Woman with her hands on her stomach experiencing gonorrhea long-term effects

Gonorrhea long-term effects: what you need to know

Medically reviewed on November 22, 2022 by Amy Harris, MS, RN, CNM. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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You may do plenty to protect your sexual health, from practicing safe sex to paying close attention to any physical changes that surface. Gonorrhea, however, often goes undetected as an asymptomatic sexually transmitted infection (STI) unless you receive regular screenings [1].

Caused by the bacterium Neisseria gonorrhoeae and transmitted through vaginal sex, anal sex, or oral sex, 2020 saw 677,769 documented cases of gonorrhea in the U.S. alone—a number believed to be much lower than the true count because many go unreported [2]. Although impacted individuals represent various ages and demographics, this STI inordinately affects young adults [3].

But while gonorrhea symptoms aren't always present, “asymptomatic” isn’t synonymous with being healthy. Left unchecked, gonorrhea can lead to various health consequences that may challenge your wellness—and even alter your life’s trajectory.

Fortunately, most accounts of gonorrhea can be cleared up with antibiotics, but it’s still worth learning more about gonorrhea long-term effects if you suspect you may have contracted this STI.

What is gonorrhea and how is it transmitted?

As mentioned above, gonorrhea is a common sexually transmitted disease or infection. The infection can be spread through sexual contact, whether that's through genital, anal, or oral sex. This can also lead some to wonder: can you get gonorrhea from kissing if it can be spread orally? While research is still being done to understand this and science is still emerging, it's unclear whether this may be the case. However, some gonorrhea cases have been known to infect the throat, eyes, mouth, or rectum. Nonetheless, untreated gonorrhea cases can lead to long-term effects, including antibiotic resistance and disseminated gonococcal infection (DGI).

Gonorrhea’s long-term effects in people assigned female at birth

Gonorrhea primarily infects the cervix in people assigned female at birth [3]. If gonorrhea symptoms emerge, they may include:

  • Vaginal discharge [3]
  • Pelvic pain [3]
  • Dysuria (or painful urination) [3]
  • Vaginal bleeding between periods [4]

However, the CDC asserts that many females show no symptoms at all; if they do, they may be subtle or easily confused with signs of a bladder or vaginal infection [4].

An untreated gonorrhea infection might lead to pelvic inflammatory disease (PID).

Pelvic inflammatory disease (PID)

Pelvic inflammatory disease affects an estimated one million females in the U.S. annually, with 85% of these cases due to an STD such as gonorrhea [5].

From tenderness low in the belly to chills and fever, PID results in various symptoms and significantly impacts the health of women’s reproductive organs.

One of the biggest concerns with PID is its capacity to scar fallopian tubes. In turn, this may cause:

  • Infertility – Studies indicated that one in eight women with PID may have trouble conceiving [5]. This is because the resultant scarring might block fallopian tubes, which can hinder the passage of sperm and prevent it from reaching an egg [4].
  • Ectopic pregnancy – During an ectopic pregnancy, a fertilized egg implants outside of the womb. Not only does this mean the pregnancy can’t go on, but it might also cause [6]: pelvic pain, shoulder pain, vaginal bleeding, life-threatening bleeding.
  • Chronic pelvic pain – Chronic pelvic pain refers to pain that persists for six months or longer [7]. This can range from a persistent, dull ache to acute, ongoing pain. And while it may be intermittent, it can radically impact one’s quality of life, such as turning both sex and bathroom trips into experiences ranging from uncomfortable to agonizing.

Gonorrhea’s long-term effects in people assigned male at birth

Only 50% of females will experience the symptoms from a case of a gonorrhea infection, but the disease is far more telling for men: 90% will show symptoms after infection.3 The three most common signs are [1]:

  • Painful urination
  • Penile discharge
  • Tenderness or swelling in one testicle

Over time, undiagnosed or untreated gonorrhea may lead to several complications for men, primarily those listed below [3].

