Chlamydia vs. Gonorrhea: Symptoms, Risks & Treatment

In recent years, infections with sexually transmitted infections (STIs) such as chlamydia and gonorrhea have risen sharply. In 2023 alone, 31% more people in the Netherlands were diagnosed with gonorrhea than the previous year (from 10,600 to 13,853), and 24,048 cases of chlamydia were registered (RIVM, 2024). Both infections often present with similar symptoms, which makes distinguishing between them difficult. In both the short and long term, these diseases can lead to serious health complications, such as infertility. This article provides a detailed overview of chlamydia and gonorrhea to raise awareness and help you with prevention and treatment.

Table of contents

• What is the difference between chlamydia and gonorrhea?

• How do the symptoms compare?

• What causes chlamydia and gonorrhea?

• How can I prevent chlamydia and gonorrhea?

• How are chlamydia and gonorrhea diagnosed?

• Treatment of chlamydia and gonorrhea

• Summary

What is the difference between chlamydia and gonorrhea?

Chlamydia and gonorrhea are bacterial infections that can be transmitted through unprotected sexual intercourse. Despite their similarities, there are important differences in the bacteria that cause them and in treatment strategies.

Chlamydia vs. Gonorrhea
A chlamydia infection is caused by the bacterium Chlamydia trachomatis. The infection primarily affects the urethra, genitals, and rectum, but can also infect the throat (Deutsche Aidshilfe, n.d.).

A gonorrhea infection is caused by the bacterium Neisseria gonorrhoeae. It commonly affects the mucous membranes of the urethra, rectum, and throat, and more rarely, the eyes (Deutsche Aidshilfe, n.d.).

How do the symptoms compare?

Chlamydia and gonorrhea infections are often not easily detected. Firstly, both infections can be asymptomatic, which is the case in 50–70% of chlamydia infections, for example. Secondly, the symptoms are often very similar, which complicates differentiation. Nevertheless, it is important to be aware of the specific signs, as both infections require different treatments (Cleveland Clinic, 2023)).

Common symptoms of both infections include:

• Burning or pain during urination

• Increased vaginal or urethral discharge

• Lower abdominal pain or pain during intercourse

• Sore throat

Source: Derived from Cassano, et al. 2024.

Chlamydia symptoms

Chlamydia symptoms usually appear one to three weeks after infection. However, many people do not notice any symptoms (70% of infected women experience no symptoms). The asymptomatic phase is particularly problematic, as individuals can unknowingly spread the disease and suffer serious complications (NHS, 2024).

Common symptoms of chlamydia infection include:

Gonorrhea symptoms

Gonorrhea symptoms usually appear within about two weeks of infection, though they can also manifest many months later. About 1 in 10 infected men and 5 in 10 infected women do not show any obvious symptoms, and the disease may go undetected for some time (NHS, 2021).

Typical symptoms of gonorrhea infection:

Do you notice any of these symptoms? Or simply want to be sure?

Homed-IQ offers tests that you can easily perform at home to check your sexual health. These tests allow you to collect a sample discreetly at home and receive results within a few days from a certified laboratory. The home test for chlamydia and gonorrhea specifically targets the two most common sexually transmitted infections. In addition, Homed-IQ offers a comprehensive STI test that also screens for trichomoniasis, HIV, and syphilis. The Basic-4 STI test includes chlamydia, gonorrhea, and trichomoniasis.

Whether you have symptoms or simply want to regularly check your STI status, Homed-IQ’s STI tests provide quick and anonymous clarity about your health.

Long-term consequences of untreated chlamydia or gonorrhea

The long-term consequences of untreated chlamydia or gonorrhea infections can be serious and differ depending on gender:

In women:

• Pelvic inflammatory disease (PID): An inflammation of the uterus, fallopian tubes, and ovaries can result from untreated STIs like chlamydia or gonorrhea. PID can lead to infertility, chronic pelvic pain, or blocked fallopian tubes.

• Pregnancy complications: An untreated chlamydia infection can lead to premature birth. The infection can also be transmitted to the newborn.

• Infertility: Untreated chlamydia infections can cause permanent damage to the fallopian tubes, uterus, or vagina.

In men:

• Epididymitis: Infection with chlamydia or gonorrhea can lead to inflammation and pain in the testicles or prostate.

