In about 1% of people with untreated gonorrhea, the infection can spread beyond the genital area to the bloodstream, skin, heart, or joints. However, taking medication to prevent HIV ( PrEP) can significantly decrease the risk of getting HIV even when there is an STI present. Rectal gonorrhea may increase your chance of getting HIV by 10-20 times. If you are HIV negative and have gonorrhea, your immune cells are especially susceptible to HIV if your partner is carrying the virus. If you are living with HIV and are not taking antiretroviral medications, a gonorrhea infection can lead to highly concentrated amounts of HIV virus in the genital tissue, causing 8-10 times more HIV to be shed in your semen or vaginal secretions. Untreated gonorrheal infections can also cause inflammation of the prostate and urethral scarring, sometimes leading to male infertility. Men with untreated gonorrhea can occasionally develop epididymitis, a painful infection of the testicles. Gonorrhea during pregnancy can cause preterm birth and miscarriage. Gonorrhea can lead to PID in women even when there are no symptoms.
Left untreated, PID can cause infertility and chronic pelvic pain. Blockage and scarring can damage the tubes, causing women who get pregnant to be more likely to have ectopic (“tubal”) pregnancies. In PID, the bacteria move from the vagina up through the cervix and into the uterus, fallopian tubes, and ovaries. Pelvic inflammatory disease (PID) is a common result of untreated gonorrheal infection in women. Untreated gonorrhea can lead to severe reproductive health problems for women, including infertility (i.e., difficulty or inability to get pregnant).