Complications of Gonorrhoea

Complications of Gonorrhoea

The complications of gonorrhoea can be severe and long-lasting if the infection is not diagnosed and treated promptly. While gonorrhoea is curable with antibiotics, delayed treatment can lead to serious reproductive, joint, and systemic problems. The most common complications of gonorrhoea involve the genital and pelvic regions, but other body systems can also be affected, especially when the infection spreads through the bloodstream.

Because many people with gonorrhoea are asymptomatic, they may unknowingly allow the infection to persist—risking their health and that of their partners. Understanding these complications underscores the importance of early screening, timely treatment, and proper follow-up.

In Women

1. Pelvic Inflammatory Disease (PID)

PID occurs when gonorrhoea ascends from the cervix into the upper reproductive tract. It may result in:

Chronic pelvic pain

Tubal scarring, leading to infertility

Ectopic pregnancy, a life-threatening condition

Menstrual irregularities and painful intercourse

PID can be mild or severe, often requiring hospital admission if symptoms are intense or if abscesses form. It is one of the most common causes of infertility in women under 35 worldwide.

2. Infertility

Even a single episode of PID can:

Block fallopian tubes, preventing fertilisation

Increase the risk of future miscarriages or pregnancy complications

Prompt treatment of gonorrhoea can prevent PID and protect fertility.

In Men

1. Epididymitis

An untreated gonorrhoeal infection may spread to the epididymis, the structure that stores and transports sperm.

Symptoms include:

Scrotal pain and swelling

Tenderness along the spermatic cord

Fever and chills

While usually treatable with antibiotics, severe cases may damage fertility if not addressed early.

2. Urethral Strictures

Prolonged infection can cause inflammation and scarring of the urethra, leading to:

Difficulty urinating

Slowed urinary stream

Painful ejaculation

These strictures may require surgical correction in advanced cases.

Disseminated Gonococcal Infection (DGI)

DGI occurs when N. gonorrhoeae enters the bloodstream and spreads to other organs. It may cause:

Septic arthritis (painful, swollen joints)

Tenosynovitis (inflammation of tendon sheaths)

Skin lesions (typically pustules on extremities)

Fever and malaise

This condition can become life-threatening if not treated with intravenous antibiotics. Hospitalisation is typically required.

Complications in Newborns

If gonorrhoea is passed from mother to child during delivery:

It can cause neonatal conjunctivitis (ophthalmia neonatorum)

May lead to permanent blindness if untreated

Rarely, systemic infections like sepsis or meningitis may occur

Routine eye prophylaxis and antenatal STI screening are key preventive strategies.

Increased HIV Risk

Gonorrhoea increases the likelihood of acquiring or transmitting HIV:

Inflammation increases susceptibility to HIV infection

Ulceration or discharge may carry higher viral loads

Co-infection with HIV and gonorrhoea is common in high-risk populations

Effective STI management can lower the community burden of HIV.

Social and Emotional Consequences

Chronic or untreated infections can result in:

Stigma and shame, especially with visible symptoms

Anxiety or depression, particularly after complications like infertility

Relationship strain, especially if reinfection occurs

Support from healthcare professionals and counselling services can help address emotional impacts.

Long-Term Impact on Public Health

The wider effects of gonorrhoea complications include:

Increased healthcare costs, due to hospitalisations and infertility treatments

Reduced quality of life for those with chronic symptoms

Burden on fertility clinics, particularly in regions with limited access

Public health interventions—like education campaigns, condom distribution, and school-based STI screening—can help reduce this burden.

Summary of Key Complications of Gonorrhoea

Conclusion

The complications of gonorrhoea can be far-reaching and serious, impacting not only individual health but also community wellbeing and healthcare systems. While easily treatable when caught early, untreated gonorrhoea can lead to infertility, chronic pain, joint damage, and neonatal harm. Raising awareness of the complications of gonorrhoea helps encourage testing, treatment, and prevention—ultimately protecting sexual and reproductive health for all.

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