Chlamydia vs Gonorrhea: Key Differences and Information

Chlamydia and gonorrhea are two of the most common sexually transmitted infections (STIs), and although they share similarities, it’s important to diagnose and treat them accurately. 

Keep reading to learn more about the symptoms of chlamydia vs. gonorrhea and how to treat both infections.

What's the difference between chlamydia and gonorrhea?

Both gonorrhea and chlamydia are spread via sexual contact, including:

• Vaginal sex
• Oral sex
• Anal sex.

The main difference between gonorrhea and chlamydia is that two different bacteria cause them. While they’re both caused by an overgrowth of harmful bacteria in the body, chlamydia is caused by the bacteria Chlamydia trachomatis, and Neisseria gonorrhoeae causes gonorrhea.  

Because two different pathogens cause them, the treatment varies, too (more on that below). 

Symptoms of chlamydia vs gonorrhea

Both chlamydia and gonorrhea are often asymptomatic (meaning you have no symptoms), making them both hard to detect. When symptoms are present, they can be similar for both infections, making it tricky to tell them apart, but there are some key differences. 

Chlamydia symptoms can include: 

• Unusual vaginal discharge that is white, yellow, and has a foul smell 
• Pus in your urine (pyuria)
• A frequent need to pee
• Burning or discomfort while peeing (dysuria) or having sex (dyspareunia)
• Pain or tenderness in the lower belly
• Vaginal bleeding between periods
• Painful periods
• itching or burning in and around your vagina.

Symptoms of gonorrhea can include: 

• Green or yellow vaginal discharge
• Burning or discomfort while peeing (dysuria) or having sex (dyspareunia)
• Pain or tenderness in the lower belly
• Vaginal bleeding between periods.

Even if you don't have any symptoms, you could still have chlamydia or gonorrhea. It can be tricky to figure out if you have these sexually transmitted diseases based on symptoms alone. That's why doing an STI screening is important to get correctly diagnosed and treated.

Discharge comparison: chlamydia vs gonorrhea

Although both STIs can cause abnormal vaginal discharge, there are some subtle differences between the two that may help you tell them apart:

Chlamydia discharge: 

• Color: White or yellowish
• Consistency: Thicker, sometimes mucus-like
• Odor: Strong or unpleasant smell.

Gonorrhea discharge: 

• Color: Yellow or green
• Consistency: Thin or watery
• Odor: Often mild, but can also be unpleasant. 

Keep in mind that discharge naturally changes throughout your menstrual cycle, so not every shift is a sign of infection. However, discharge that feels unusual for your body — especially when paired with other symptoms like burning, pain, or bleeding — is worth getting checked out.

I tested negative for chlamydia and gonorrhea but still have discharge

If you tested negative for chlamydia and gonorrhea but still have unusual discharge, a few things could be going on. First, while STI tests are highly accurate, false negatives can happen, especially if you test too early. Both infections have a window period (usually two weeks after exposure) before they show up on a test. If you were exposed recently, it might be a good idea to retest after two weeks to confirm your results.

That said, discharge is a normal part of vaginal health, and changes can happen for lots of reasons — from hormonal shifts to other infections like bacterial vaginosis (BV), trichomoniasis, or yeast infections.

If you're still experiencing symptoms, a comprehensive vaginal health test like the Evvy Vaginal Microbiome Test can help you understand what’s really going on by identifying a wider range of microbes that could be affecting your discharge.

Testing window and accuracy for chlamydia and gonorrhea

Gonorrhea and chlamydia don’t show up immediately after exposure — they each have a testing window of about 14 days, depending on the type of test and your body’s response. Testing too early can lead to false negatives, so if you've had a recent exposure, it's a good idea to wait at least a week or retest after two weeks if symptoms continue.

Most STI tests for chlamydia and gonorrhea are nucleic acid amplification tests (NAATs), which are highly sensitive and accurate, often detecting infections even when symptoms aren’t present.

Evvy tests use metagenomic sequencing, an advanced technology that not only detects chlamydia and gonorrhea with high accuracy, but also identifies a wide range of microbes in the vaginal microbiome. This helps uncover the root causes of symptoms like discharge, itching, or odor, even when traditional STI tests come back negative.

Can chlamydia and gonorrhea co‑occur?

Yes, gonorrhea and chlamydia can absolutely co-occur, and it’s actually more common than many people realize. Coinfection with Chlamydia trachomatis and Neisseria gonorrhoeae is well-documented in medical research and regularly seen in clinical settings.

Large studies show that among people with confirmed gonorrhea, 20–70% also test positive for chlamydia, depending on the population and setting. Meanwhile, 7–9% of those diagnosed with chlamydia also have gonorrhea. Factors that increase the risk of coinfection include being under 25, having multiple sexual partners, and a history of STIs.

Because the symptoms of both infections can overlap (or not show up at all), providers typically test for and treat both at the same time. 

How to determine chlamydia vs gonorrhea

Both chlamydia and gonorrhea can be diagnosed using similar methods. Your healthcare provider will perform a nucleic acid amplification test (NAAT) to check for the bacteria that cause chlamydia or gonorrhea. 

