Chlamydia vs. gonorrhoea

Reviewed by our clinical team

When it comes to sexually transmitted infections (STIs), chlamydia and gonorrhoea are by far the two most common conditions.

According to Government data, chlamydia was the most common STI in the UK in 2023, with almost 200,000 cases reported. Gonorrhoea, meanwhile, followed in second place with just over 82,500 cases. 

The two conditions are similar in a few ways, meaning they can be easily mixed up, however, their effects and treatments are different, so it’s important to know the difference.

In this article, we’ll look at both conditions, including how they affect you, the signs to look out for, and how they can be treated. Whether you're looking for something specific or just curious, our online chlamydia and gonorrhoea guide has everything you need to know. 

What is the difference between chlamydia and gonorrhoea?

Knowing the differences between chlamydia and gonorrhoea is key to recognising and treating them effectively. Although they’re both types of STI, they can affect you differently.

Both conditions are caused by bacteria (tiny organisms) that are transmitted through sexual contact, whether that’s vaginal sex, anal sex, or another kind of non-penetrative contact such as oral sex (blow jobs).

Chlamydia is caused by a type of bacteria called Chlamydia trachomatis, while gonorrhoea comes from a bacteria called Neisseria gonorrhoeae. If these bacteria are present in your sexual partner, there’s a chance they can be passed on to you. 

Both conditions, while potentially serious, are curable, but it’s important to test yourself regularly and speak to your doctor to find the right treatment for the best chance of success. 

Symptoms of chlamydia and gonorrhoea

Both chlamydia and gonorrhoea can be symptomless, like having a cold without a runny nose or a cough, so you might not know your partner has them unless they tell you. Even they might not know.

If you’ve had sex (protected or unprotected) with an untested partner, and haven’t gotten an STI test since, there’s a chance you might have chlamydia, gonorrhoea, or another type of STI, and not even know it. 

When symptoms do appear, they can be quite similar for both infections and might even mimic other, non-sexually transmitted conditions. Symptoms can also appear differently for men and women. 

Chlamydia and gonorrhoea symptoms in men

For men, both infections might cause a burning feeling when peeing, as well as discharge (fluid) from the penis. 

With chlamydia, men might also experience:

• Discharge from the penis that is white, watery or cloudy
• Itching or burning in the urethra
• Pain and swelling in the testicles
• Redness, pain and discharge in the eye (conjunctivitis) if infected semen or discharge reached these areas
• Discharge from and pain in the rectum 

Symptoms of male gonorrhoea can include:

• Discharge from the tip of the penis that is green, white or yellow
• Inflammation of the foreskin
• Pain or tenderness in the testicles (although this is rare)
• Infection in the rectum (anus) or throat, usually presenting with pain 

Chlamydia and gonorrhoea symptoms in women

For women, symptoms of both chlamydia and gonorrhoea can include:

• Discharge that is white, watery or cloudy
• Pain or a burning feeling when peeing
• Pain during sex
• Bleeding between periods or after sex. 

Symptoms specific to chlamydia in women include:

• Pain in your abdomen and pelvis
• Eye irritation
• Rectal pain 

Gonorrhoea in women might also cause heavier periods, as well as discharge that is usually green, white or yellow.

Chlamydia vs. gonorrhoea discharge

One of the biggest differences between gonorrhoea and chlamydia symptoms is the type of discharge (fluid) that can come from the penis or vagina - discharge from chlamydia is usually clear or milky, while discharge from gonorrhoea tends to be thicker and can be yellow, white, or green.

Remember, it's important to get checked if you notice any of these signs. This is especially important for women, as untreated chlamydia can lead to a condition called pelvic inflammatory disease (PID), which can cause problems with fertility. 

How are chlamydia and gonorrhoea spread?

Chlamydia and gonorrhoea are both spread via sexual or genital contact, but you don’t need to have full penetrative (vaginal or anal) sex to catch them. Understanding how STIs pass from one person to another is a crucial part of safe sex. The most common methods of transmission for STIs are: 

• Sex without a condom: Whether it's vaginal, anal, or oral sex, not using a condom hugely increases the chance of spreading these infections. Condoms are not 100% effective at preventing STIs, but studies have shown they can lower the risk of catching chlamydia by 90% and are around 98% effective at preventing gonorrhoea.
• Sharing sex toys: If you use sex toys, not cleaning them or sharing them without a cover can also spread infection.
• From mother to baby: a pregnant woman can pass these infections to her baby during childbirth, potentially causing serious post-natal complications. 

Remember, it's always best to be safe. Using condoms and being careful about personal contact can help stop these STIs from spreading, but the most effective way of preventing STI transmission is by being careful about who you sleep with, asking partners to get tested, and getting regular STI tests yourself.

If you've had unprotected sex recently and you’re worried you might have picked up an STI, learn more about your options here. 

What causes chlamydia and gonorrhoea?

Chlamydia and gonorrhoea are caused by tiny germs called bacteria. Bacteria are present everywhere, but these in particular make their home in the private areas of the body, such as your genitals and anus. Chlamydia is caused by the bacteria Chlamydia trachomatis, while gonorrhoea comes from a bacteria called Neisseria gonorrhoeae. 

We call these types of infections ‘sexually transmitted infections’, or STIs. You might also hear them referred to as sexually transmitted diseases, or STDs. There are some small differences between these two terms, but they essentially mean the same thing. 

Complications of chlamydia and gonorrhoea

While chlamydia and gonorrhoea might sometimes seem harmless because they don't always show symptoms, they can cause serious health problems if they're not treated. 