Epididymitis

With epididymitis, the rear of a man’s testicle—the part responsible for keeping and carrying sperm—becomes inflamed from a bacterial infection [10]. Some of its most ubiquitous symptoms include:

  • Blood in semen
  • Discharge
  • Pelvic and lower abdominal pain
  • A red or swollen scrotum

Although it’s uncommon, epididymitis might result in infertility–which underlines the importance of never ignoring symptoms.

Prostatitis

Prostatitis refers to a cluster of conditions that affect the prostate—the walnut-sized gland that sits underneath a man’s bladder and in front of the rectum. When the prostate becomes inflamed—whether from an STD like gonorrhea or another cause—it might manifest as [11]:

  • A persistent urge to urinate
  • Painful urination and sex
  • Erectile dysfunction

Proctitis

STDs are a notorious cause of proctitis, which is associated with symptoms including rectal pain, discharge, bleeding, and diarrhea [12]. Without treatment, proctitis may cause further complications like:

  • Anemia
  • Fistulas
  • Ulcers

Additional gonorrhea complications in females and males

Although rarer than the health conditions listed above, unchecked gonorrhea may also result in [3]:

  • Septic arthritis – Untreated gonorrhea has the potential to infect the bloodstream and travel to some of our most prominent joints, including our elbows, knees, and hips. This may result in pain, fever, and swelling—and, in some cases, permanent damage to the joint.
  • Gonococcal endocarditis – Gonococcal endocarditis is exceedingly unusual, affecting 1 to 2% of people suffering from gonorrhea [8]. It’s characterized by inflammation of the interior lining of the heart’s valves and chambers and may be fatal if medical treatment isn’t sought [9].

Additionally, contracting gonorrhea heightens anyone’s risk of contracting HIV. In very rare instances, it may also result in what’s known as the Fitz-Hugh Curis syndrome—a liver condition that impacts fertility [3,13].

Sexual health with Everlywell

Gonorrhea may not always show the most obvious symptoms, but that doesn’t make it any less dangerous than other STIs or health conditions. It's important to know how to treat gonorrhea for both your and your sexual partner's health. So if you suspect you’ve contracted an STI, you should schedule a test or check up right away.

But when it comes to your health and wellness, you want ultimate discretion. Here at Everlywell, we’re building a world where everyone can access insightful and life-changing lab tests. As a leading digital health company, we offer several different STI tests with sample collection at home and physician-reviewed results—including a gonorrhea test.

Can you get gonorrhea from kissing?

How long can you have gonorrhea without knowing?

How to treat gonorrhea

References

  1. Gonorrhea. Mayo Clinic. Published October 5, 2021. URL
  2. National overview. Centers for Disease Control and Prevention. Published April 12, 2022. URL
  3. Gonorrhea - StatPearls - NCBI Bookshelf. URL
  4. Std facts - gonorrhea. Centers for Disease Control and Prevention. Published August 22, 2022. URL
  5. Pelvic inflammatory disease (PID): Symptoms, treatments & causes. Cleveland Clinic. URL
  6. Ectopic pregnancy. Mayo Clinic. Published March 12, 2022. URL
  7. Chronic pelvic pain in women. Mayo Clinic. Published July 17, 2021. URL
  8. Olayemi G, Oferczak M, Elagizi A, El-Abbassi I, Eschete M, Crowe J. Gonococcal Endocarditis: The Gift That Stops Giving! An Uncommon Presentation of a Common Disease. J La State Med Soc. 2017;169(2):47.
  9. Endocarditis: Causes, symptoms and treatment. Cleveland Clinic. URL
  10. Epididymitis. Mayo Clinic. Published January 23, 2021. URL
  11. Prostatitis: Types, symptoms, causes, diagnosis & treatment. Cleveland Clinic. URL
  12. Proctitis. Mayo Clinic. Published March 5, 2022. URL
  13. Saurabh S, Unger E, Pavlides C. Fitz-hugh-curtis syndrome in a male patient: a case report and literature review. Case Rep Surg. 2012;2012:457272. doi:10.1155/2012/457272
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