“The clap” is a centuries-old slang term for gonorrhea, one of the most common sexually transmitted infections in the world. In 2024, over 543,000 cases were reported in the United States alone, though the true number is likely much higher because the majority of infected people never develop symptoms. Gonorrhea is caused by a bacterium that targets the moist mucous membranes of the body, including the genitals, rectum, and throat.
Why Is It Called “The Clap”?
The exact origin of the nickname is debated. One popular theory traces it to an old French word, “clapoir,” meaning a swelling or sore associated with a sexually transmitted infection. Another theory suggests it referred to an old (and painful) folk treatment that involved clapping the penis between both hands to force out the discharge. Whatever the true origin, the term has stuck around for centuries and remains widely recognized today.
How Gonorrhea Spreads
Gonorrhea spreads through vaginal, anal, and oral sex. The bacterium thrives on mucous membranes, so any contact between the genitals, rectum, or throat of an infected person and a partner can transmit it. It can also pass from a mother to her baby during childbirth, potentially causing a serious eye infection that can lead to blindness if untreated. That’s why newborns routinely receive antibiotic eye ointment immediately after delivery.
You don’t need to have penetrative sex to get gonorrhea. Sharing sex toys or genital-to-genital contact without penetration can be enough. The bacterium cannot survive long outside the body, so you won’t catch it from toilet seats, swimming pools, or casual contact like handshakes.
Symptoms in Men and Women
Here’s the tricky part: most people with gonorrhea have no symptoms at all. Roughly 90% of women and anywhere from 56% to 87% of men carry the infection without knowing it. This is a major reason it spreads so easily.
When symptoms do appear, they differ by sex and by the body part infected:
- In men: A burning sensation when urinating, white, yellow, or green discharge from the penis, and occasionally painful or swollen testicles.
- In women: Painful urination, increased vaginal discharge, and bleeding between periods. These symptoms are often mild enough to be mistaken for a bladder or yeast infection.
- Rectal infections (any sex): Discharge, anal itching, soreness, bleeding, or painful bowel movements. Many rectal infections cause no symptoms at all.
- Throat infections: Usually cause no symptoms, or just a persistent sore throat that’s easy to dismiss.
When men do develop symptoms, they typically show up within two to five days of exposure, though it can take up to two weeks. Women who notice symptoms may not see them for days to weeks, and because the signs are so mild, many never connect them to an STI.
How It’s Diagnosed
Testing for gonorrhea is simple and highly accurate. The standard method uses a urine sample or a swab from the infected site (vagina, rectum, or throat). For women, vaginal swabs are more reliable than urine samples, catching about 97% of infections compared to about 91% for urine. For men, a urine test works well. If you’ve had oral or anal sex, a throat or rectal swab is necessary because a urine test won’t detect infections in those locations.
Results typically come back within a few days. Many clinics now test for gonorrhea and chlamydia at the same time, since the two infections frequently occur together.
What Happens If It Goes Untreated
Untreated gonorrhea can cause serious health problems, especially for women. An estimated 10% to 20% of untreated infections in women progress to pelvic inflammatory disease, a condition where the infection spreads to the uterus and fallopian tubes. PID can cause chronic pelvic pain, scarring of the fallopian tubes, ectopic pregnancy, and permanent infertility. The damage happens because the infection replaces healthy tissue with scar tissue, which can block the tubes entirely.
In men, untreated gonorrhea can lead to epididymitis, a painful infection of the tubes near the testicles that can also affect fertility. In rare cases, the bacteria can enter the bloodstream and cause a body-wide infection that affects the joints, heart valves, or brain. This disseminated infection is uncommon but serious.
Treatment and Antibiotic Resistance
Gonorrhea is curable with antibiotics, but treating it has become more complicated over time. The bacterium has developed resistance to nearly every antibiotic previously used against it. About 35% of tested samples now resist a commonly used class of antibiotics called fluoroquinolones. Resistance to other older antibiotics like penicillin and tetracycline is also widespread.
The current standard treatment is a single injection of a powerful antibiotic. This approach still works well: as of the most recent surveillance data, fewer than 0.1% of tested samples showed reduced susceptibility to the drug currently recommended. But health officials watch these numbers closely because gonorrhea has a track record of eventually outsmarting every antibiotic thrown at it.
If you’re treated for gonorrhea, you should avoid sex for at least seven days after treatment and until any partners have been treated as well. Retesting about three months later is recommended to make sure you haven’t been reinfected.
Who’s Most Affected
In 2024, men accounted for about 63% of reported cases in the U.S. (roughly 342,000), while women accounted for about 37% (roughly 199,000). The gap partly reflects the fact that men are somewhat more likely to develop noticeable symptoms and get tested. Gonorrhea rates have actually been declining recently, dropping about 10% from 2023 to 2024, marking the third consecutive year of decline.
Sexually active people under 25 and men who have sex with men face the highest risk. Using condoms consistently and correctly significantly reduces transmission, and regular STI screening catches the many infections that produce no symptoms before they can spread or cause damage.