Short answer
Gonorrhea shows men two very different faces, and both matter.
Symptomatic urethral infection is unmistakable. Thick burning discharge within days of exposure.
Throat and rectal infections, meanwhile, are usually totally silent while remaining transmissible.
Complete care therefore means testing every exposed site (urine plus throat and rectal swabs), treating with current guideline regimens that respect rising antibiotic resistance, treating partners simultaneously, and retesting. Because reinfection, not treatment failure, drives most repeat cases.
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See Tests & Prices →Symptoms in men, by site
- Urethral: thick yellow-green discharge, burning urination, urethral itching. Typically 2–7 days after exposure. Milder or scant discharge occurs too; absence of drama doesn’t rule it out.
- Rectal (after anal exposure): pain, discharge, or bleeding. Or nothing at all.
- Throat (after oral exposure): usually nothing; occasionally mild soreness easily mistaken for a cold.
- Ascending: testicular pain and swelling (epididymitis) signals spread beyond the urethra and needs same-day evaluation.
See Testicular Pain: When to Get Urgent Care.
Testing that misses nothing
First-catch urine NAAT (hold urine 1–2 hours beforehand) plus throat and rectal swabs matched to exposures. Genital-only testing misses extragenital infections entirely, and they are common.
Cultures ride alongside NAAT when resistance matters: treatment failures, throat infections, and surveillance programs need live bacteria for susceptibility testing, which DNA tests can’t provide.
Treatment with resistance in mind
Current CDC guideline regimens cure gonorrhea reliably. But the organism has defeated sulfonamides, penicillins, tetracyclines, and fluoroquinolones historically, so regimens evolve and self-treatment with leftover antibiotics is dangerous as well as ineffective.
Expect chlamydia co-coverage when co-infection isn’t excluded, strict abstinence through cure, simultaneous partner treatment, and 3-month retesting.
Persistent symptoms trigger cultures (not just repeat NAAT) to guide next-line therapy.
When to seek care
For discharge or burning (same-day testing and treatment start), testicular swelling, rectal symptoms, or any exposure. Plus routine multi-site screening with ongoing risk.
Back promptly for anything surviving treatment; that visit is a resistance workup, not a repeat prescription.