Gonorrhea is far more likely to cause symptoms in men than in women. In men, symptoms typically appear after 2 to 14 days, but occasionally appear months after infection. There is a discharge of yellow or greenish pus from the penis and a frequent need to urinate. Urinating often causes burning pain that can be severe. The opening of the penis may be red and swollen.
Most women don't have symptoms unless there are complications. A few may experience pain on urination. A few have a noticeable vaginal discharge, which may actually be coming from the cervix. The discharge is usually yellow or green, but it may also contain blood. It often has an unpleasant odour. Symptoms in women appear later if they appear at all, usually 7 to 21 days after infection. Most women are diagnosed only when their partner seeks treatment.
While women feel fewer symptoms, they are far more vulnerable to serious complications of gonorrhea. Left untreated, gonorrhea can work its way up the urethra and cervix to other pelvic organs. The result is pelvic inflammatory disease (PID), a very common condition that strikes well over a million North American women every year and can cause infertility. The main complication in men is epididymitis (inflammation of the part of the testicles where sperm is stored), which can cause infertility if not treated.
Other complications of gonorrhea occur when the bacteria get into the bloodstream. They can cause inflammation and pain in the joints (arthritis) and liver (perihepatitis) and a potentially serious infection of the heart valves (endocarditis).
Gonorrhea of the throat is usually asymptomatic but sometimes causes a sore throat and difficulty swallowing. Gonorrhea in the eyes is serious – it can cause blindness if left untreated.
Some people with gonorrhea have symptoms involving the rectum such as itching and discharge or possibly painful bowel movements.