Gonorrhea (tulo): symptoms, testing and the right treatment

Tulo means "drip". It is the Filipino word for gonorrhea, an infection with the bacteria Neisseria gonorrhoeae that passes from person to person during sex. In English it is also called "the clap".

It is one of the most common STIs in the world, with about 82 million new cases in 2020, many in the Western Pacific region, which includes the Philippines. It can be cured.

People also say "tulo" for any drip from the penis. Other infections, such as chlamydia, cause the same drip, and the two often come together. A check-up, with a lab test where one is available, shows which medicine you need.

Symptoms usually start 1 to 14 days after sex with someone who has gonorrhea, sometimes months later. Many people have no symptoms but can still pass it on.

In men (tulo sa lalaki):

• white, yellow or green discharge (nana) from the penis
• burning or pain when you pee, or peeing more often
• pain or swelling in the testicles

In women (tulo sa babae), most have no symptoms or mild ones that are easy to mistake for another infection, such as a urinary tract infection (UTI). Signs can include:

• more vaginal discharge than usual, yellow or green, sometimes smelly
• burning when you pee
• bleeding between periods or after sex
• pain during sex or in the lower belly

Anus, throat and eyes. Gonorrhea can infect any part that touches semen or vaginal fluid. In the anus it can cause discharge, itching or pain when you poop. In the throat it often causes no symptoms, sometimes a sore throat. In the eyes it causes redness, pain and pus, which needs quick care (see sore eyes).

Gonorrhea spreads through vaginal, anal or oral sex without a condom. A mother can also pass it to her baby during birth.

Your chance is higher if you:

• have a new partner, more than one partner, or a partner with other partners
• have a partner who has, or recently had, an STI
• do not use condoms, or drink heavily or use drugs before sex

Gonorrhea also makes it easier to catch or pass on HIV: WHO links it to a five-fold increase in HIV transmission. When you test for tulo, ask for an HIV test too. See our HIV symptoms and testing guide.

Even if the drip stops, the infection often stays. Untreated gonorrhea can lead to:

• pelvic inflammatory disease (PID) in women, an infection of the womb, tubes and ovaries that can cause long-term pain, infertility (hirap magbuntis) and ectopic pregnancy, a dangerous pregnancy outside the womb
• infection of the testicles or prostate, scarring of the urine tube and sometimes infertility in men
• early birth and a small baby, and a serious eye infection in newborns that can cause blindness
• rarely, spread through the blood, with fever, rash, painful joints, or infection of the heart or brain lining. This is serious.

Where to go. Many cities and municipalities run a social hygiene clinic (SHC) through their health office. Ask your health office whether its SHC tests and treats tulo, and what it charges. You can also start at your barangay health station or RHU or YAKAP clinic, find testing sites, or ask our care navigator. Private clinics and labs charge, so ask the price first.

Privacy. If you worry about who will find out, ask the staff how your records are kept. For HIV testing, Republic Act 11166 lets young people from age 15 test without their parents' consent.

What happens:

1. A health worker asks about your symptoms and partners, and may check your genitals.
2. You give a urine sample or a swab from the penis, vagina, anus or throat. Sometimes you can do the swab yourself.
3. You may be offered tests for HIV, syphilis and chlamydia too. Say yes if you can.

Where lab tests are not available, the health worker may treat you based on your symptoms the same day.

Tell the staff if you have taken antibiotics. A test done very soon after sex can miss the infection.

Gonorrhea is cured with antibiotics prescribed by a doctor after a check-up.

• WHO's preferred treatment is ceftriaxone, usually given as an injection at the clinic. When that is not possible, a doctor may use cefixime by mouth, with a follow-up test.
• If you may also have chlamydia, the doctor may add another antibiotic.

After treatment:

• No sex, including oral sex, for at least 7 days, and until your partners have finished treatment too.
• Get re-tested when your doctor says. Experts often advise another test about 3 months after treatment.
• Go back quickly if symptoms stay. The bacteria may resist the medicine, you may have been re-infected, or another infection may be the cause.

