“The clap” is a common slang term for gonorrhea, a sexually transmitted infection caused by a type of bacteria that targets the moist, warm lining of the genitals, throat, and rectum. With over 543,000 reported cases in the United States in 2024 alone, it remains one of the most common STIs in the country. Gonorrhea is curable with antibiotics, but left untreated it can cause serious problems, including infertility.
Why Is Gonorrhea Called “the Clap”?
The origin of the nickname isn’t definitively settled, but the most widely cited explanation traces it to the French word “clapoir,” an old term for a venereal sore. Another theory suggests it comes from an old English slang word “clappan,” meaning to throb or beat, referring to the burning pain of the infection. Whatever its origin, “the clap” has been used for centuries and remains widely understood today.
How Gonorrhea Spreads
Gonorrhea passes from person to person through vaginal, anal, and oral sex. The bacteria thrive on mucous membranes, so any contact between the genitals, mouth, or rectum can transmit the infection. You don’t need to have penetrative sex to get it. Oral sex on a partner who has a genital infection can lead to a throat infection, and vice versa.
Condoms and dental dams significantly reduce the risk when used correctly every time. However, because gonorrhea can infect the throat and rectum, barrier methods need to be used during oral and anal sex too, not just vaginal intercourse. A pregnant person with gonorrhea can also pass the infection to their baby during delivery.
Symptoms in Men
Men tend to notice symptoms more readily than women. The most common signs include a white, yellow, or green discharge from the penis, along with a burning sensation when urinating that can range from mild to severe. Swollen or painful testicles can also develop. Most people experience symptoms within about two weeks of exposure, though some men remain symptom-free and can unknowingly pass the infection to partners.
Symptoms in Women
Most women with gonorrhea don’t have noticeable symptoms, which makes routine screening especially important. When symptoms do appear, they often mimic a urinary tract infection or mild vaginal issue: a burning sensation when peeing, increased vaginal discharge, or bleeding between periods. Because these signs are easy to dismiss or misattribute, many women carry the infection without realizing it, increasing the risk of complications and transmission.
Throat and Rectal Infections
Gonorrhea doesn’t only affect the genitals. It can infect the throat (from giving oral sex to an infected partner) and the rectum (from receiving anal sex). Throat infections often cause no symptoms at all, or just a mild sore throat that’s easy to ignore. Rectal infections may cause discharge, itching, soreness, or bleeding, but they can also be completely silent. These infections won’t show up on a standard urine test, so if you’ve had oral or anal exposure, you need to specifically ask for swabs at those sites.
How Gonorrhea Is Diagnosed
The standard test is a nucleic acid amplification test, or NAAT, which detects the bacteria’s genetic material from a urine sample or a swab of the infected area. It’s highly accurate and is the recommended method for initial screening. If you’ve been exposed, testing is typically reliable within about two weeks, though the exact window can vary depending on the site of infection. After treatment, a follow-up test is recommended to confirm the infection has cleared.
What Happens If It Goes Untreated
Untreated gonorrhea can cause damage that isn’t reversible. In women, the bacteria can travel upward from the cervix into the uterus and fallopian tubes, causing pelvic inflammatory disease (PID). PID can permanently scar the fallopian tubes, leading to chronic pelvic pain, ectopic pregnancy (where a fertilized egg implants outside the uterus, a life-threatening emergency), and infertility. This damage can happen even without obvious symptoms, a process sometimes called “silent” upper genital tract infection.
In men, untreated gonorrhea can cause epididymitis, a painful inflammation of the tube that carries sperm from the testicle. This too can lead to fertility problems if left unchecked. In rare cases, gonorrhea can spread through the bloodstream to other parts of the body, causing joint pain, skin lesions, and even heart valve infections.
Treatment and the Resistance Problem
Gonorrhea is treated with a single injection of an antibiotic. The current recommended regimen is a one-time shot, and for anyone who might also have chlamydia (a common co-infection), a course of oral antibiotics is added for seven days. Treatment is straightforward and typically clears the infection quickly.
The bigger concern is that gonorrhea has developed resistance to nearly every antibiotic ever used against it. Over the past 80 years, the bacteria have outpaced treatments one by one: penicillins, tetracyclines, fluoroquinolones, and macrolides have all lost effectiveness. The World Health Organization has flagged strains called “super gonorrhea” that resist virtually all available treatments, including what are considered last-resort options. Treatment failures have been confirmed in Australia, France, Japan, Sweden, the UK, and other countries. In 2018, a strain was identified in the UK that resisted both of the two antibiotics used in combination therapy.
This doesn’t mean your infection can’t be treated today. The current first-line antibiotic still works in the vast majority of cases. But the trend is worrying, and it’s one reason follow-up testing after treatment matters. If the infection doesn’t clear, your provider needs to know so an alternative approach can be tried.
Who Should Get Tested
Anyone who is sexually active and has a new partner, multiple partners, or a partner who has been diagnosed with gonorrhea should consider testing. Annual screening is generally recommended for sexually active women under 25, as well as for men who have sex with men. Because so many infections produce no symptoms, especially in women and in throat or rectal sites, waiting for symptoms before getting tested means many cases go undetected. Testing is simple, fast, and widely available at clinics, doctor’s offices, and public health centers.