Gonorrhoea

What is it and how do you get it?

Gonorrhoea, or 'the clap', is a bacterial infection of the urethra (the tube you piss out of), arse, throat or eyes. It can be passed on by rimming, sucking cock, fucking or getting fucked without a condom. Rates of gonorrhoea amongst gay men had remained fairly steady over the last ten years but increased dramatically in 2010, when around 4,500 gay men were treated for gonorrhoea at sexual health clinics in the UK.

How do you prevent it?

The more men you have sex with, the more likely you are to get an STI, including gonorrhoea. Using condoms will prevent many cases of gonorrhoea. If you wanted to reduce the risks further, you would have to use condoms for oral sex. Sucking cock carries a risk even if he doesn't cum in your mouth.

How do you know you've got it?

Noticeable symptoms can include a white or greenish pus discharge from your cock and a burning sensation when you piss or cum. Infection in your arse may be noticeable by a yellowish discharge, fresh blood on your shit, mild diarrhoea, or itching and pain when shitting. Infection via your mouth can result in a sore throat. Sometimes there are no symptoms, or they are too mild to be noticeable, particularly with gonorrhoea in the throat or arse.

A sexual health clinic can test you for gonorrhoea and this should form part of routine sexual health check-ups. It is tested for by taking a urine sample or a swab from your cock and arse.

How do you treat it?

Gonorrhoea is treatable with antibiotics and is completely curable. Left untreated the body's natural defences would normally be able to clear gonorrhoea from the system, although this would take several months (during which time the infection could be spread to other sexual partners) and be painful. In some cases, untreated gonorrhoea can spread to the prostate gland and balls, which may lead to infertility. In the worst case scenario, it could also spread throughout your body causing inflammation of the joints and septicaemia, which can, in rare cases, be fatal.

If you have gonorrhoea you should inform your recent sexual partners. It's important that you tell any regular partner so that they can get tested and treated too. You then need to avoid sex with them until the treatment has taken effect (usually a couple of weeks) as it's common for people to pass it back and forth to each other. If this happens you'll need treatment again.

Drug resistant gonorrhoea

The important thing is to know that in the UK gonorrhoea can still be cured by antibiotics. But gonorrhoea is changing (although the symptoms remain the same) and the antibiotics used to treat it are getting less effective. For this reason, clinics now need to give higher doses and this means that a pill on its own is not enough. The drug must now be given as an injection into the buttock. A second, different antibiotic is also given as a tablet to increase the chance that treatment works. Because of the possibility of drug resistant gonorrhoea clinics now call you back to test that your treatment has worked (until recently they would often give one pill and not ask you to return to the clinic). Some experts believe that within a few years treating gonorrhoea will be difficult or no longer possible around the world, including in the UK.

Bacteria (like gonorrhoea) can be killed by antibiotics but often they grow resistant to these drugs. With gonorrhoea this has happened many times over past decades. One type of antibiotic gradually stops being effective and a new antibiotic takes its place, until the bacteria develops resistance to it too, and a new drug is needed, and so it goes on.

Unfortunately there are no new types of antibiotic against gonorrhoea on the horizon. Unless new ones are created (and none are in the pipeline) we will have no effective treatments once the current antibiotics stop working.

Which sexual partners should I inform if I've been diagnosed with gonorrhoea?

If you have urethral symptoms (symptoms in your cock), you should inform anyone you've had sex with up to two weeks before the symptoms started.

If you don't have any symptoms, you should inform anyone you've had sex with up to three months before you were diagnosed with the infection, or your most recent sexual partner if it was longer than three months.

GMFA runs an online partner notification system with selected GU services in England. This free and confidential service allows men to contact recent sexual partners via text, email or a message on a gay dating website. Messages can be anonymous. If you are diagnosed with gonorrhoea at a GU clinic in England, ask for information about GMFA’s Sexual Health Messaging Service.

References:

HPA: Number of selected STI diagnoses made at genitourinary medicine clinics in England: 2001 - 2010