Chlamydia vs gonorrhea: Understanding these sexually transmitted infections — and the difference between them!

If you are sexually active, you may be at risk for getting or transmitting sexually transmitted infections (STIs). The chances of getting an STI may be higher if you have sex with multiple partners or do not use a barrier method like a condom. Still, you should know all about chlamydia and gonorrhea, two common STIs that affect millions of people in the world. Both are similar in many ways, including how they are diagnosed, and transmitted. But there are also differences between chlamydia and gonorrhea such as the cause and the way they are treated.

What is chlamydia?

Chlamydia is a common sexually transmitted infection (STI) caused by the bacteria Chlamydia trachomatis. It is a preventable and curable STI that is primarily transmitted through oral, anal and vaginal sex. As per the data from the World Health Organization, more than 128 million infections were reported in 2020 in adults between the ages of 15 and 49 globally. This infection is believed to be asymptomatic but some people may experience certain symptoms such as vaginal discharge and unusual urethral. It can also increase the risk of HIV infection and lead to other health problems such as infertility in women. It is vital to get it treated timely to avoid complications.

What is gonorrhea?

Caused by the bacterium Neisseria gonorrhoeae, gonorrhea is a sexually transmitted infection that can be prevented and cured. Like chlamydia, it is also transmitted through vaginal, oral or anal sex. As per the data by WHO, approximately 82.4 million new infections were reported in 2020 among adults throughout the globe. While people with this condition may not experience any symptoms, some men and women may experience more discharge than usual. It is a serious and growing problem that needs to be addressed timely as it can increase the risk of several health problems in people. It may increase infertility in both women and men and put you at risk of developing HIV infection.

Chlamydia vs gonorrhea: What are the symptoms?

Globally, more than one million STIs are acquired every day in people aged between 15 and 49, according to the World Health Organization. One of them is chlamydia. About 128.5 million new chlamydia infections among people over the age of 15 across the globe were reported in 2020, as per the WHO. “It can infect both men and women, often affecting the genital tract, but it can also infect the rectum and throat,” says obstetrician and gynaecologist Dr Madhu Juneja.

Symptoms of chlamydia

Chlamydia is often referred to as a “silent” infection because many people do not experience noticeable symptoms. But some people may experience the following symptoms –

• Unusual vaginal discharge that may be more fluid-like and have a strong odour.
• A burning sensation and pain while urinating.
• Discomfort or pain in the lower abdomen.
• Discomfort or pain while having sex.
• Spotting or bleeding that occurs outside the normal menstrual cycle.
• Pain, discharge, or bleeding if the infection spreads to the rectum.

Symptoms of gonorrhea

In the case of gonorrhea, which primarily infects the mucous membranes of the reproductive tract, but can also affect the throat, and rectum, most women do not have any symptoms. If they do, the symptoms are often mild and can be mistaken for a vaginal infection, according to the US Centers for Disease Control and Prevention.

Here are some of the signs of this sexually transmitted infection:

• Pain while peeing
• Heavy vaginal discharge in yellow or green colour
• Bleeding in the vagina between periods
• If the throat is infected, symptoms may include a sore throat.

Chlamydia vs gonorrhea: What are the causes?

“Chlamydia is an infection primarily caused by the bacterium chlamydia trachomatis,” says the expert. Here are the key factors that contribute to its transmission:

• Engaging in unprotected vaginal, anal, or oral sex with an infected partner. The bacteria can be transmitted through bodily fluids.
• Having multiple sexual partners increases the risk of exposure to chlamydia, especially if partners are not tested for STIs.
• Pregnant women with chlamydia can transmit the infection to their newborn during childbirth, which can lead to complications such as pneumonia or conjunctivitis in the baby.
• Using shared or unwashed sex toys without proper cleaning can also lead to transmission if one person is infected.

Gonorrhea can also be transmitted if you have sex with an infected partner and don’t use protection or have multiple sexual partners. Like chlamydia, pregnant women with gonorrhea can transmit the infection to their baby during childbirth. “But the bacterium Neisseria gonorrhoeae is the main reason behind gonorrhea,” says the expert.

Chlamydia vs gonorrhea: How are these STIs diagnosed?

Similar diagnostic methods are used to find out if you have chlamydia or gonorrhea. One or more of these tests may be done:

• Physical examination to spot the signs of an STI.
• Urine test to check your pee for the bacteria that cause these infections.
• Blood test to look for signs of a bacterial infection.
• Swab culture to take a sample from your vagina, throat or anus.

Chlamydia vs gonorrhea: How are these STIs treated?

Antibiotics are effective in treating chlamydia. If people take their antibiotics correctly, more than 95 percent of people can get cured, according to the UK National Health Service.

The following antibiotics are mostly prescribed for chlamydia treatment:

• Doxycycline, which is to be taken every day at least for a week
• One dose of 1gram of Azithromycin then 500 mg once a day for two days

“Gonorrhea treatment can be challenging due to drug-resistant strains of the bacteria,” says Dr Juneja. Usually, dual therapy with ceftriaxone or cefixime along with doxycycline, and azithromycin is recommended, according to research published in the Canadian Medical Association Journal in 2023.

How to prevent chlamydia and gonorrhea?

Here are some ways to prevent STIs like chlamydia and gonorrhea:

• Consistently using latex condoms while having sex (vaginal, anal, and oral) can significantly reduce the risk of gonorrhea and chlamydia.
• Reduce the number of sexual partners.
• Regular testing is essential, especially for people who are sexually active and have multiple partners or do not use protection.
• Discuss sexual health and STI testing with partners before engaging in sexual activity. Open communication helps ensure both partners are aware of each other’s sexual health status.
• If you use sex toys, ensure they are cleaned thoroughly between uses or go for a new condom or toy for each partner to minimise the risk of infection.

Chlamydia and gonorrhea are sexually transmitted infections that can take two weeks or more to clear up. Their causes and treatment are different, but it is best to avoid having sex until the infections clear up.