“The clap” is a common slang term for gonorrhea, a sexually transmitted infection caused by bacteria. It’s one of the most frequently diagnosed STIs in the United States, with over 543,000 cases reported in 2024 alone. Despite declining for three consecutive years, gonorrhea remains widespread and often goes undetected because many infections produce no symptoms at all.
Where the Nickname Comes From
No one is entirely sure why gonorrhea earned the name “the clap,” but there are three popular theories. One traces the term to French brothels called “les clapiers” (literally “rabbit huts”), small quarters where sex workers lived and where gonorrhea spread easily. Another explanation points to the burning, clapping sensation some people feel during urination when infected. A third, more colorful theory refers to an old folk remedy of “clapping” the infected penis between two hands or heavy objects to squeeze out pus. All three explanations have circulated for centuries, and the nickname has stuck.
How Gonorrhea Spreads
Gonorrhea is caused by a specific type of bacteria that targets the moist mucous membranes of the body. It spreads through vaginal, anal, or oral sex with an infected person. The bacteria latch onto the lining of the urethra, cervix, throat, or rectum using tiny hair-like structures on their surface. Once attached, they essentially trick your cells into pulling them inside, where they begin multiplying.
This is why gonorrhea can infect several different body sites depending on the type of sexual contact. It can also be passed from a pregnant person to their baby during delivery.
Symptoms in Men
Men are more likely than women to notice symptoms, though not all do. When symptoms appear, they typically include a burning sensation while urinating, discharge from the penis that may be white, yellow, or green, and occasionally painful or swollen testicles. The discharge and burning tend to be the most recognizable signs, and they’re often what prompts someone to get tested.
Symptoms in Women
Most women with gonorrhea have no symptoms at all. When symptoms do show up, they’re usually mild enough to be mistaken for a bladder infection or yeast infection. These can include painful or burning urination, increased vaginal discharge, and vaginal bleeding between periods. Because the signs are so easy to overlook, many women carry the infection without realizing it, which raises the risk of complications and unknowingly passing it to partners.
Throat and Rectal Infections
Gonorrhea doesn’t only affect the genitals. It can infect the throat through oral sex and the rectum through anal sex. Both types of infection are frequently asymptomatic, which makes them easy to miss.
Rectal gonorrhea, when it does cause symptoms, can lead to discharge, anal itching, soreness, bleeding, and painful bowel movements. Throat infections are almost always silent but are considered a major source of ongoing transmission in communities. They’re also harder to treat than genital or rectal infections, which is why a follow-up test 7 to 14 days after treatment is recommended specifically for throat cases.
How Gonorrhea Is Different From Chlamydia
Gonorrhea and chlamydia are frequently confused because they share many of the same symptoms: burning urination, unusual discharge, and pelvic discomfort. They also infect the same body sites and are both bacterial STIs. In fact, the two infections co-occur so often that standard practice is to test for both at the same time.
The key difference is that they’re caused by entirely different bacteria that behave differently inside your body. The bacterium behind chlamydia can only survive inside your cells, hijacking them to reproduce. Gonorrhea’s bacterium is more versatile and can survive both inside and outside cells. In practical terms, what matters most is that both need to be identified and treated, because leaving either one alone can lead to the same serious complications.
What Happens If It Goes Untreated
Untreated gonorrhea can cause significant damage, especially in women. The bacteria can travel from the cervix up into the uterus and fallopian tubes, triggering pelvic inflammatory disease (PID). PID can cause permanent scarring in the reproductive tract, leading to chronic pelvic pain, ectopic pregnancy (where a fertilized egg implants outside the uterus), and infertility. This damage can happen even when the original infection never caused noticeable symptoms.
In men, untreated gonorrhea can lead to a painful condition in the tubes attached to the testicles, which in rare cases can also affect fertility. In both sexes, the bacteria can occasionally spread through the bloodstream to other parts of the body, causing joint pain, skin lesions, and other systemic problems.
Testing and Diagnosis
Modern gonorrhea testing is fast and highly accurate. The standard method uses a type of DNA-based test that detects the bacteria’s genetic material from a urine sample or a swab of the infected site. These tests have sensitivity and specificity rates of 95% or higher, meaning they catch nearly all true infections while producing very few false positives.
If you’ve had oral or anal sex, it’s worth mentioning that to your provider, since routine testing typically focuses on genital samples. Throat and rectal infections will only be found if those sites are specifically tested.
How Gonorrhea Is Treated
Gonorrhea is curable with antibiotics. The current standard treatment in the United States is a single injection, which clears most uncomplicated infections at genital and rectal sites. For straightforward cases, no follow-up test is needed after treatment. Throat infections are the exception, requiring a return visit for a repeat test to confirm the bacteria have been eliminated.
Antibiotic resistance is a growing concern with gonorrhea. The bacteria have developed resistance to nearly every class of antibiotic used against them over the decades, which is one reason why public health agencies monitor treatment effectiveness closely. If you’re treated for gonorrhea, your sexual partners also need treatment to prevent reinfection, since getting gonorrhea once doesn’t protect you from getting it again.
Who Gets Gonorrhea Most Often
Of the roughly 543,000 gonorrhea cases reported in the U.S. in 2024, about 63% were in men and 37% in women. The higher number in men partly reflects the fact that men are more likely to develop noticeable symptoms and seek testing. The true number of infections is almost certainly higher than what’s reported, given how many cases are asymptomatic and never diagnosed. Gonorrhea rates have been declining since 2022, dropping 10% from 2023 to 2024 alone, but the infection remains one of the most common bacterial STIs in the country.