Gonorrhea is a sexually transmitted bacterial infection that can affect both men and women. Each year, more than 500,000 adults in the United States are diagnosed, according to the Centers for Disease Control and Prevention (CDC). While gonorrhea is most common in young people aged 15 to 24, anyone who has unprotected sex is at risk for being infected.
Though it’s long been considered curable with medication, gonorrhea has become harder to treat in recent years. That’s because the bacteria that causes the infection has grown resistant to many of the drugs used in the past. But in 2025, for the first time in decades, the U.S. Food & Drug Administration (FDA) approved two new oral medications for treatment, zoliflodacin and gepotidacin.
Gonorrhea symptoms and complications
Gonorrhea is caused by Neisseria gonorrhoeae (N. gonorrhoeae), a type of bacteria. It can infect the:
- Mouth and throat
- Eyes
- Rectum, the last part of your digestive system
- Urethra, tube that carries urine out of the body
- The female reproductive system, including the uterus (womb) and vagina
Gonorrhea often has no noticeable symptoms, especially for women. But it can cause pain or burning during urination and discharge from the penis or vagina.
Left untreated, gonorrhea can become more serious. The infection can lead to pain in the pelvis and abdomen, pregnancy complications, and infertility issues in both men and women. It can also cause pelvic inflammatory disease (PID) in women. PID is a serious infection of the upper genital tract involving the uterus, fallopian tubes, and ovaries. In some cases, a pregnant person may pass gonorrhea to their baby during birth. Gonorrhea can also increase the risk of acquiring HIV.
Antibiotic resistance and gonorrhea treatment
Antibiotics are drugs used to treat bacterial infections. Over time, N. gonorrhoeae has become increasingly resistant to a variety of antibiotics. That means the drugs no longer work as well as they used to. Eventually, they may not work at all.
The resistance is caused by many factors, including genetic mutations within N. gonorrhoeae and overuse of antibiotics in general. When antibiotics are used unnecessarily on a large scale, it helps stronger bacteria to survive and multiply, leading to more powerful infections that no longer respond to treatments.
The Centers for Disease Control and Prevention (CDC) used to recommend treating gonorrhea with the antibiotics azithromycin and ceftriaxone. Due in part to increasing resistance, the CDC updated guidelines in 2020 to recommend that only a single injection of ceftriaxone be used. Ceftriaxone remains a first-line treatment.
In 2025, the FDA’s approval of zoliflodacin and gepotidacin gave healthcare providers (HCPs) additional treatment options. Both antibiotics treat uncomplicated urogenital gonorrhea, which means the infection hasn’t spread to the blood or other body parts.
- Zoliflodacin is a single-dose treatment, given as granules that dissolve in water. It’s meant for people ages 12 and older who weigh 77 pounds or more.
- Gepotidacin is given in two doses of four tablets each about 12 hours apart. It’s meant for people who are 17 and older who weigh at least 99 pounds.
Whatever medication a person receives, if symptoms continue for more than a few days afterward, a follow-up test should be given to ensure effective treatment. People with gonorrhea should also be retested three months after treatment, regardless of whether they think their sexual partners were successfully treated, too.
Screening for gonorrhea infection
A screening is a test that looks for signs of a disease before symptoms appear. It’s one of the best ways to detect an infection and prevent it from growing worse or spreading. Some people should be screened for gonorrhea once a year. They include the following, according to the CDC:
- All sexually active women ages 24 years or younger
- Women 25 years or older who are at increased risk for infection
- Men who have sex with men
These factors may raise infection risk:
- If you have more than one sex partner
- If your partner is having sex with other people
- If you’re not in a monogamous relationship and you don’t use condoms consistently
- If you have had a sexually transmitted infection in the past or currently have one
Men who have sex with men and have multiple or anonymous partners should be screened more than one time a year. Talk with your HCP about whether and how often it makes sense for you to be screened.
If you develop symptoms of gonorrhea, always be sure to check in with an HCP. The sooner you can get effective treatment, the better your chances of eliminating the infection.
