While regular "regular" gonorrhoea (AKA the clap) is the UK's second most common STI, the number of cases of the new antibiotic-resistant strain is slowly on the rise.
Last year, the first recorded case was diagnosed in the UK after a guy caught it having sex while on his holiday in South East Asia.
A month ago, we had two new cases in heterosexual women from Britain.
ITV's resident GP and a founding GP of GPDQ, Dr Sara Kayat, says that what is more worrying about the most recent cases is that one was contracted in the UK and the other in mainland Europe.
"The super STI is getting closer," she said.
Because it's often symptomless, gonorrhoea can go for quite a while sometimes without being treated.
If left to fester, it can lead to septicaemia, pelvic inflammatory disease and infertility… and that's without it's "super" hat on.
How has gonorrhoea become 'super'?
Dr Kayat said: "There is a common misconception that when people discuss antibiotic resistance, that it is the human themselves that become resistant to a certain antibiotic, but actually it is the bacteria.
Symptoms of gonorrhoea
The tricky thing about the STI is that it doesn't always present with symptoms.
Dr Kayat said that while around 90 per cent of men with the infection will have symptoms, half of women are symptomless.
In women, the symptoms 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 abdomen
- bleeding between periods, heavier periods and bleeding after sex
In men, the signs include:
- an unusual discharge from the tip of the penis, which may be white, yellow or green
- pain or a burning sensation when peeing
- inflammation of the foreskin
- pain or tenderness in the testicles
"The bacteria are able to change and mutate so that the antibiotics we use against it no longer works.
"In the case of gonorrhoea, it has slowly shown signs of resistance over the years and the treatment regimens have had to change to reflect that.
"It is becomingly increasingly resistant to the current first-line treatment which is a combination of two antibiotics—azithromycin and ceftriaxone and the Centres for Disease and Control have labelled drug-resistant gonorrhoea as one of the top three urgent superbug threats for 2019."
Antibiotic resistance happens naturally but the chronic over-use of antibiotics in recent years has massively sped up the process.
Many people demand to be prescribed antibiotics needlessly, and they're used in many farmed animals – meaning that even if you aren't actively taking them in pill form, you may still be ingesting them through your milk and meat.
"Where antibiotics can be bought without a prescription, resistance can be made worse, furthermore where standard treatment guidelines are not followed, antibiotics may be over-prescribed and over-used," Dr Kayat explained.
More STIs may develop 'super' strains in future
Dr Kayat told The Sun: "Although gonorrhoea has developed the strongest resistance to drugs with 77 countries reporting resistance to at least one antibiotic, it is not the only STI becoming drug-resistant.
"Health officials have claimed that other STIs including chlamydia, syphilis, HIV and mycoplasma are also developing resistance to antimicrobial treatments – just not at the same rate as gonorrhoea."
She says that the British Association for Sexual Health and HIV (BASHH) has warned the mycoplasma “has the potential to become the next superbug within a decade".
All of this drug resistance has huge implications for everyone.
We may need to use multiple antibiotics to treat these STIs, where before only the one was needed, and where that fails to treat, the concern is that other antimicrobials are in short supply.
How to improve your performance in bed – naturally
Dr Kayat's three top tips for having satisfying sex:
- Exercise: We know that exercise not only boosts your endorphins but also your libido and your improved cardiovascular health will mean that you can keep going for longer without needing catch-your-breath breaks, the increased blood flow to your sexual organs may also help maintain that erection and/or improve your orgasm. Exercise is also an excellent way to manage stress, which is a common trigger for sexual dysfunction.
- Reduce the booze: We often have a couple of glasses to unwind and to "get us in the mood" but alcohol is actually a depressant and can reduce your sexual desire and can lessen the intensity of an orgasm. Regularly exceeding the recommended weekly consumption of alcohol can be a cause of erectile dysfunction in men because of the way that chronic alcohol use can damage the nerves that provide the signals to the penis
- Quit smoking: The chemicals in cigarette smoke harm your blood vessels, including the vessels to the penis and can result in erectile dysfunction.
Dr Kayat added: "In parts of the world where they are blindly treating gonorrhoea (and many other infections for that matter) without knowing the bacteria's sensitivity, i.e. what antibiotics will treat it and what it is resistant to, this global epidemic is being driven further.
“In terms of the 'super' STIs spreading globally, there are many factors involved including the increase in trade and travel, big cuts in sexual health services, but possibly the biggest factor is human behaviour and increasing use of social media and new social/sex apps emerging.
"The way we meet and engage with people is changing, but the way bacteria spreads hasn’t changed.”
So, what's the solution?
"While it is difficult to control what is happening around the world with their prescribing policies, in the UK, we can help stall this post-antibiotic era by listening to doctors and only taking antibiotics prescribed by these healthcare professionals and taking them in the way they have advised," Dr Kayat said.
"Avoid pushing for or demanding antibiotics if your healthcare professional doesn’t think you need them.
"It is also always important to think 'prevention is better than cure', so avoid picking up infections through regular handwashing, avoiding contact with sick people, practising safe sex, preparing food hygienically, and staying up to date with your vaccinations."
The BBC reports that there have been growing cases of the super-STI around the world, with cases being reported in Japan, Canada and Australia.
In terms of treating it, the guy from last year was given three days-worth of intravenous treatment with antibiotic ertapenem.
Your best bet by far is simply to practice safe sex and use a condom.
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