“The clap” is gonorrhea, a bacterial sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. It’s one of the most common STIs in the United States, with over 543,000 cases reported in 2024 alone. The nickname has been around for centuries, though its exact origin is debated. Some historians trace it to an old French word for brothel, others to an older English term describing the burning symptoms.
How Gonorrhea Spreads
Gonorrhea transmits through vaginal, anal, and oral sex. The bacteria infect warm, moist areas of the body, including the urethra, cervix, rectum, and throat. A pregnant person can also pass it to their baby during delivery. You don’t need to have visible symptoms to spread it, which is one reason it remains so common.
Symptoms in Men
Men are more likely than women to notice symptoms, though not all do. When symptoms appear, they typically show up within 1 to 14 days after exposure. The most recognizable signs are a burning sensation when urinating and a white, yellow, or greenish discharge from the penis. Some men also experience swollen or painful testicles, though this is less common.
Symptoms in Women
Most women with gonorrhea have no symptoms at all, which makes routine screening especially important for sexually active women under 25 or those with new or multiple partners. When symptoms do develop, they can include a painful or burning sensation when urinating, increased vaginal discharge, and vaginal bleeding between periods. These symptoms overlap with common conditions like urinary tract infections or yeast infections, so many women don’t realize they have an STI.
Throat and Rectal Infections
Gonorrhea in the throat (from oral sex) rarely causes noticeable symptoms, though it can produce a sore throat. Rectal infections, from anal sex or from bacteria spreading from the vaginal area, may cause discharge, itching, soreness, or bleeding. Both sites can harbor the bacteria silently and transmit it to partners even without symptoms.
What Happens If It Goes Untreated
Left untreated, gonorrhea can cause serious problems in both men and women. In women, the infection can spread to the uterus and fallopian tubes, causing pelvic inflammatory disease. This can lead to chronic pelvic pain, scarring, and infertility. In men, the infection can reach the epididymis (the tube connected to the testicle), causing fever, scrotal pain, and swelling. In rare cases, this can also affect fertility.
In rare cases, gonorrhea bacteria enter the bloodstream and spread to other parts of the body, a condition called disseminated gonococcal infection. This can cause fever, joint pain and swelling, rash, and skin sores. It requires immediate treatment.
How It’s Diagnosed
The standard test for gonorrhea is a nucleic acid amplification test, which detects the bacteria’s genetic material with high accuracy. For men, a urine sample is usually sufficient. For women, a vaginal or cervical swab is preferred. If you’ve had oral or anal sex, your provider may also swab your throat or rectum, since a urine test won’t catch infections at those sites.
Results typically come back within a few days. Because gonorrhea and chlamydia frequently occur together, most labs test for both at the same time.
Treatment
Gonorrhea is curable with antibiotics. The current standard treatment is a single injection of an antibiotic, which is given at the clinic in one visit. If chlamydia hasn’t been ruled out, you’ll also receive a week-long course of oral antibiotics to cover that infection. You should avoid sexual contact for seven days after treatment and until any partners have been treated as well.
A follow-up test is recommended about two weeks after treatment to confirm the infection is gone. This is increasingly important because of antibiotic resistance.
The Antibiotic Resistance Problem
Gonorrhea has developed resistance to nearly every class of antibiotic ever used against it, including penicillins, tetracyclines, and fluoroquinolones. The current first-line treatment is the last reliable option for most cases, and resistance to it is growing. The World Health Organization has flagged strains resistant to this treatment spreading across multiple countries, including the UK, France, Japan, and Denmark.
These extensively drug-resistant strains, sometimes called “super gonorrhea,” are resistant to every available antibiotic class. This is why completing your treatment exactly as prescribed matters. It’s also why public health agencies emphasize prevention: condom use significantly reduces transmission risk, and regular screening catches infections before they spread further.
Who’s Most Affected
In 2024, gonorrhea rates were higher in men (203 cases per 100,000 people) than in women (116 per 100,000). Cases have been declining for three consecutive years, dropping 10% from 2023 to 2024. Still, with over half a million cases annually in the U.S., it remains one of the most reported infectious diseases in the country. Sexually active people under 25, men who have sex with men, and anyone with multiple partners face the highest risk.