“The clap” is a slang term for gonorrhea, one of the most common sexually transmitted infections worldwide. It’s caused by a bacterium called Neisseria gonorrhoeae, which infects the mucous membranes of the genitals, rectum, and throat. The nickname has been around for centuries, originating from the French term “les clapiers,” which referred to the small huts where sex workers lived and saw clients in medieval France. Today, gonorrhea remains a major public health concern, partly because the bacterium is becoming increasingly resistant to antibiotics.
How Gonorrhea Spreads
Gonorrhea passes from person to person during vaginal, anal, or oral sex. The bacterium thrives on warm, moist tissue, so it can establish infections in the urethra, cervix, rectum, and throat. A pregnant person with gonorrhea can also pass the infection to their baby during delivery, which typically causes an eye infection in the newborn that leads to redness, soreness, and ulcers if untreated.
The bacterium is well equipped to survive in the body. Its surface is covered in tiny hair-like structures that latch onto human cells with strong affinity, and its outer coating helps it evade the immune system’s first line of defense. This is why infection takes hold quickly and why reinfection is common even after successful treatment.
Symptoms in Men and Women
One of the trickiest things about gonorrhea is that most people who have it don’t know it. Roughly 90% of women with a genital infection show no symptoms at all. The numbers for men are surprisingly high too: studies estimate that 56% to 87% of infected men are also asymptomatic.
When symptoms do appear, they typically show up 1 to 14 days after exposure. In men, the most recognizable sign is a white, yellow, or green discharge from the penis, along with a burning sensation when urinating. Less commonly, the testicles may become painful or swollen.
Women may notice increased vaginal discharge, pain or burning during urination, or bleeding between periods. Because these symptoms overlap with other common conditions like urinary tract infections or yeast infections, gonorrhea in women often goes unrecognized without testing.
Rectal infections, which can occur in anyone who has receptive anal sex, may cause discharge, anal itching, soreness, bleeding, or painful bowel movements. Throat infections are usually silent, though some people develop a sore, red throat. The lack of obvious symptoms in so many cases is exactly why gonorrhea spreads so easily.
What Happens If It Goes Untreated
Left alone, gonorrhea doesn’t just resolve on its own. In women, the infection can travel upward into the uterus and fallopian tubes, causing pelvic inflammatory disease (PID). PID can permanently scar the reproductive tract, leading to chronic pelvic pain and infertility. This damage is irreversible even after the infection is eventually cleared.
In rare cases, the bacteria enter the bloodstream and spread to other parts of the body, a condition known as disseminated gonococcal infection. This can affect the skin, joints, and internal organs, causing fever, rash, skin sores, and painful joint swelling. Men can also develop painful inflammation in the tube that carries sperm, which may affect fertility.
Testing and Detection
The standard test for gonorrhea is a nucleic acid amplification test (NAAT), which detects the bacterium’s genetic material in a urine sample or swab. NAAT is highly sensitive and can pick up very small amounts of the bacterium’s DNA, meaning you don’t need to wait long after a potential exposure. Expert guidance suggests NAAT can be performed without a mandatory waiting period, though older culture-based tests may give false negatives if done within 48 hours of exposure.
If you’ve had unprotected sex with a new partner or a partner who tested positive, getting tested is the only reliable way to know your status, given how often the infection produces no symptoms. Testing typically involves a urine sample for genital infections or a swab for throat and rectal infections.
How Gonorrhea Is Treated
Current guidelines recommend a single injection of the antibiotic ceftriaxone to treat uncomplicated gonorrhea of the genitals, rectum, or throat. Because gonorrhea and chlamydia frequently occur together, a course of oral antibiotics for chlamydia is often added unless chlamydia has been specifically ruled out by testing.
Treatment is straightforward when the infection is caught, but there’s a growing problem. Gonorrhea has developed resistance to nearly every class of antibiotic ever used against it. Resistance to older drugs like ciprofloxacin is already widespread in many countries. Resistance to azithromycin is climbing. And perhaps most concerning, strains with resistance to ceftriaxone, the current last-line treatment, have begun to appear.
The Rise of “Super Gonorrhea”
Strains of gonorrhea that resist multiple antibiotic classes, including the current recommended treatment, have earned the nickname “super gonorrhea.” These extensively drug-resistant strains can shrug off penicillin, tetracycline, fluoroquinolones, azithromycin, and in some cases ceftriaxone. The first confirmed global failure to cure a throat infection with the standard dual therapy of ceftriaxone plus azithromycin was reported in the United Kingdom in 2016. Two years later, in 2018, the UK also reported the first gonococcal strain with resistance to both ceftriaxone and high-level azithromycin resistance.
Treatment failure cases have since been reported in Austria, the UK, and other countries, and the numbers are rising. The World Health Organization considers antibiotic-resistant gonorrhea a serious global threat. For now, ceftriaxone still works against the vast majority of infections, but the window is narrowing. This makes prevention, early testing, and proper treatment more important than ever, since incomplete or incorrect antibiotic use accelerates resistance.
Reducing Your Risk
Condoms significantly reduce the chance of transmission during vaginal, anal, or oral sex. Because gonorrhea is so often asymptomatic, regular STI screening is one of the most practical defenses, especially if you have new or multiple sexual partners. If you test positive, any recent sexual partners need to be notified and tested too, since reinfection from an untreated partner is common. Having gonorrhea once does not create immunity; you can catch it again immediately after treatment.