial DNA from a sample is duplicated to provide enough material to carry out a diagnostic assay. The diagnosis is then completed by comparing the DNA from the sample to that of a known laboratory standard.

Treatment

Antibiotics are the standard treatment for both infections, but the specific drugs used are not the same. People with chlamydia typically take either erythromycin or azithromycin, while gonorrhea is most often treated with ceftriaxone, cefixime, or doxycycline. Depending on the medication, a patient might be given either a short course of the antibiotic or a single-dose treatment.

Complications

Men and women with untreated chlamydia are at risk of developing Reiter’s syndrome, a combination of urethral inflammation, conjunctivitis, and arthritis. Women are also at risk of pelvic inflammatory disease, which affects the uterus and fallopian tubes, and can cause infertility. In addition, a woman who is infected at the time of giving birth has up to a 50% chance of passing the disease to her infant.

Untreated gonorrhea can lead to meningitis, joint infections, and heart valve infection in both women and men. Men are also at risk of urethral inflammation that can lead to scarring. Women can develop pelvic inflammatory disease, scarring of the fallopian tubes, and infertility or be more likely to have an ectopic pregnancy. The infection can also be transmitted from a woman to a fetus either during pregnancy or delivery.

Prevention

Chlamydia and gonorrhea can both be transmitted via vaginal and anal intercourse, as well as through oral sex. A person who wishes to protect himself or herself from these and other sexually transmitted infections should use a condom or other means of protection for all types of sexual contact. This is particularly important because the high rate of infections with no symptoms means it is not always possible to tell whether someone is infected.

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Discussion Comments
By anon330058 — On Apr 14, 2013

@JessiC: I think it may be half and half. Back in the day, this is actually how they treated gonorrhea! It's actually the reason it also goes by the name "the clap." They would actually clap the discharge out of the penis, usually with an object (maybe a hammer; I'm not sure)!

However, I'm fairly certain they haven't used this method in very many decades. So, it's a very good chance your uncle told you about this scary old practice as a means of scaring you straight!

By JessiC — On Jun 29, 2011

Okay. I’ve got this uncle who told me that he had chlamydia once a few years back. He ended up going to the doctor and what he told me they did to him made my skin crawl. I will also tell you that I used protection faithfully until I was married and in a purely monogamous relationship.

Now, I’m wondering if the ‘treatment’ he described to me was a real method or if he was just trying to make sure a young man about to become sexually active really was careful.

He told me that his penis swelled up and that he couldn’t pee. That was bad enough, but he said that the nurse (a lady, no less) actually hit the head of it with a hammer to break apart the infection.

At the time, I totally bought it. Now I’m thinking I might have been a moron, but at least I was a moron without gonorrhea or chlamydia.

By dimpley — On Jun 29, 2011

@Eviemae – So sorry that you’re having this worry right now, and I’m afraid I don’t have any answers for you. I’m not sure if these are tests that are routinely tested with a pap smear or not.

But, I would like to offer you some encouragement for one simple reason. If this is gonorrhea or chlamydia it is really a great thing that you are having symptoms. This will prompt you to get treatment, hopefully.

However, people can have both of these for years without ever having a symptom at all. That means that they can spread it without even knowing and that they can develop some really serious diseases as a result later in life.

Go to the doctor and get checked out. Make sure everything is okay.

By Eviemae — On Jun 28, 2011

I have the distinct pleasure of having fallen victim to a man who cheated on me. Unfortunately for me, I completely trusted this man one hundred and ten percent. In other words, sometimes we weren't exactly careful.

I have always had issues with bladder and yeast infections, and so I didn’t think much of it when I began to experience painful urination. However, none of the over the counter meds that usually take care of the issue are coming through this time.

I didn’t think that it was possible for me to have either chlamydia or gonorrhea for the simple fact that I’ve had a pap since I was sexually active with this cheater.

Now I’m starting to wonder though if they routinely test for chlamydia and gonorrhea or if they have to be requested.

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