Gonorrhea is cured with a single antibiotic injection. The standard treatment is a one-time shot of ceftriaxone, which clears the infection in the vast majority of cases. You cannot cure gonorrhea with home remedies, over-the-counter medications, or by waiting it out. Prescription antibiotics are the only effective treatment.
What the Standard Treatment Looks Like
The CDC-recommended treatment for uncomplicated gonorrhea is a single 500 mg injection of ceftriaxone, given in a muscle (usually the hip or thigh). If you weigh 300 pounds or more, the dose increases to 1 g. That one shot is the entire treatment for gonorrhea itself. There are no pills to take at home afterward, no multi-day course to complete.
There’s one important caveat: if chlamydia hasn’t been ruled out (and it often co-occurs with gonorrhea), you’ll also be prescribed a week-long course of oral doxycycline to cover that second infection. About 23% of people diagnosed with gonorrhea also have chlamydia, so this combination is common.
If you have a cephalosporin allergy, an alternative regimen exists. A single injection of gentamicin paired with a single oral dose of azithromycin cured 100% of genital infections in clinical trials. This combination is less effective for throat and rectal infections, clearing about 80% of pharyngeal cases and 90% of rectal ones.
How Quickly Symptoms Go Away
A prospective study of 216 patients found that the median time for symptoms to resolve after treatment was 2 days. Ninety percent of patients reported their symptoms were gone within a week, and 94% were symptom-free by the two-week mark.
Women tend to recover a bit more slowly, with a median of 4 days compared to 2 days for men. If you have a co-infection with chlamydia, expect symptoms to linger about a day longer as well (median of 3 days). If your symptoms haven’t improved after a week, that’s worth a follow-up visit to make sure the antibiotic worked.
Why You Can’t Skip the Doctor
Gonorrhea has steadily outsmarted the antibiotics once used to treat it. Resistance to ciprofloxacin, a pill that used to be a go-to treatment, has reached 95% globally. That means the old approach of simply taking an oral antibiotic at home no longer works for most strains. The injectable ceftriaxone remains effective, but it requires a clinic visit.
There is no legitimate way to get this treatment without seeing a healthcare provider. Walk-in clinics, urgent care centers, sexual health clinics, and local health departments can all provide the injection, often on the same day as your visit. Many public health clinics offer testing and treatment on a sliding-fee scale.
What Happens If You Don’t Treat It
Untreated gonorrhea doesn’t resolve on its own. In women, 10% to 20% of untreated gonococcal infections progress to pelvic inflammatory disease, which can cause chronic pelvic pain, scarring of the fallopian tubes, and infertility. In men, the infection can spread to the epididymis (the tube behind the testicle), causing painful swelling that can also affect fertility. In rare cases, the bacteria enter the bloodstream and cause disseminated gonococcal infection, which affects the joints, heart valves, and other organs.
Gonorrhea also increases susceptibility to HIV. The inflammation it causes in the genital tract creates more entry points for the virus, raising the risk of both acquiring and transmitting HIV during unprotected sex.
Getting Tested and Confirming the Cure
The standard test for gonorrhea is a nucleic acid amplification test, or NAAT, which detects the bacteria’s genetic material from a urine sample or swab. These tests have sensitivity above 90% and specificity of 99% or higher, making them highly reliable.
After treatment, you don’t necessarily need a follow-up test to confirm the infection is gone if you received the standard ceftriaxone injection and your symptoms have resolved. However, re-testing is recommended if you had a throat infection (which is harder to clear), if an alternative antibiotic was used, or if symptoms persist. When a follow-up test is done, it’s typically scheduled at least two weeks after treatment, because the NAAT can detect residual genetic material from dead bacteria for up to two weeks, which could produce a false positive.
Regardless of whether you get a test of cure, the CDC recommends re-testing for gonorrhea about three months after treatment. This isn’t to check whether the original treatment worked. It’s to catch reinfection, which is common.
Protecting Yourself and Your Partners
You should wait at least seven days after treatment before having sex, and your symptoms should be completely gone. If your partner hasn’t been treated yet, having sex before they complete treatment will reinfect you.
Your recent sexual partners need treatment too. In 48 states plus Washington D.C., a practice called expedited partner therapy allows your prescriber to give you a prescription or medication to deliver directly to your partner, even if that partner hasn’t been examined. This is particularly useful when a partner can’t easily get to a clinic. It’s legal in nearly every state, though Kansas and South Dakota have less clear legal standing on the practice.
Condoms significantly reduce the risk of gonorrhea transmission but don’t eliminate it entirely, since the bacteria can infect the throat and rectum through oral and anal sex. If you’ve had gonorrhea once, you have no immunity to it and can be reinfected any number of times. Regular screening is the most practical way to catch new infections early, especially since gonorrhea often produces no symptoms at all, particularly in women and in throat infections.