No home remedy cures gonorrhea. Drinking lots of water, buko juice or herbal tea does not kill the bacteria.

Many people feel shy about seeing a doctor, so they buy antibiotics at the botika, use a friend's leftover pills, or order an injection online. This is risky.

Tulo has learned to survive many antibiotics. WHO calls drug-resistant gonorrhea a serious and growing problem. Many strains resist penicillins, tetracyclines and ciprofloxacin, and resistance to the last good medicines is starting to appear. Overuse and wrong choices of antibiotics make it worse.

This is happening in the Philippines too. In 21 samples from 2013 to 2014 studied by the Research Institute for Tropical Medicine, nearly all resisted penicillin and ciprofloxacin, and 10 resisted tetracycline as well. None resisted ceftriaxone or cefixime. Amoxicillin is a penicillin-type antibiotic, so it is not a reliable cure.

The wrong antibiotic can also make the drip fade while the infection goes on.

Since 2012, the DOH and FDA Philippines have told pharmacies not to sell antibiotics without a prescription, and the DOH asks people never to share antibiotics. Seeing a doctor may cost less than you think: see what it costs.

Your current partner and anyone you had sex with recently need testing and treatment, even if they feel fine. If not, you can pass tulo back and forth (pasahan).

• Keep it simple: "I have an infection that is easy to cure. You need a test and treatment too."
• Ask the clinic for help. Some clinics can contact partners for you without naming you.

If telling a partner could put you in danger, tell the health worker.

"Mawawala rin 'yan." (It will go away.) The drip may fade, but the infection can stay and cause infertility. Get tested.

"Iinom lang ako ng amoxicillin." (I'll just take amoxicillin.) Penicillin-type antibiotics often fail against tulo.

"Nakuha ko sa CR." (I caught it from a toilet.) Health authorities describe gonorrhea as spread through sex and from mother to baby at birth. Worrying about toilets only delays testing and treating you and your partner.

"Nakakahiya." (It's shameful.) Gonorrhea is a common infection, not a sign of being a bad person. Getting treated protects you and your partner.

Gonorrhea in pregnancy raises the chance of early birth, and the baby can catch it during birth. If you are pregnant and think you may have tulo, see your doctor or midwife soon, and do not take any antibiotic on your own. Ask about STI tests at your prenatal check-ups.

WHO recommends antibiotic eye ointment for newborns to prevent gonorrhea eye infection.

• Social hygiene clinics and other government clinics: ask what they charge for tulo tests and medicines. In 2018 the DOH said it gives HIV treatment for free.
• PhilHealth YAKAP: consultations at your YAKAP clinic are free, and your YAKAP doctor can order the lab tests YAKAP covers. As of July 2025, a private YAKAP clinic may charge up to ₱900 per patient a year. See our PhilHealth YAKAP guide.
• PhilHealth GAMOT: as of 2026, the free-medicine list includes cefixime, which PhilHealth lists for uncomplicated gonorrhea, plus azithromycin and doxycycline, listed for chlamydia. Claim an antibiotic prescription at an accredited GAMOT pharmacy within 2 days. As of July 2025, each member and dependent can get up to ₱20,000 worth of medicines a year. Ceftriaxone injection is not on the list, so ask your clinic about its cost.

Not sure where to start? Ask our symptoms assistant or book a call with a nurse. See also what PhilHealth covers.

• Use a condom every time you have vaginal, anal or oral sex. Condoms greatly lower the risk, though not to zero.
• Get tested at least once a year if you are at higher risk, and with each new partner.
• Have fewer partners. One partner who tested negative and has sex only with you is safest.
• Finish treatment, and make sure your partners are treated, before sex again.
• Do not share sex toys, or cover them with a new condom each time.

There is no vaccine made for gonorrhea yet, though a meningitis B vaccine shows some promise. More guides are on our infections and fever page.