Introduction

Gonorrhea is a bacterial sexually transmitted disease that infects both men and women. It is caused by the bacterium Neisseria gonorrhea. Gonorrhea symptoms and complications can affect men, women, and newborns.

It often affects the urethra, rectum, or throat in men and women. In females, it can also infect the cervix. Subsequently, symptoms pertaining to the infected part develop.

Gonorrhea is most commonly spread during vaginal, oral, or anal sex. But, infected mothers can pass on the infection to their babies during childbirth. In babies, gonorrhea most commonly affects the eyes causing conjunctivitis.

When you develop gonorrhea symptoms and signs, you will seek treatment and get cured. But, what happens to the 10% of the infected males and 80% of the infected females who remain asymptomatic (without symptoms) even after being infected?

Secondly, when symptoms do appear after being infected, they do so after a window period (incubation period) of 2 to 10 days. Rarely, they can occur even after a month.

This makes gonorrhea a more dangerous sexually transmitted disease (STD) because asymptomatic patients do not know they have the gonococci infection and therefore, do not take treatment. But, they continue to infect other healthy individuals.

In such asymptomatic individuals, the infection continues to spread in the body giving rise to complications such as pelvic inflammatory disease and infertility in women and swelling of the testicles and sterility in men.

Please note that at times, symptoms appear even 30 days after the gonococcal infection has entered your body. This window period can lead to unconsciously passing the infection to others. Therefore, asymptomatic infected persons can be hazardous to other “clean” partners.

Any doubtful sexual exposure should be followed up with testing after the incubation period (ideally two weeks).

If positive, you should inform your partner and get him or her tested for STDs and treated if necessary. If doubtful exposure is ignored and you catch the infection, it can lead to long-term complications (described below).

Symptoms of gonorrhea in women

  • Burning sensation while passing urine
  • Increased frequency of urination
  • Purulent (greenish-yellow or whitish) discharge from the vagina. Many women tend to think of this as a yeast infection and self-treat with antifungal creams. Consult your doctor for the correct diagnosis and complete treatment.
  • Lower abdominal (pelvic) pain
  • Vulvitis (swelling of the labia)
  • Irregular vaginal bleeding
  • Oral sex with an infected person can give rise to burning in the throat and swollen glands in the neck due to gonococcal infection
  • Painful bowel movements, anal discharge, and itching due to anal sex with an infected person
  • Dyspareunia is painful sexual intercourse

Symptoms of gonorrhea in men

  • Burning urination is the most common gonorrhea symptom
  • Increased frequency of passing urine
  • Purulent discharge from the penis
  • Sore throat and swollen glands in the neck due to oral sex
  • Testicular pain and swelling

Gonorrhea symptoms appear usually in the morning and may not appear during the day. In men, especially, these symptoms may be mild. This can cause you to ignore the problem, which you should not.

Any symptoms, however mild, should be thoroughly investigated and you should take complete treatment for a permanent cure

Gonorrhea complications in men, women, and newborns

Gonorrhea is a sexually transmitted disease that is highly contagious and extremely common. In the U.S., there is a new gonorrhea case every minute.

If untreated or incompletely treated, the gonorrhea bacteria can spread locally and invade other parts of the body through the bloodstream.

Complications of gonorrhea which then develop can seriously impact your life. These gonorrhea complications in most cases are long-term and irreversible.

Complications of gonorrhea in men

  • Scarring in the urethra
  • Epididymitis is a painful condition in which the epididymis gets inflamed. This is situated on the rear side of the testicles and consists of the sperm ducts. If left untreated, it can lead to sterility.
  • Prostatitis is a complication in which the prostrate gets inflamed. This can lead to abnormalities in semen and sterility.
  • Untreated gonorrhea greatly increases your risk of developing cancer of the urinary bladder

Complications in women

  • Irregular bleeding in-between periods
  • In untreated gonorrhea, the gonococci spread into the reproductive tract, invading the uterus and the fallopian tubes. This gives rise to pelvic inflammatory disease (PID) causing chronic pain in the lower abdomen. PID is a major cause of infertility in women.
  • Endometritis is inflammation of the inner lining of the uterus.
  • Infection in the fallopian tubes and the ovaries can give rise to a tubo-ovarian abscess.
  • An untreated vaginal infection can cause inflammation of the Bartholin’s glands, which can cause a cyst. These are glands near the vaginal opening, which help to lubricate the vagina. Their blockage can cause vaginal dryness.

Complications during pregnancy

  • Infection of the amniotic sac causes the sac to rupture or leak. Prompt treatment is necessary.
  • Preterm labor. Labor pains start before time.
  • Miscarriage
  • Premature delivery

Complications in the newborn

  • Conjunctivitis is the most common complication in newborns (gonococcal ophthalmia neonatorum).
  • Sepsis – infection of the blood
  • Arthritis due to the transport of gonococcal bacteria to the joints
  • Meningitis is due to the same reason. Meningitis is an infection of the protective membranes that cover the brain and the spinal cord.

Long-term complications of gonorrhea

In untreated gonorrhea, the infection spreads through the bloodstream and travels through the body.  This is called disseminated gonococcal infection (DGI). This disseminated infection then causes complications that can be widespread affecting the joints, heart, and blood, and can be life-threatening.  This complication occurs in between 0.6 and 3.0% of women and 0.4 and 0.7% of men.

  • Arthritis is an infection of the joints that causes stiffness, pain, and swelling of the joints (arthritis). The joints of the hand and the knee are most commonly affected by gonococcal infection. The proximal tendons too can get inflamed.
  • Blood sepsis is a widespread infection of the blood that causes blood sepsis. If not treated, it can result in multi-organ failure and death.
  • Endocarditis is an infection spreading to the heart that causes endocarditis. This is an infection of the heart valves and the inner lining of the chambers of the heart. If left untreated, the endocarditis infection can spread to other organs in the body through the blood and can cause organ failure.
  • Cellulitis is an infection spreading to the skin and can cause cellulitis wherein the skin becomes swollen; there is the formation of skin rash, sores, pus, fever, and malaise.
  • Meningitis is the infection of the meninges, which are the membranes covering the brain and the spinal cord.

In all the above complications, fever is a common symptom.

Besides, abstaining from sex (which is not practical), using a condom when you have sex, and better still, being in a mutually monogamous relationship are the best ways to prevent sexually transmitted infections.