In women, chlamydia can be particularly damaging if left untreated. It can travel up to the womb and tubes, leading to a condition called pelvic inflammatory disease (PID). This can be very painful and can lead to infertility, leaving you unable to get pregnant.

For men, both infections can lead to discomfort and pain in the testicles. There's also a chance of the infection moving to the prostate gland, causing a condition called prostatitis, as well as a host of other conditions. 

It's really important not to ignore STIs thinking they'll just go away. Without treatment, they can get worse and cause even bigger problems down the line. 

Chlamydia vs gonorrhoea vs syphilis

Syphilis is another kind of STI that spreads via bacteria. However, it manifests differently, showing up in stages, usually starting with sores or ulcers on the genitals or mouth.

The consequences of leaving syphilis untreated can be even more serious. If it's not treated, syphilis may reappear with rashes or soreness across the body, before going on to cause serious problems with the heart and brain. 

The good news is that all three of these conditions can be easily tested for and treated. This is why STI tests are crucial. If you’ve had unprotected sex recently, or you’re unsure about a partner’s STI status, you can purchase a male STI test kit or a female STI test kit via our website. 

Can chlamydia and gonorrhoea be cured?

Both chlamydia and gonorrhoea can be cured with minimal consequences if detected early, usually with antibiotics.

If you’ve taken a test and gotten a positive result, you need to book an appointment with your GP or a sexual health clinic so they can discuss your options with you. 

Treatment for chlamydia and gonorrhoea

If you’ve taken a test and found out that you've got chlamydia or gonorrhoea, don't panic. Taking a test is the first step to sorting the problem out, so don’t leave it too long if you’re concerned. 

Treatment for chlamydia

Chlamydia is usually treated with antibiotics. The most common ones are: 

• Doxycycline: This is the first treatment. This course of antibiotics lasts over a week.
• Azithromycin: this usually consists of one tablet once a day for 2 days. 

Treatment for gonorrhoea

Gonorrhoea treatment can differ slightly from chlamydia treatment. This is because some types of gonorrhoea have developed a resistance to nearly all antibiotics due to overuse. The treatment for gonorrhoea usually includes:

• An antibiotic injection usually given in the bottom or thigh.
• An antibiotic tablet taken at the same time as the injection. 

It's really important to finish the entire course of antibiotics, even if you start feeling better, to make sure the infection is completely cleared up. You should also avoid having sex until you've finished the treatment to prevent spreading it to others.

It's a good idea to get retested after three months, even if you feel fine, to make sure you’re no longer infected.

Remember, these treatments are effective, but they don't prevent future infections, and you can’t become immune to chlamydia or gonorrhoea, so remember to practice safe sex to avoid reinfection. 

Preventative measures

Preventing chlamydia and gonorrhoea is all about being careful and knowing how to protect yourself. Here's a list of steps you can take to lower your risk of catching these STIs: 

• Use condoms: this is one of the best ways to prevent STIs. Whether it's for vaginal, anal, or oral sex, using a condom can help keep the bacteria behind STIs at bay.
• Get regular STI tests: especially if you have multiple partners, regular testing can help catch any infections early, even if there are no symptoms.
• Limit your number of sexual partners: the fewer partners you have, the lower your risk of catching an STI.
• Avoid sharing sex toys: or make sure they're cleaned or covered with a new condom before someone else uses them.
• Communicate with your partners: talk about STIs, testing, and protection before getting intimate.
• Avoid sex with partners who show symptom: If your partner has signs of an STI, avoid sexual contact and encourage them to get tested. 

Remember, it's still possible to catch an STI even when you take all the right precautions. Condoms are very effective, but not completely. Read our article for more on how condoms protect you from STIs.

Chlamydia and gonorrhoea tests

If you're worried about chlamydia or gonorrhoea, or just want to be sure you're STI-free, getting tested is the way to go. It's really easy to do, and you don't even have to step out of your house. LloydsPharmacy Online Doctor offers simple and discreet tests that you can do yourself. Here's how it works:

1. Order your test online: we have tests which can detect both gonorrhoea and chlamydia from the same sample. There are specific tests for women and for men, so pick the right one for you.
2. Take the test at home: the test usually involves a urine sample or a swab from the vagina. It's quick and straightforward – you'll get all the instructions with your test kit.
3. Send it back: once you've taken the test, just send your sample back in the post.
4. Get your results online: in a few days, you'll be able to check your results online securely and privately. 

Testing for STIs is an important part of taking care of your sexual health. It's easy, confidential, and can give you peace of mind or help you get treatment quickly if you need it. 

Summary

Chlamydia and gonorrhoea are two very common STIs that often occur with no symptoms at all. When symptoms do occur, they can be very uncomfortable, and even lead to serious complications. Thankfully, both can be cured with early detection and the right antibiotics. 

Condoms, limiting sexual partners, and getting regular STI tests can all help reduce the risk of STI transmission. 

It’s crucial to look after your sexual health, which is why we make it as easy as possible to access STI tests, and why our expert online video GPs are always on hand to answer any questions you might have. 

References

https://www.gov.uk/government/statistics/sexually-transmitted-infections-stis-annual-data-tables/sexually-transmitted-infections-and-screening-for-chlamydia-in-england-2022-report 
https://www.nhs.uk/conditions/gonorrhoea/symptoms/ 
https://sti.bmj.com/content/81/4/323 
https://www.better2know.co.uk/blog/3-stis-you-can-catch-even-if-you-use-a-condom/
https://www.nhs.uk/conditions/pelvic-inflammatory-disease-pid/ 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7587489/
https://www.who.int/news-room/fact-sheets/detail/multi-drug-resistant-gonorrhoea