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Reviewed by Dr David Delvin, GP and member of the British Association for Sexual Health and HIV
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What is gonorrhoea?
There are various different 'strains' of this germ, and unfortunately antibiotic-resistant ones have become more common during the 21st century. As a result, the recommended method of treatment used in the UK was changed in October 2011. During the late 20th century, gonorrhoea became common in Britain, largely as a result of freer and easier attitudes to sex. Happily, the incidence has fallen substantially during the first part of the 21st century, perhaps because more people are practising safe sex. In the latest year for which figures are available, the number of new cases of gonorrhoea was 17,385. Unfortunately, this was a slight increase on the figure for the previous year. The annual total was made up of about 5,700 women and 11,700 men. Of the males, about 30 per cent were men who have sex with men (MSM). The disease most frequently affects 15 to 30-year-olds. Please note that gonorrhoea (the clap) is more common in many other regions of the world, particularly parts of the tropics. Therefore, casual sex while overseas may be risky. How do you contract gonorrhoea? Gonorrhoea is transmitted through sexual contact. This includes vaginal intercourse and anal intercourse. Oral sex can also pass on the germ, and some people actually develop a sore throat due to gonorrhoeal infection. But sex workers and others may carry the bacterium in their throats without realising it. A research paper presented at a VD conference in Newcastle in May 2011 revealed that there's a high incidence of gonorrhoea of the throat among British prostitutes because so many of them give oral sex several times per day. Mothers infected with gonorrhoea can transfer the disease to their children during delivery. If they were untreated, such children would develop a serious inflammation of the eyes – which could result in blindness. However, these days nearly all infected babies are rapidly cured by antibiotic eye drops. What are the symptoms of gonorrhoea? Of those infected, approximately half the women and a few of the men do not show any symptoms. In men, the main symptom is painful urination. There's also a discharge from the tip of the penis, which may be white, yellow or green. Gonorrhoea in the rectum can occur in people who practice anal intercourse. This may be symptom-free. But it can give you rectal pain, irritation or a discharge from the anus. In women, the symptoms of gonorrhoea are more limited or absent. But there may be painful urination and a discharge from the vagina. In both sexes, a throat infection can occur as a result of oral sex with an infected partner. Sometimes the sore throat is accompanied by a fever. However, there may be no symptoms at all. How can I avoid gonorrhoea?
The bacterium can be detected through obtaining a sample from the urethra (the urinary pipe), the cervix (the 'neck' of the uterus) and the throat or the rectum. But first of all, the clinic will want to have a look at a fresh specimen of your urine, so please don’t urinate a couple of hours before you go along. Clinic doctors and nurses are experts at painlessly taking drops of moisture from the urinary pipe, the vagina and cervix, the rectum and the throat. These samples will be examined under a microscope immediately and also sent for 'culture' at the lab (which takes a few days). If you do have gonorrhoea, you'll be given the appropriate antibiotic – and this should cure you. Gonorrhoea used to be treated – and treated very effectively – with penicillin. But penicillin-resistant strains of the germ emerged in the last 30 years, so experts switched to a drug called cefixime, which is given by mouth. But in March 2011, the British Association for Sexual Health and HIV (BASHH) recommended that the new 'first line' treatment of gonorrhoea should be changed, because of the increasingly common problem of resistance to cefixime. And in October 2011, Britain’s Health Protection Agency (HPA) announced that 17.4 per cent of samples of gonorrhoea bacteria were now cefixime-resistant. So, they recommended that when treating gonorrhoea, doctors should henceforward use a combination of TWO drugs:
The clinic will ask you to give 'contact slips' to your recent sexual partner(s), so that they too can be tested and treated. Nevertheless, anything you tell the clinic staff will be completely confidential. They will not even inform your own doctor that you have had gonorrhoea. What happens if gonorrhoea is left untreated? If gonorrhoea is left untreated it can develop into an inflammation of the sexual organs in women and in men an inflammation of the epididymis (a tightly-coiled tube located next to the testicle) or other parts of the genitals. In women, a possible long-term consequence of gonorrhoea is blockage of the Fallopian tubes, even if the person has never had any symptoms. If this blockage happens, the passage of the fertilised egg into the uterus is made difficult and so the risk of sterility and ectopic pregnancy increases. Women may also develop acute salpingitis – a painful inflammation of the Fallopian tube. So, gonorrhoea should always be treated promptly. What should I do if I think I've run a risk of gonorrhoea? Call your local genitourinary medicine (GUM) clinic and arrange to go and see them ASAP. In the meantime, don't have sex. You can find out where your nearest GUM clinic is by calling NHS Direct on 0845 – 46 47. Other people also read: Sexually transmitted diseases (STDs): you'll find a number of conditions. Genital warts: who is at risk? Genital herpes: how do you get medical help? HIV and AIDS: how do you get infected? |
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| Based on a text by Dr Flemming Andersen and Dr Ulla Søderberg, specialist |
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| Last updated 24.10.2011 |
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