Gonorrhea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. It is spread through unprotected vaginal, oral, or anal sex with an infected partner. Many men with gonorrhea are asymptomatic, meaning they show no signs or symptoms. This allows gonorrhea to go undiagnosed and untreated for prolonged periods. But can a man really have gonorrhea for years and not know it? Let’s take a closer look.
Silent Nature of Gonorrhea
Gonorrhea is often called a “silent” infection because approximately 50% of men and 80% of women with gonorrhea exhibit no symptoms. When symptoms do occur, they often go unrecognized as signs of an STI. Common symptoms in men include:
- Burning/painful urination
- White, yellow, or green penis discharge
- Pain or swelling of the testicles
However, these symptoms may be very mild and are easy to mistake for something else. Urinary tract infections, yeast infections, and prostate problems can all cause similar symptoms. Because of its ambiguous symptoms, gonorrhea can infect men for months or years before being detected.
How Long Can Gonorrhea Go Undetected?
There are documented cases of asymptomatic gonorrhea infections lasting several years in men. According to one study, 53% of men with untreated gonorrhea still had detectable infections after 1 year. After 2 years, 10% still had gonorrhea.
This demonstrates gonorrhea can persist silently for extended periods. But exactly how long gonorrhea can go undetected likely depends on individual immune response. Some men may naturally clear the infection after a few months, while others may harbor it for several years before symptoms appear.
Factors Allowing Prolonged Gonorrhea Infections
Certain factors increase the likelihood of long-term asymptomatic gonorrhea in men:
No Routine Screening
Many men don’t get regularly screened for STIs if they are asymptomatic and have no known exposures. Lack of routine screening allows infections to go undetected. The CDC recommends all sexually active gay and bisexual men get tested for gonorrhea every 3-6 months.
Lack of Symptoms
As discussed, lack of symptoms is common with gonorrhea. No symptoms means no cause for concern or reason to seek testing.
Re-exposure to Infection
Men who continue having unprotected sex with infected but undiagnosed partners are at risk for re-exposure to gonorrhea. Being re-exposed may “reseed” the infection even after initial treatment.
Location of Infection
Gonorrhea can infect the urethra, rectum, or throat. Urethral infections are most likely to produce symptoms, while rectal and throat infections are more often asymptomatic. Undetected rectal or throat gonorrhea is at higher risk of persisting for years.
Evolving Antibiotic Resistance
Gonorrhea has become resistant to many antibiotics once used to reliably cure infections. Some resistant strains may not be fully treatable with a single round of antibiotics, increasing odds of persistence.
Consequences of Untreated Gonorrhea
Allowing gonorrhea to go untreated for months or years has serious consequences:
Increased Spread
Men unaware they are infected often unknowingly transmit gonorrhea to others until symptoms emerge. This fuels greater spread of disease.
Higher Risk of HIV
Studies show untreated gonorrhea significantly increases risk of contracting HIV if exposed. One study found gonorrhea infection of the rectum increased HIV risk by up to 9 times.
Epididymitis
Untreated gonorrhea can spread to the epididymis, causing this tube behind the testicles to become inflamed and painful (epididymitis). Epididymitis untreated can result in infertility.
Disseminated Gonococcal Infection (DGI)
Rarely, untreated gonorrhea spreads through the bloodstream to cause painful, systemic infection. DGI can cause fever, rash, and arthritis-like joint pain. It requires hospitalization.
Infertility
Over time, untreated gonorrhea can scar the male reproductive tract, blocking sperm passage. It is estimated 10-30% of untreated gonorrhea cases lead to infertility in men.
When to Seek Care
If you are a sexually active man, don’t wait for symptoms to emerge. Get screened regularly for gonorrhea and other STIs. Testing is recommended every 3-6 months for gay/bisexual men and others at heightened risk.
See a doctor for evaluation if any unusual penile discharge, testicular pain, or urinary symptoms occur. Inform partners of potential gonorrhea exposure and abstain from sex until fully treated to avoid reinfection. With appropriate screening and safe sex practices, prolonged hidden gonorrhea can be avoided.
Conclusion
Yes, it is possible for men to have asymptomatic gonorrhea infections lasting for years when left untreated. The ambiguous symptoms of gonorrhea along with inconsistent screening practices allow this STI to be stealthy. While advanced cases with overt symptoms will eventually emerge, gonorrhea can persist silently for months or even years in some men. This puts them and their partners at risk for serious health complications down the road. Increased awareness, routine screening, and safer sexual behaviors are keys to reducing long-term hidden gonorrhea infections in men.