How Can My Partner and I Have Gonorrhea If We've Been Faithful?

Neisseria Gonorrhoeae
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Question: How Can My Partner and I Have Gonorrhea If We've Been Faithful?

I got an e-mail the a few years back from someone who wanted to know how both he and his partner could have gonorrhea if the two of them had been faithful since they started dating. The answer was simple - one or both of them must have been infected before they became monogamous.

Answer: Just like chlamydia and many other common STDs, gonorrhea is a sexually transmitted disease that is often asymptomatic.

Many people don't have chlamydia symptoms or gonorrhea symptoms when they become infected, which is why regular STD screening is essential. Screening is the only way to detect and treat asymptomatic STDs before they escalate into other problems, such as pelvic inflammatory disease, or are transmitted to other partners.

It's entirely possible for someone to be infected with gonorrhea for years without knowing it, although that is more common in women than it is in men. (Gonorrhea is much more likely to be symptomatic in men.) Therefore, as I explained to my correspondent, it's possible that one or both of them could have brought the infection into the relationship, if they hadn't been tested before they started dating. It wouldn't require malice, just ignorance. It wouldn't even be particularly uncommon.

Because of the high prevalence of asymptomatic STD infections, it's always a good idea for both of you to be screened for STDs before you start a new relationship with someone.

That requires actually talking to your doctors about testing -- since STD screening is not part of most people's annual exam.

Once you have been tested, however, it's still a good idea to use condoms and practice safe sex -- even if you're monogamous. Although condoms and other barrier methods are not 100% protective, they can help decrease your risk of acquiring an infection, and it's important to remember that not every type of infection can be easily detected using an STD test.

There are also some STDs that take some time to show up on tests, which can be a problem when people are moving quickly from one relationship to another, something that is sometimes called serial monogamy.


Detels R, Green AM, Klausner JD, Katzenstein D, Gaydos C, Handsfield H, Pequegnat W, Mayer K, Hartwell TD, Quinn TC. The incidence and correlates of symptomatic and asymptomatic Chlamydia trachomatis and Neisseria gonorrhoeae infections in selected populations in five countries. Sex Transm Dis. 2011 Jun;38(6):503-9.

Farley TA, Cohen DA, Elkins W. Asymptomatic sexually transmitted diseases: the case for screening. Prev Med. 2003 Apr;36(4):502-9

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