Untreated gonorrhea can lead to severe reproductive health problems for women, including infertility (i.e., difficulty or inability to get pregnant). Pelvic inflammatory disease (PID) is a common result of untreated gonorrheal infection in women. In PID, the bacteria move from the vagina up through the cervix and into the uterus, fallopian tubes, and ovaries. Blockage and scarring can damage the tubes, causing women who get pregnant to be more likely to have ectopic (“tubal”) pregnancies. Left untreated, PID can cause infertility and chronic pelvic pain. Gonorrhea can lead to PID in women even when there are no symptoms. Gonorrhea during pregnancy can cause preterm birth and miscarriage.

Men with untreated gonorrhea can occasionally develop epididymitis, a painful infection of the testicles. Untreated gonorrheal infections can also cause inflammation of the prostate and urethral scarring, sometimes leading to male infertility.

If you are living with HIV and are not taking antiretroviral medications, a gonorrhea infection can lead to highly concentrated amounts of HIV virus in the genital tissue, causing 8-10 times more HIV to be shed in your semen or vaginal secretions. If you are HIV negative and have gonorrhea, your immune cells are especially susceptible to HIV if your partner is carrying the virus. Rectal gonorrhea may increase your chance of getting HIV by 10-20 times. However, taking medication to prevent HIV (PrEP) can significantly decrease the risk of getting HIV even when there is an STD present.

In about 1% of people with untreated gonorrhea, the infection can spread beyond the genital area to the bloodstream, skin, heart, or joints. This is called Disseminated Gonococcal Infection (DGI). Symptoms include fever, multiple skin lesions, arthritis, infection of the inner lining of the heart, and meningitis. DGI can be treated with antibiotics.

Most men who are infected with gonorrhea in the penis will develop symptoms within two to five days after being exposed, with a possible range of 1-30 days. Although most women don’t have symptoms, for those who do, they usually appear within 10 days after being exposed.

The symptoms depend on what body part is infected with gonorrhea:

Penis

• Discharge from the head of the penis
• Pain and/or burning with urination
• Occasional swelling of the penis or testicles
• Occasionally, discharge may appear then go away without treatment, although you may still be infected.

Throat

Gonorrhea can be transmitted to the throat by an infected penis. Most of the time there are no symptoms, although it may cause a sore throat.

Butt/Anus/Rectum

• Anal discharge
• Anal bleeding
• Pain
• Painful bowel movements
• Itching
• Often there are no symptoms

Vagina

Most women with gonorrhea have no symptoms. If symptoms develop, they usually appear within 10 days after being exposed.

• Vaginal discharge
• Lower abdominal pain
• Pelvic cramping, especially with sex
• Unusual vaginal or anal bleeding
• Pain or burning with urination

Gonorrhea is treated with antibiotics. Usually gonorrhea is treated with two antibiotics: one is given as an injection, and the other is an oral medication. If you are prescribed antibiotics, take all of the pills, even if you feel better before you finish the prescription, so the bacteria is completely wiped out.

You should not have sex for one week from when you start antibiotics. If you still have symptoms after you've completed the treatment, it's important to go back to your provider for a checkup.

Your sex partners need to be treated as well. If your sex partners are not treated, they can give the infection back to you or infect others. We can provide you with medicine for your partner.

Using condoms consistently and correctly for oral, anal, and vaginal sex is your best bet for staying sexually healthy. Since gonorrhea can be passed even if the penis does not completely enter into the vagina or butt, it's important to use a condom from the very beginning to end of sexual contact.

If you’re thinking of having sex with a new partner:

1. Talk about STDs, including when each of you were last tested.

• Women up to age 25 should be tested at least annually.
• Trans women and trans men who have sex with men should be tested every three months.
• Men who have sex with men should be tested every three months.
• Men who have sex with women up to age 25 should be tested in certain situations, for instance if you’ve had one of these infections in the past, have a partner with an STD, or you live in an area where your chances of getting an STD are high.

2. Male and female condoms are effective in reducing the risk of infection.

3. Do not have sex if you or a sexual partner has abnormal discharge, burning with urination, or any other symptom that could be due to an STD.