• Reduced fertility: Chlamydia or gonorrhea infections can negatively impact fertility.

Sources: Cleveland Clinic, 2022;  Cleveland Clinic 2023. 

Early diagnosis and treatment of chlamydia and gonorrhea are crucial to avoid these complications and maintain long-term health. Regular STI testing, especially after risky encounters, is recommended to prevent the spread of infections.

What causes chlamydia and gonorrhea?

1. Sexual transmission through unprotected intercourse
Chlamydia and gonorrhea are mainly transmitted through unprotected vaginal, anal, or oral sex. The bacteria are present in the secretions of the infected person and can be transmitted through direct contact with the mucous membranes of a non-infected person.

2. Transmission from mother to child during birth
Newborns can become infected with chlamydia or gonorrhea during delivery if the mother is infected. This can lead to serious complications in the newborn and usually requires specialized medical care.

3. Indirect transmission through contaminated objects
Chlamydia and gonorrhea can also be transmitted through shared use of contaminated items like sex toys. The bacteria can survive on these items and cause infection upon contact with another person’s mucous membranes.

Source: Cleveland Clinic 2023.

What does not cause chlamydia and gonorrhea?

• Kissing

• Sharing food or drinks

• Hugging or holding hands

• Using the toilet after someone else

• Inhaling droplets after someone coughs or sneezes

Sources: Cleveland Clinic, 2022;  Cleveland Clinic, 2023; NHS, 2021.

What are risk factors?

Certain factors increase the risk of contracting chlamydia or gonorrhea:

• Unprotected sex

• Multiple sexual partners

• Existing sexually transmitted disease

• Younger age (especially under 25)

• Lack of knowledge about sexual health

Source: Cleveland Clinic, 2023

How can I prevent chlamydia and gonorrhea?

Preventing chlamydia and gonorrhea involves specific actions to effectively reduce the risk of infection:

• Condoms and barrier methods: Consistently and correctly use condoms or other barrier methods to prevent STI transmission.

• Seek information: Educate yourself thoroughly about STIs using reliable sources such as health authorities, doctors, or specialized websites to make informed decisions.

• Regular testing: Get tested regularly for STIs, especially if you have a new or multiple sexual partners.

• Limit the number of sexual partners: Reduce the risk of exposure by limiting the number of sexual partners.

• Open communication: Talk openly with your partners about sexual health and share test results to promote responsible behavior.

• Sex toy hygiene: Avoid sharing sex toys or disinfect them thoroughly before each use.

Source: CDC, 2024.

How are chlamydia and gonorrhea diagnosed?

Chlamydia and gonorrhea are diagnosed through specific tests that can be performed either at a doctor’s office or at home. Diagnosis typically involves urine tests or swabs from the affected areas (e.g., vaginal, throat, or rectal swabs) to detect the presence of bacteria (Mayo Clinic, 2023).

Treatment of chlamydia and gonorrhea

Both infections—chlamydia and gonorrhea—can be successfully treated with antibiotics. These kill the bacteria and help cure the infection. The choice of antibiotics and the exact treatment plan depend on several factors, including the severity of the infection, the individual's medical history, and potential resistance of the bacteria.

• Chlamydia is typically treated with oral antibiotics such as azithromycin or doxycycline (Cleveland Clinic, 2023).
• Gonorrhea is often treated with antibiotics such as ceftriaxone or gentamicin and azithromycin (Cleveland Clinic, 2022).
  
  Early and correct treatment is crucial to prevent complications and stop the infection from spreading to sexual partners.

Can chlamydia and gonorrhea be cured?

Yes. Both chlamydia and gonorrhea can usually be completely cured if diagnosed early and treated properly. However, some sexually transmitted infections cannot be cured. Regular testing or visits to a trusted doctor are the best ways to take care of your health (Cleveland Clinic, 2022; Cleveland Clinic, 2023).

Summary

Chlamydia and gonorrhea are among the most common sexually transmitted infections, and if left untreated, they can lead to serious health complications. Despite similar modes of transmission and symptoms, they differ in their causative bacteria and treatment approaches. Regular testing, safe sexual practices, and early treatment are key to keeping these infections under control and maintaining long-term health.