[Question #9763] Gonorrhea not being transmitted with hundreds of times having vaginal sex.

29 months ago

I recently Tested Positive for Gonorrhea after experiencing pain during urination. I have not had sex of any kind with anyone other than my GF for 5 years. We have had sex 2-3 times a week for nearly that entire period almost exclusively vaginal. She stated that she previously had an STI or STD but received treatment, although I'm uncertain that it was the correct treatment. I have done a great deal of investigation in terms of chance of transmission of Gonorrhea, but I can't find anything that states how many times an asymptomatic woman can have Intercourse without infecting her partner, other than the 20% for a single exposure kind of thing. She does seem to secret an excessive amount of fluid, which, I have read, can be an indication of having Gonorrhea. She assures me that she has been faithful, and I desire to believe her. My question, very simply, is...Is it possible she had had this the entire time, and I have not contracted it until very recently if she has been 100% faithful?

H. Hunter Handsfield, MD

29 months ago

Welcome to the forum. Thank you for your confidence in our services.

As you suspect, the usual explanation for such situations is that one or the other partner has had other partners. Gonorrhea is relatively short lived: even without treatment, the immune system clears the large majority of infections within a few weeks in males and a few months in women. Some infections may persist for more than a year, but this is believed to be rare. And you are correct in citing 20% as an estimate of the likelihood of transmission during unprotected vaginal sex. It may even be as high as 50%. Whatever the figure, it would be surprising for a partner exposed 2-3 times a week to remain uninfected more than a few weeks. So assuming you have had no other sex partners yourself, it is likely your girlfriend has.

That said, there are other potential explanations. First and perhaps most likely, what do you and your partner consider "sex" with someone to mean? Did you receive oral sex from someone else, for example? Did she have an oral sex event with anyone else? Some research indicates that on rare occasions oral gonorrhea may be acquired by kissing: did either of you kiss other persons (meaning sexual, open mouth kissing)? Second, your positive test result might have been false. The gonorrhea lab tests are excellent, but few tests are perfect and false positive results might occur. Specimen mix-up in the lab (i.e. someone else's specimen mislabeled as your partner's) theoretically could happen. Most labs take great care to avoid such errors, but nobody can say it never happens. However, these explanations seem especially unlikely given your symptoms.

While we don't generally provide relationship advice, I would suggest you go easy on your partner. Have a calm and mutually sensitive and respectful conversation about it.

Probably it is obvious that your partner should be tested, if not yet done, and of course you both need treatment for gonorrhea. (She should be treated without waiting for her own test result.) Probably you both have been tested for other STDs as well; if not, get tested for chlamydia and have blood tests for syphilis and HIV. Better safe than sorry!

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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