This test involves taking a vaginal swab or urine sample, which can be done in a clinic or from the comfort and privacy of your home with the Evvy Vaginal Health Test with the Expanded PCR Panel add-on.

Getting tested for STIs during regular health check-ups is a great way to stay on top of your sexual health, especially for women. The Centers for Disease Control and Prevention (CDC) recommends that sexually active women under 25, women who are pregnant, or those at a higher risk of getting an STI, should have yearly STI screenings. Risk factors for contracting chlamydia and gonorrhea include:

• Being under 25
• Having sex with a new partner
• Having multiple sexual partners
• Having had chlamydia or gonorrhea in the past.

Treatment options for chlamydia and gonorrhea

Although both STIs will go away with antibiotics, the treatment for chlamydia and gonorrhea differs slightly. 

For chlamydia, the most commonly prescribed antibiotics are oral and highly effective:

• Doxycycline: 100 mg taken twice daily for 7 days (most commonly recommended)
• Azithromycin: A single dose (often used during pregnancy or when doxycycline isn’t suitable). 

Due to rising resistance to oral antibiotics, gonorrhea requires a different approach:

• Ceftriaxone: A single intramuscular injection of 500 mg is the CDC-recommended first-line treatment
• In some cases, oral antibiotics may be added if a chlamydia co-infection is suspected and not yet confirmed. 

It's essential to complete the full course of treatment, avoid sex until your provider gives the green light, and notify recent partners so they can be tested and treated. For eligible testers, Evvy provides prescription treatment for both chlamydia and gonorrhea, making it easier to get the care you need from home.

Can metronidazole treat chlamydia and gonorrhea?

No. Metronidazole is an antibiotic used to treat BV, but it won’t clear up a sexually transmitted infection like chlamydia or gonorrhea.

Will gonorrhea or chlamydia go away on its own?

No, neither gonorrhea nor chlamydia will go away on their own. Even if symptoms are mild or completely absent, the bacteria can continue to live in your body and cause complications over time. Untreated STIs can lead to serious health issues, including:

• Pelvic inflammatory disease (PID)
• Chronic pelvic pain
• Infertility
• Increased risk of ectopic pregnancy
• Ongoing transmission to sexual partners. 

Some people might notice their symptoms fade temporarily, but that doesn’t mean the infection is gone — it just becomes harder to detect and more likely to cause long-term damage.

Luckily, both infections are easily treatable with antibiotics. If you’ve tested positive (or suspect exposure), it’s important to get treated promptly, and Evvy’s Clinical Care can help eligible users access prescription treatment quickly and conveniently.

FAQs

How can you tell the difference between gonorrhea and chlamydia?

Gonorrhea and chlamydia are both sexually transmitted infections (STIs), but they're caused by different bacteria. They can often show similar symptoms, making it tricky to tell the difference without an STI test. Both infections can cause abnormal vaginal discharge, a burning sensation when you pee, and pelvic pain. However, gonorrhea is more likely to cause a thicker, yellow, or green discharge, while chlamydia typically leads to a white, watery, or thick discharge. To accurately diagnose and tell the difference between the two, it's important to get tested by a healthcare professional, as both infections can be effectively treated with antibiotics. If you're experiencing unusual symptoms and suspect you have either chlamydia or gonorrhea, you can take Evvy's at-home STI test. 

Are chlamydia and gonorrhea treated with the same antibiotics?

No, they require different antibiotics because they are caused by different types of bacteria. Chlamydia is usually treated with azithromycin or doxycycline, while gonorrhea is typically treated with a single intramuscular injection of the antibiotic ceftriaxone. It's really important to follow the treatment plan given by your healthcare provider and make sure that both partners are treated to prevent getting reinfected.

Which is more serious, gonorrhea or chlamydia?

Any sexually transmitted infection should be taken seriously. Untreated chlamydia and gonorrhea infections can result in pelvic inflammatory disease, chronic pelvic pain, ectopic pregnancy, and infertility, especially for women and AFAB people. Untreated sexually transmitted infections can also increase your risk of developing reactive arthritis and contracting HIV.

Can you have chlamydia and gonorrhea at the same time?

We hate to be the bearers of bad news, but yes, it's possible to have more than one sexually transmitted disease (STD) at the same time. Both chlamydia and gonorrhea are spread through sexual contact, and unfortunately, they’re not mutually exclusive.

Can chlamydia be mistaken for gonorrhea?

Yes, they can definitely be mistaken for one another because they often cause very similar symptoms, or no symptoms at all. When symptoms do appear, both can lead to things like unusual discharge, pain or burning during urination, pelvic discomfort, or bleeding between periods. Because these signs overlap, it’s almost impossible to tell them apart based on symptoms alone. That’s why healthcare providers typically test for both infections at the same time. Evvy's STI testing also includes both to ensure nothing gets missed.

Does gonorrhea or chlamydia require partner treatment?

Yes, if you’re diagnosed with either chlamydia or gonorrhea, your sexual partner(s) need to be treated too. Even if they don’t have symptoms, they can still carry the infection and pass it back to you or someone else. Treating partners helps prevent reinfection and reduces the spread of STIs. Most clinical guidelines recommend avoiding sex until everyone has completed treatment, which usually takes about seven days after starting antibiotics.