Sexually transmitted infections (STIs)
What is it?
Gonorrhoea is a sexually transmitted infection caused by bacteria called Neisseria gonorrhoeae. It is the second most common bacterial sexually transmitted infection in the UK.
Gonorrhoea is easily treated. However, if left untreated in women, gonorrhoea can spread to other reproductive organs (the womb and the fallopian tubes), causing long-term pain, blocked tubes, infertility and ectopic pregnancy (this is when a pregnancy develops in the fallopian tube rather than in the womb). If untreated in men, gonorrhoea can cause a painful infection in the testicles and prostate gland.
In April 2016 Public Health England (PHE) issued a statement about a highly drug-resistant type of gonorrhoea with the warning that it may become untreatable.
A powerful strain of the STI, first seen in the north of England, has since been found in the West Midlands and the south-east.
The strain is highly resistant to the antibiotic azithromycin, which means clinicians are relying on a second drug, ceftriaxone, to treat it. However, there are no other effective drugs to tackle the strain, raising the prospect of it becoming untreatable if it builds further resistance.
PHE has urged people to use condoms with new or casual partners to cut the risk of catching the disease. If untreated, gonorrhoea can result in severe complications and in rare cases lead to infertility or septicaemia.
Dr Gwenda Hughes, the head of PHE’s STI section, said: “Fortunately, the current outbreak strain can still be treated with ceftriaxone. Nonetheless, we know that the bacterium that causes gonorrhoea can rapidly develop resistance to other antibiotics that are used for treatment, so we cannot afford to be complacent.
“If strains of gonorrhoea emerge that are resistant to both azithromycin and ceftriaxone treatment options would be limited as there is currently no new antibiotic available to treat the infection.”
By 17 April 2016 there had been 34 confirmed cases since November 2014. Since September 2015, 11 cases had been confirmed in the West Midlands and in the south of England, five of them in London.
At least 16 cases were first detected in northern England, including 12 in Leeds, where the mutated strand was first recorded, PHE said in September 2015.
How do I catch it?
Gonorrhoea is easily passed from one person to another during vaginal, oral or anal sex. It can also be spread by sex toys if they are not washed or covered by a new condom each time they are used.
The bacteria infect the cells lining the cervix (neck of the womb), urethra (the tube that runs through the penis), rectum (back passage) and sometimes the eyes or throat.
You can’t catch gonorrhoea from kissing, hugging, sharing towels, swimming pools, toilets or sharing cups, plates or cutlery.
Women may notice a change in vaginal discharge – it can increase, change to yellow or green, or have a strong smell. They may also experience pain when passing urine, itching or discharge from the anus, or lower stomach pain. However, they may not have any symptoms at all.
Men may have a yellow or white discharge (liquid) from the penis, pain or tingling when passing urine, inflammation of the testicles, or discharge or discomfort in the anus.
Gonorrhoea in the eyes can cause redness and irritation. Less commonly, gonorrhoea can cause inflammation of the joints and tendons, skin lesions or, rarely, can affect the brain and heart.
Gonorrhoea tests can be done on a urine sample or swabs taken from the genitals (penis or vagina), back passage and throat. We can recommend the best test for you depending on whether you have any symptoms and what they are.
If you’re aged 16 or over and living in Birmingham or Solihull, you can request a free sexually transmitted infection (STI) self-sampling kit. Just follow the instructions in the kit to take your own samples, and return to us for testing, all for free.
Gonorrhoea is treated with antibiotics – this is likely to be a combination of an injection and some tablets.
If you are treated for gonorrhoea, it is important that your partner is also treated before you have sex again.
All Umbrella clinics provide treatment for sexually transmitted infections. To find clinics, and to see which services they offer, please see the service locator.
Detailed information on STIs is available on the NHS website.
See the FPA website for a range of downloadable leaflets on sexually transmitted infections.
The British Association for Sexual Health and HIV (BASHH) website also features a range of downloadable leaflets on STIs.