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STI: Fears rise amid prospect of untreatable gonorrhoea – symptoms to spot

Gonorrhoea is one example of a common STI; it is caused by bacteria known as Neisseria gonorrhoea or gonococcus. Formerly known as “the clap” in informal settings, gonorrhoea is normally treated with a course of antibiotics. These antibiotics are normally enough to treat the infection and pain in the testicles or buttocks caused by the infection tend to dissipate within two weeks. However, doctors have become increasingly concerned by the possibility of untreatable gonorrhoea.

Untreatable, or super-gonorrhoea, as it is sometimes referred to is a type of gonorrhoea which can’t be treated because it is resistant to antibiotics.

At the moment, there is just a single drug, ceftriaxone, which is effective against the infection, and scientists are concerned gonorrhoea may soon learn to evade this too.

This isn’t a recent development, since the first treatments were developed in the 1930s, gonorrhoea has learnt to resist the treatments.

Now there are forms of super-gonorrhoea which can render these antibiotics useless, and unless further treatments are developed, patients could find themselves at risk of complications from the bacteria.

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Medical officer at the WHO (World Health Organisation) Dr Teodora Wi said that the drug resistant gonorrhoea can be slowed by controlled use of the drugs and increased availability of diagnostic tests.

Dr Wi added that the world “must prepare urgently for the moment” when the final treatment no longer works.

Wi said: “Gonorrhoea has been around since the Bible, it will work out a way to survive.”

Other common STIs include chlamydia and syphilis, but gonorrhoea has been the most efficacious when it comes to resisting antibiotics.


While ceftriaxone is still effective, it is beginning to show signs of losing efficacy; in the US and UK it is no longer combined with azithromycin because gonorrhoea is becoming resistant to this drug.

STI section head at the UK Health Security Agency (UKHSA) Katy Sinka added: “Our ceftriaxone-resistant cases are rare but they are treatable, especially if you’ve got resistance testing to know what they [the infections] might still be susceptible to.

“Super-gonorrhoea is something rarer still and much harder to treat and something very much of concern.”

Symptoms of gonorrhoea are important to look out for but vary between men and women.

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Symptoms in women include:
• An unusual vaginal discharge, which may be thin or watery and green or yellow in colour.
• Pain or a burning sensation when passing urine
• Pain or tenderness in the lower abdominal area
• Bleeding between periods
• Heavier periods
• Bleeding after sex.

Meanwhile, in men the symptoms are:
• Unusual penile discharge, which may be white, yellow, or green
• Pain or burning sensation when urinating
• Inflammation/swelling of the foreskin
• Pain or tenderness in the testicles.

The infection can also appear around the rectum, throat, or eyes as well as the genitalia.

As well as symptoms differing between men and women so do the complications.

Complications of gonorrhoea

In women, gonorrhoea can cause pelvic inflammatory disease if it spreads to the reproductive organs; this occurs in around 20 percent of cases of untreated gonorrhoea.

If left untreated, PID can increase the risk of infertility, pelvic pain, and ectopic pregnancy, as well as a miscarriage, and premature birth.

With men the infection can cause a painful infection in the testicles and infertility in a small number of patients.

In very rare cases gonorrhoea can also cause life-threatening sepsis infection in the blood.

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