Gonorrhoea (and Super-Gonorrhoea) Explained
Last month, a UK man hit the headlines for contracting the first recorded case of "super-strength" gonorrhoea. As reported by The Guardian, the man contracted the infection in South East Asia and visited a UK clinic at the beginning of the year for treatment. Unfortunately, the two antibiotics which were administered – azithromycin and ceftriaxone – failed to cure the infection. This is the first time that a strain of gonorrhoea has proved resistant to both antibiotics.
In recent years, we’ve heard many accounts of super-gonorrhoea – a name for strains of the infection that have developed resistance to first line antibiotics. Today, the treatment for gonorrhoea involves an injection in the buttocks or thigh, and one oral antibiotic (1); as explained here, the recommended antibiotics are usually ceftriaxone (in injection form) and azithromycin or doxycycline (in tablet form). This combination is usually sufficient, even for super-gonorrhoea – but as we have seen, it was not effective in the case of the man discussed above.
News of super-strength gonorrhoea strains is worrying because gonorrhoea is a fairly common STI. There are an estimated 78 million new cases each year (2); in 2016 there were 36,000 diagnoses in England alone (3). It’s also worrying because, when left untreated, gonorrhoea can cause serious complications such as pelvic inflammatory disease and pregnancy complications – in rare cases it can even cause septicaemia.
If you’re concerned about contracting gonorrhoea, read on for a guide to staying safe.
How is gonorrhoea spread?
Gonorrhoea is a bacterial infection that is spread during unprotected sex. The bacteria responsible, Neisseria gonorrhoeae, are found in semen and vaginal fluid.
Sexual acts that can lead to the spread of gonorrhoea include:
- Vaginal sex
- Anal sex
- Oral sex
- Sharing sex toys
Penetrative sex is not required for gonorrhoea to be passed on; if semen or vaginal fluid from an infected person gets inside the penis, vagina, rectum, throat or eyes it can cause an infection.
Gonorrhoea cannot be caught by kissing, hugging, sharing towels, toilet seats or crockery, or by using public swimming pools.
How can I avoid gonorrhoea?
The best way to avoid catching gonorrhoea is to always practise safe sex. If you aren’t sure of your partner’s STI status, or if you haven’t recently been tested yourself, it’s always a good idea to use condoms and dental dams during sex.
Condoms should be used for penetrative vaginal and anal sex. They can also be used for oral sex, and to cover sex toys. Dental dams should be used for oral sex.
Remember that gonorrhoea doesn’t always cause symptoms in its early stages. This means that you or your sexual partner may have it and not know that you are infected. It’s estimated that 1 in 10 men, and half of all women don’t experience any obvious symptoms in the early stages of infection (4).
What are the symptoms of gonorrhoea?
Though gonorrhoea doesn’t always cause obvious symptoms, it’s worth familiarising yourself with the symptoms that can occur. If you’re aware of the symptoms you can get tested promptly if you notice them in yourself; you will also be better prepared to notice them in potential sexual partners.
Symptoms of gonorrhoea in men can include:
- Unusual discharge from the penis that is often white, green or yellow
- Pain when urinating
- Inflamed foreskin
- Painful, tender testicles
Symptoms of gonorrhoea in women can include:
- Unusual vaginal discharge that may be thin or watery and yellow or green
- Pain when urinating
- Pain in the abdomen
- Irregular bleeding e.g. between periods, after sex
- Heavy periods
In both men and women, gonorrhoea can cause an infection of the rectum, throat or eyes. Symptoms of these infections can include irritation, pain and discharge.
How do you get tested for gonorrhoea?
If you develop any of the symptoms above it’s a good idea to get tested for gonorrhoea; your doctor may also want to test you for other STIs such as chlamydia. It’s also a good idea to get tested if you’ve had unprotected sex with someone whose STI status isn’t known, or if you regularly engage in casual sex with new partners.
If you would prefer not to visit a clinic in person, you can order a home test kit through The STI Clinic. Click here to find out more.
Sources:
(1) https://www.nhs.uk/conditions/gonorrhoea/treatment/
(2) https://www.medicalnewstoday.com/articles/155653.php
(3) https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/617025/Health_Protection_Report_STIs_NCSP_2017.pdf
(4) https://www.nhs.uk/conditions/gonorrhoea/symptoms/