Gonorrhoea symptoms: signs and treatment options as UKHSA warn over rise of antibiotic resistant cases

• In 2023, there were over 85,000 gonorrhoea cases reported in England.
• Gonorrhoea can usually be easily treated, however some strains are resistant to commonly used antibiotics.
• This makes gonorrhoea cases harder to treat, with ceftriaxone-resistant gonorrhoea posing a particular threat.
• Between June 2022 and May 2024, 15 cases were detected in England, with the UKHSA warning over the concerning rise in numbers.

Cases of antibiotic resistant gonorrhoea are on the rise according to the UK Health and Security Agency (UKHSA).

Between June 2022 and May 2024, 15 ceftriaxone-resistant gonorrhoea cases were confirmed in England, making up almost half of the 31 cases detected so far since the strain was first detected in 2015.

All cases have been recorded amongst heterosexual patients, mostly in their 20s, who acquired the infection abroad, with limited transmission in England. But the rising cases numbers has been causing worries due to the risk of the infection spreading and the treatment challenge this poses.

Speaking about the concerning rise in antibiotic resistant cases, Dr Helen Fifer, Consultant Microbiologist at UKHSA, said: “Gonorrhoea is becoming increasingly resistant to antibiotics, risking the possibility of it becoming untreatable in the future.”

Dr Fifer continued: “Untreated gonorrhoea can lead to serious health issues, including pelvic inflammatory disease and infertility. Condoms are the best defence, but if you didn’t use one with a recent new or casual partner, get tested to detect the infection and prevent onwards transmission.”

It’s not just gonorrhoea cases on the rise, with the latest data from UKHSA revealing that syphilis rates are also increasing across the UK. In 2023, cases rose by 9.4% compared to 2022, with 9,513 infections detected.

Is gonorrhoea becoming resistant to antibiotics?

Gonorrhoea can usually be easily treated, however, the UKHSA has reported that some strains are proving harder to treat as they are resistant to commonly used antibiotics.

Ceftriaxone is a “first line” antibiotic for treating gonorrhoea, resistance to this medication can make treatment difficult. According to the UKHSA, between June 2022 and May 2024, there were 15 cases of ceftriaxone-resistant in England, with 5 being extensively drug-resistant (resistant to both first- and second-line treatment options and to other antibiotics).

Since the first case of ceftriaxone-resistant gonorrhoea was detected in England in 2015, there have been a total of 31 cases so far, 7 which were extensively drug-resistant.

What are the symptoms of gonorrhoea?

Symptoms of gonorrhoea include a thick green or yellow discharge from the penis or vagina, pain when urinating and in women bleeding in-between periods. However, according to the NHS, around one in 10 people infected men and half of infected women do not experience any symptoms, which is why regular testing is important for detection.

You can also develop a gonorrhoea infection in the rectum, throat or eyes. Symptoms of gonorrhoea in the rectum can cause discomfort, pain or discharge. Whilst in the eyes you can experience irritation, pain, swelling and discharge. Gonorrhoea of the throat often causes no symptoms.

If gonorrhoea is left undiagnosed and untreated, not only could you spread the infection, there are also potentially serious complications including infertility.

You can find out more about the signs and symptoms of gonorrhoea and what treatment options are available at NHS.UK.