Gonorrhea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. It primarily affects the mucous membranes of the urogenital tract, rectum, pharynx, and, in less common cases, the eyes. According to data from the World Health Organization (WHO), an estimated 87 million new cases occur annually worldwide, making it one of the most prevalent bacterial STIs.
In men, gonorrhea can present with bothersome symptoms and, if not treated properly, can lead to serious complications, such as infertility, chronic pain, and even systemic infections. Furthermore, the emergence of antibiotic-resistant strains has made this disease a growing public health problem, especially in populations with high rates of unprotected sexual activity.
In this article, you'll find a complete guide to gonorrhea in men, covering everything from its causes and symptoms to the most effective treatments and best prevention strategies.
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What is Gonorrhea?
Gonorrhea is a bacterial infection transmitted primarily through sexual contact (vaginal, anal, or oral) with an infected person. It affects the mucous membranes of the urethra, rectum, throat, and, in some cases, the eyes.
According to the CDC (Centers for Disease Control and Prevention), gonorrhea is one of the most commonly reported STIs, with millions of new cases each year. Its incidence has increased due to antibiotic resistance, making it difficult to treat in some cases.
Causes and risk factors
Gonorrhea is spread primarily through unprotected sexual contact, whether vaginal, anal, or oral. The bacteria Neisseria gonorrhoeae It is found in the bodily fluids of an infected person, such as semen, vaginal secretions, and, to a lesser extent, saliva (in cases of pharyngeal gonorrhea).
Gonorrhea is spread through unprotected sex, which is the main risk factor; oral sex, which can cause gonorrhea in the throat; anal sex, which can cause rectal gonorrhea; or mother-to-child transmission during childbirth, which can cause a serious infection in the newborn, known as neonatal ophthalmia.
Some risk factors for infection include risky sexual behaviors such as having multiple sexual partners in a short period of time, not using condoms consistently, or consuming drugs or alcohol before sex, as these can decrease adherence to protection.
The populations most at risk for gonorrhea are men who have sex with men, due to the increased risk of anal and oral transmission; people with a history of STIs, such as chlamydia or HIV, since concurrent infections are common; and young men aged 15 to 24, who represent the largest group with the highest incidence of gonorrhea.
The overuse of antibiotics can also create bacterial resistance and has led to the emergence of resistant strains of gonorrhea, making treatment difficult in some cases. According to the WHO, resistance to ceftriaxone, one of the most widely used antibiotics, is a growing concern.
How do you know if a man has gonorrhea?
Symptoms in men usually appear between 2 and 14 days after exposure, although in some cases the infection may be asymptomatic.
So when should you get tested? Gonorrhea screening is recommended for the following:
If you have symptoms** (urethral discharge, pain when urinating, testicular pain), if you have had unprotected sex with a new partner or multiple partners, if your sexual partner has been diagnosed with gonorrhea or another STI, or if you belong to a high-risk group (MSM, people with HIV, sex workers).
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How many days does it take to appear?
According to the New York City Department of Health, symptoms typically appear between two and 2 days after infection, although in some cases they can take up to 14 days.
However, up to 10% of infected men do not show symptoms, facilitating the silent spread of the disease.
Early detection and diagnosis
Gonorrhea can be diagnosed using different techniques.
A urine test can be performed to detect the bacteria's genetic material using PCR (polymerase chain reaction), which is the most common and least invasive method.
Urethral, rectal, or pharyngeal samples can also be collected using a swab from the affected area, which is then analyzed in a laboratory using bacterial culture or molecular testing.
Some health centers offer rapid tests that provide results in minutes. However, these tests may be less accurate than laboratory methods.
Another option is to use combined tests for STIs, since gonorrhea often coexists with other infections such as chlamydia or syphilis, many doctors recommend complete STI testing.
What are the complications of gonorrhea?
If left untreated, gonorrhea can cause a variety of problems.
Epididymitis
La epididymitis It is the condition in which the epididymis, which is the tube behind the testicles, becomes inflamed and can cause infertility if left untreated.
Prostatitis
Infection of the prostate that causes pelvic pain and difficulty urinating.
Systemic dissemination (disseminated gonorrhea)
The bacteria can enter the bloodstream, causing fever, joint pain, and skin rashes.
Increased risk of HIV
Genital lesions caused by gonorrhea facilitate the entry of HIV.
antibiotic resistance
Some strains of gonorrhea are resistant to common treatments, making them difficult to cure.
How is gonorrhea cured in men?
The standard first-line treatment for uncomplicated gonorrhea in men consists of intramuscular injection of ceftriaxone plus a single oral dose of azithromycin.
This combination regimen is used to reduce the risk of bacterial resistance.
If the patient is allergic to antibiotics, alternatives such as an injection of gentamicin plus azithromycin, or an oral dose of cefixime, can be used, although their effectiveness is lower compared to ceftriaxone.
Treatment for resistant gonorrhea, if the infection does not respond to initial treatment, may require an antibiogram (to identify which antibiotics are effective) or second-line antibiotic therapy (such as spectinomycin).
Key steps after treatment include abstaining from sexual intercourse for at least 7 days after completing treatment. All sexual partners from the past 60 days should be notified so they can also be tested, and a follow-up test should be performed 3 months after treatment to rule out reinfection.
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Additional care during and after treatment
Abstain from sexual relations
They should be avoided until treatment is completed and negative test results are obtained.
use condom
Its use should be maintained in all future sexual relations.
Perform control tests
They should be performed periodically to confirm the elimination of the bacteria.
How to prevent gonorrhea and reinfection?
Correct use of condoms
Latex or polyurethane condoms significantly reduce the risk of transmission and should be used from the beginning to the end of each sexual encounter, whether vaginal, anal, or oral.
Reduction of sexual partners
The number of sexual partners should be limited, which reduces exposure to the bacteria, and it is recommended to opt for mutually exclusive monogamous relationships with an unaffected partner.
Regular STI testing
You should be tested at least once a year if you are sexually active, and every 3 to 6 months if you are in high-risk groups, such as men who have sex with men, or people with multiple partners.
Pre-exposure prophylaxis (PrEP) and other strategies
PrEP for HIV does not protect against gonorrhea, but its use is associated with improved STI control. In some countries, the use of antibacterial mouthwashes is being studied to reduce throat gonorrhea.
Sexual education and awareness
It's important to educate yourself about STI symptoms and see a doctor if you suspect any, and to avoid sex under the influence of alcohol or drugs, which increases risky behaviors.
Frequently Asked Questions (FAQs)
How serious is it to have gonorrhea?
If treated early, it's not serious. But without treatment, it can cause infertility, chronic pain, and systemic complications.
What is the risk of leaving it untreated?
It can cause infertility, chronic infections, and increase the risk of contracting HIV.
How long does gonorrhea last in the body?
Without treatment, it can persist for months or years, causing progressive damage.
Can gonorrhea go away on its own?
No. It always requires antibiotic treatment.
Can gonorrhea remain symptom-free for months?
Yes, especially in the throat and rectum.
Can I have sex again after treatment?
Yes, but only after confirming the cure and using protection.
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Book your first medical consultation now
and discuss your case with one of our medical specialists, no strings attached.
Conclusion
Gonorrhea in men is a preventable and treatable infection, but its management requires awareness, timely diagnosis, and treatment adherence. Although symptoms may be mild or even absent, long-term complications—such as infertility, chronic pelvic pain, and increased susceptibility to HIV—make early detection essential.
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