When initially infected, about 50% of men have some signs or symptoms. Symptoms and signs include a burning sensation when urinating and a yellowish white discharge from the penis. Sometimes men with gonorrhea get painful or swollen testicles. In men, gonorrhea can cause epididymitis, a painful condition of the testicles that can sometimes lead to infertility if left untreated. Without prompt treatment, gonorrhea can also affect the prostate and can lead to scarring inside the urethra, making urination difficult.
In women, the early symptoms of gonorrhea are often mild, and many women who are infected have no symptoms of infection. Even when a woman has symptoms, they can be so non-specific as to be mistaken for a bladder or vaginal infection. The initial symptoms and signs in women include a painful or burning sensation when urinating and a vaginal discharge that is yellow or bloody. Women with no or mild gonorrhea symptoms are still at risk of developing serious complications from the infection.
Untreated gonorrhea in women can develop into pelvic inflammatory disease (PID). About 1 million women each year in the United States develop PID. Women with PID do not necessarily have symptoms or signs. When symptoms or signs are present, they can be very severe and can include strong abdominal pain and fever. PID can lead to internal abscesses (pus pockets that are hard to cure), long-lasting pelvic pain, and infertility. PID can cause infertility or damage the fallopian tubes (egg canals) enough to increase the risk of ectopic pregnancy. Ectopic pregnancy is a life-threatening condition in which a fertilized egg grows outside the uterus, usually in a fallopian tube
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