In April 2016, gonorrhoea hit the headlines after Public Health England revealed that antibiotic-resistant strains (known as "super-gonorrhoea") had been found in the Midlands and the southeast of the country, after originally being identified in the north. This information was alarming because it suggested the spread of a disease that is becoming harder to treat day by day.

Currently, super-gonorrhoea strains are resistant to the antibiotic azithromycin. A secondary antibiotic, ceftriaxone, is being used in place of azithromycin, but it’s feared that gonorrhoea strains could develop resistance to that as well, leaving doctors unable to treat the infection at all.

With this issue becoming one of the big health scares of the moment, it’s unsurprising that scientists are dedicating more time to looking into the precise mechanisms of the infection. Most recently, researchers at the University of Maryland carried out a study investigating how gonorrhoea bacteria – "Neisseria gonorrhoeae" – are able to penetrate the cells of the cervix in women.

This study was undertaken because the cervix is usually able to shed and dispose of infected cells without compromising the integrity of the cervix lining. It was found that the N. gonorrhoeae bacteria disrupt this normal function, by breaking the tight connections between the cells of the cervix lining and inducing cell shedding; this in turn enables the bacteria to infect the cervix cells. The study indicated that gonorrhoea has this effect upon the cervix lining by provoking the activation of a certain protein.

It isn’t yet known how this study could affect the current medical approach to gonorrhoea, but it’s hoped that this kind of research will, in the future, suggest alternative, safe treatments for antibiotic-resistant strains. Until this kind of treatment has been developed, it’s advised that people take more caution than usual when engaging in sexual activity.

Staying Safe in the Bedroom

The main rules for engaging in safe sex are:

• Always use condoms for penetrative sex when you aren’t sure your partner is free from STIs
• Never share sex toys without washing them or applying a new condom
• Use dental dams for oral sex if you aren’t sure your partner is free from STIs
• Don’t engage in sexual contact if you or your partner has any noticeable symptoms (see below)
• Get tested if for STIs if you have unprotected sex (e.g. if the condom splits) with someone who may have an infection
• Get tested if you develop any symptoms
• Get tested regularly if you are having regular sex with new or multiple partners, particularly if you are in the high risk group of men who have sex with men

The above can all be applied to the risks associated with contracting gonorrhoea. This is because gonorrhoea is carried in semen and vaginal fluid, and can be passed on through vaginal, anal and oral sex. It can also be transmitted via unwashed sex toys. Less commonly, gonorrhoea infects the eyes and throat, which is why it can be a good idea to use condoms for oral sex.

The classic symptoms of gonorrhoea can be confused with other STIs such as chlamydia; however, whatever the cause, it’s important to get them checked out. It’s also worth noting that gonorrhoea doesn’t always cause symptoms in its early stages – for that reason, you should get tested if you think you may have been exposed, even if you feel completely healthy.

Gonorrhoea symptoms in women include:

• Unusual vaginal discharge that is thin, watery or green or yellow in colour
• Pain or a burning sensation when urinating
• Pain in the abdomen
• Irregular bleeding e.g. after sex, between periods
• Heavier periods

Gonorrhoea symptoms in men include:

• Unusual white, yellow or green discharge from the penis
• Pain or a burning sensation when urinating
• Swelling in the foreskin
• Pain in the testicles

If you have had unprotected sex with someone displaying the symptoms listed above, or if you are experiencing them yourself, you should get tested for gonorrhoea. You can do this for free at NHS centres; alternatively you can order a home test kit through an online service like The STI Clinic. Click here to learn more.