[Question #3288] Gonorrhea or chlamydia: is it possible symptoms never show up, to awful effect?

37 months ago
Hello. My question is this: Is it possible that infections like gonorrhea and chlamydia can never show symptoms, and yet go on to wreak havoc, silently so to speak? Here's the motivational background of my question: Recently I had STD testing done, but on the gonorrhea and chlamydia test there was a snafu (the "source" listed was listed as cervix rather than urine--I am a man). The hospital claimed it was just a typing error, but it made me question the negative result, and they resisted letting me do the test again for no pay. Before I go in for another test somewhere else, though, I wanted to make sure it was worth my effort and money. Currently I do not show any symptoms of having either infection. But I have read that gonorrhea, for example, can go without ever showing symptoms. My worry is that, having no symptoms, I decline to get tested and then discover, say a year down the road, that I have severe complications from untreated gonorrhea. Is this at all a plausible scenario? Or will symptoms EVENTUALLY arise before it ever gets that dire? Thanks!
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
Thanks for your question.  Several comments.

First and most importantly, both gonorrhea and chlamydial infection can be present and asymptomatic but can still be transmitted to others and cause complications (women are at far greater risk for complications than men but either gender can have complications from asymptomatic infection).  In fact, the majority of chlamydial infections in men are asymptomatic.  For these reasons we encourage our clients to have regular sexual health checks which include testing for gonorrhea and chlamydia, even if asymptomatic. 

Secondly, I suspect that your problem was truly a clerical error but I also think that the lab owes you a repeat test.  If you communicate with them again, I would ask to speak to the supervisor, explaining that this is their mistake.  Hopefully they will do the right thing and provide a re-test at no expense to you.

Finally, having recommended testing, I should also point out that statistically only a very small proportion of asymptomatic persons are found to have gonorrhea or chlamydia when tested.  Thus screening is not emergent but I do agree with you that it is a good idea.

I hope these comments are helpful.  EWH
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37 months ago
Thank you for the response, doctor. I still would be interested to know whether or not a person could be asymptomatic indefinitely, that is, not to show any symptoms of gonorrhea or chlamydia UNTIL it is too late, that is, until extreme complications arise from an untreated infection. I ask because websites online say only that symptoms can take 30 days or so to show up, but they never address the possibility that a person can go for years without knowing, only to end up with severe complications. I do plan to get re-tested. But even then there is a tiny chance that even that test could give a wrong result, so this is just something I'd like to know. I believe it could also help others who would be interested in the answer. Thanks!
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
Infections can remain asymptomatic however how long is unknown since it would not be ethical to follow persons without treatment.  Certainly the infections can persist for several months without symptoms.  Over time, the body fights off the infection and eliminates nearly, if not all, infections, even without therapy.   OTOH, the current tests for these infections are among the most sensitive tests in all of medicine.  If your test is negative, the result should be believed.  EWH
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37 months ago
Thanks again, doctor. 
37 months ago
Just one last question, slightly different than before. I have heard about drug resistant gonorrhea and was wondering what would happen if a person contracted the disease but could not be cured. I know this is currently more of a worry than a reality, but if it does come to pass, does it mean gonorrhea could theoretically cause symptoms with no relief insight unless it clears naturally?  Or are there drugs and treatments that can at least mitigate symptoms like burning pee etc? That is my last question and I thank you in advance for answering.
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
Statements about drug resistant gonorrhea are a bit over stated.  Gonorrhea is becoming more resistant to antibiotics but it is still relatively uncommon in most of the world and even when drug resistant stains are encountered, there are alternate antibiotics that are highly effective.  So far there has never been a case of gonorrhea that could not be treated and this is unlikely to occur.  The problem and concern about antibiotic resistant gonorrhea is a public health problem in which management and control of infections becomes more challenging due to not being able to rely on previously recommended medications which might be more costly to purchase.  As I said however, at the current time, while resistant gonorrhea is something that specialists need to plan for, it is not a problem for infected patients.

In answer to the second part of your question, even when the infection persists, the body fights the infection and symptoms typically go away.

Thanks for your interest in our site.  As you know, we provide up to 3 responses to clients and this is my 3rd response.  Thus, as per Forum guidelines, this thread will be closed in a few hours.  EWH 
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37 months ago
I was waiting for this thread to close as well, doctor, but since it is allowing me one more comment let me just add the footnote, on drug-resistant gonorrhea, that this very site--ASHA--says this about it "Treatment: Can be cured with antibiotic medicines, but drug-resistant strains of gonorrhea are increasing in many parts of the world, including the US." This language suggests that there are actual. currently drug-resistant strains. Very confusing. But thank you for your answers again.
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
This sort of resistance is important for persons to be aware of and to be sure to use recommended,therapy.  At the same time people should have confidence in recommended therapy.  EWH---