How to tell the difference between gonorrhea and chlamydia

Here we will show you the differences between chlamydia and gonorrhea from a doctor’s perspective. Chlamydia and gonorrhea are very similar conditions. Moreover, they occur at the same time in 38% of cases. The differences in the sign and symptoms of these two conditions are so subtle that even experienced doctors will have doubts.

The signs and symptoms must be considered the right context. The right context in this case means looking at the prevalence of the condition in the geographic area, the amount of time that passed between the suspected exposure and the development of signs or symptoms, differences in the symptoms and signs, and other factors.

Signs and symptoms: differences and similarities

Photographic comparison

In the images below, pay attention to the differences in the color and amount of discharge .

Gonorrhea

Image source: Usatine RP, Smith MA, Mayeaux EJ Jr, Chumley M, Tysinger J: The Color Atlas of Family Medicine: www.accessmedicine.com

Frequently Asked Questions

Here we summarize real patients’ questions, grouped by topic, and Dr. Fuzayloff’s answers to them. “Dr. F” (his patients’ name for him) has been an STD doctorfor over two decades in Midtown Manhattan, NYC.

• I am a 22-year-old male with a penile discharge. Can I tell what I have (chlamydia or gonorrhea) based on the discharge?

  No, it’s difficult to say what condition you have based on the information provided since these two conditions can present very similarly. We need more information (discharge characteristics and when it appeared) to make the correct assumption. We need to compare the two conditions based on the most obvious difference between them.

  Discharge color and amount

  Chlamydia, unlike gonorrhea, causes a scanty, transparent discharge. It needs to be squeezed to be visible. Gonorrhea discharge is greenish and produced in abundance (dripping).

  When did the discharge appear?

  It’s important to know when the symptoms began. The incubation period for gonorrhea is much shorter than for chlamydia, which means gonorrhea symptoms appear much sooner after exposure. On average, gonorrhea symptoms appear within a week and chlamydia symptoms appear within 2–3 weeks.

  Important to keep in mind

  • Symptoms and presentation can be very similar
  • Chlamydia and gonorrhea often coexist (24% of males and 38% of females with gonorrhea are chlamydia-positive), which results in symptom overlap

  The table below summarizes the most important difference that helps practicing physicians make an assumption about which condition they’re dealing with.

  	Chlamydia	Gonorrhea
  Incubation period	7–21 days (2 weeks on average)	1–14 days (2–5days on average)
  Discharge	Whitish (milky) or watery Scanty	Greenish or yellowish, thick, purulent Abundant

  Although the information in this table may help rule out one of these infections, the exact diagnosis can be established only after proper testing (a swab or urine test).

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