Gonorrhea in women is treated with a single injection of ceftriaxone, a strong antibiotic given as a one-time shot in the muscle. Because chlamydia commonly occurs alongside gonorrhea, most providers also prescribe a week-long course of oral doxycycline unless chlamydia has been ruled out by testing. For many women, that means one clinic visit, one shot, and one week of pills to cover both infections at once.
The Standard Treatment
The current CDC-recommended regimen is a single 500 mg intramuscular injection of ceftriaxone. You receive this shot at a clinic or doctor’s office, typically in the upper arm or buttock. It works quickly and clears most uncomplicated gonorrhea infections of the cervix, urethra, and rectum.
If your provider hasn’t confirmed that chlamydia is absent, you’ll also receive doxycycline, 100 mg taken by mouth twice a day for seven days. Roughly 10 to 30 percent of women with gonorrhea also have chlamydia, so this dual approach prevents a second untreated infection from lingering and causing damage. You should avoid sex for at least seven days after treatment and until any sexual partners have been treated as well.
Why Older Antibiotics No Longer Work
Gonorrhea has steadily developed resistance to nearly every antibiotic used against it over the past several decades. According to 2025 surveillance data from the World Health Organization, resistance to ciprofloxacin (a once-common oral treatment) has reached 95 percent globally. Azithromycin resistance sits at about 4 percent, which is low but rising enough that it was dropped as part of the routine gonorrhea regimen. Ceftriaxone remains effective for the vast majority of infections, which is why it’s the only first-line option left. This also means there is no reliable oral-only treatment for gonorrhea right now. You need that injection.
Treatment During Pregnancy
Pregnant women receive the same 500 mg ceftriaxone injection, which is considered safe throughout pregnancy. Doxycycline, however, is not used during pregnancy because it can affect fetal bone and tooth development. Your provider will substitute a pregnancy-safe antibiotic to cover a possible chlamydia co-infection.
If you have a cephalosporin allergy, treatment becomes more complex. Some alternative drugs carry risks during pregnancy. Gentamicin, for instance, is used cautiously because of potential harm to fetal kidneys and hearing. In these cases, the CDC recommends consultation with an infectious disease specialist to find the safest effective option.
If You Have a Cephalosporin Allergy
For non-pregnant women who can’t take ceftriaxone due to a confirmed allergy, the options are limited. The CDC advises working with an infectious disease specialist or STI clinical expert rather than substituting a different antibiotic on your own provider’s best guess. This matters because the wrong alternative can lead to treatment failure, and a partially treated gonorrhea infection can spread and develop further resistance.
Why Gonorrhea Is Riskier in Women
Gonorrhea in women often produces mild symptoms or none at all, which means many infections go undetected for weeks or months. During that time, the bacteria can travel from the cervix into the uterus and fallopian tubes, causing pelvic inflammatory disease (PID). This is one of the most serious complications of untreated gonorrhea and can lead to chronic pelvic pain, scarring of the fallopian tubes, and infertility.
Signs that gonorrhea may have progressed to PID include lower abdominal or pelvic pain, pain during sex, unusual vaginal discharge, and fever above 101°F. If your provider suspects PID, treatment is more intensive: a longer course of antibiotics (typically 14 days) combining multiple drugs to cover the broader range of bacteria involved. Most mild-to-moderate PID can be treated on an outpatient basis, but if symptoms are severe, if you’re pregnant, or if you don’t improve within 72 hours of starting oral antibiotics, hospital-based treatment with intravenous antibiotics becomes necessary.
In rare cases, gonorrhea spreads through the bloodstream, causing joint pain, swelling in the tendons of the hands and feet, and scattered skin lesions. This condition, called disseminated gonococcal infection, requires hospitalization and intravenous antibiotics.
Throat and Rectal Infections
Gonorrhea doesn’t only infect the cervix. Women can also carry the bacteria in the throat (from oral sex) or rectum (from anal sex or spread from vaginal discharge). These sites are treated with the same ceftriaxone injection. Pharyngeal (throat) gonorrhea is notably harder to clear than cervical or rectal infections, which is one more reason the injectable antibiotic is essential. Throat infections are also easy to miss because they rarely cause symptoms beyond a mild sore throat, if anything at all.
Follow-Up Testing
The CDC recommends retesting three months after treatment. This isn’t because the antibiotics failed. It’s to catch reinfection, which is common, especially if a sexual partner wasn’t treated or if you’ve had new partners. If you can’t return at three months, get retested within 12 months at your next healthcare visit. A standard test of cure (confirming the original infection cleared) isn’t routinely needed for uncomplicated cases treated with ceftriaxone, but your provider may order one if your symptoms persist or if you had a pharyngeal infection.
Partner Treatment
Your treatment won’t last if your partner is still carrying the infection. All sexual partners from the past 60 days should be tested and treated. In many states, a practice called expedited partner therapy allows your provider to write a prescription for your partner without examining them first. This is particularly useful when a partner is unlikely to visit a clinic on their own. The CDC considers EPT a practical tool for managing gonorrhea, especially for male partners of women with the infection. Check your state’s laws, as EPT legality varies.
Until both you and your partner have completed treatment and waited at least seven days, sexual contact risks passing the infection back and forth. Using condoms consistently after treatment significantly reduces the chance of reinfection going forward.