Gonorrhea is a common sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. It can affect the genital tract, mouth, throat, or rectum. If left untreated, the infection can lead to serious long-term consequences. For men, a specific concern following a Gonorrhea diagnosis is the potential impact on their ability to father children.
The Risk of Infertility in Males
Gonorrhea does not cause immediate infertility, but it poses a serious, indirect risk when the infection goes unrecognized and untreated. The complication arises from the subsequent inflammatory damage it inflicts on the reproductive tract. Prompt antibiotic treatment almost always cures the infection and prevents this long-term damage, making permanent infertility a relatively rare outcome today.
However, the risk is real because the infection can progress silently, especially as many men experience very mild or no symptoms at all. The resulting complications, which involve the delicate tubes responsible for sperm transport, can permanently impair fertility. Early detection and immediate intervention are important to prevent this potential for severe, long-term damage.
How Gonorrhea Affects the Male Reproductive System
The infection typically starts as urethritis, which is the inflammation of the urethra, the tube that carries urine and semen out of the body. From the urethra, the Neisseria gonorrhoeae bacteria can travel upward in the male reproductive system. This ascension leads to inflammation in higher structures, which is where the risk to fertility begins.
The most common severe complication is epididymitis, an inflammation of the epididymis, the coiled tube located at the back of the testicle that stores and carries sperm. Untreated, severe inflammation can cause tissue damage and scarring. This scarring can lead to a blockage or obstruction in the epididymis or the vas deferens, the tube that transports sperm.
When these ducts become blocked, sperm cannot travel from the testicles into the ejaculated fluid. This condition, known as obstructive azoospermia, means no sperm are present in the semen, or oligozoospermia, meaning a very low sperm count. The structural damage caused by this infection prevents the physical release of sperm, which is the direct mechanism leading to infertility.
Recognizing Symptoms and Testing
Many men do not experience any noticeable signs of infection. When symptoms do occur, they usually appear within two to fourteen days following exposure. The most common signs are painful or burning sensations during urination and a pus-like discharge from the tip of the penis, which may be yellow, white, or green.
If the infection progresses to epididymitis, men may experience pain or swelling in one or both testicles, sometimes accompanied by lower abdominal discomfort. Because the infection can hide without symptoms, routine screening is vital for sexually active men, especially those with new or multiple partners. Diagnosis is typically confirmed through a nucleic acid amplification test (NAAT) performed on a urine sample or a swab taken from the urethra.
Treatment and Preventing Long-Term Damage
The standard treatment involves a course of antibiotics. Due to increasing antibiotic resistance, the Centers for Disease Control and Prevention (CDC) currently recommends a single, intramuscular dose of the antibiotic ceftriaxone for uncomplicated infections. This treatment eliminates the Neisseria gonorrhoeae bacteria, curing the infection and halting its progression.
The timing of this treatment is the most important factor in preventing long-term fertility issues. Prompt antibiotic intervention can stop the inflammatory process before it causes extensive scarring in the epididymis or vas deferens. However, if the infection has already progressed and caused significant structural damage or obstruction, the antibiotics will clear the bacteria but cannot reverse the existing physical scarring. In cases where ductal blockage has already occurred, surgical intervention may be required to attempt to restore sperm transport, though this is not always successful.