The STI infection the NHS doesn’t test for

Gonorrhoea: The facts and how to prevent the infection

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Dr Manoj Malu is director of Clarewell Clinics. On the general resurgence of STIs he said: “Many countries including the UK are experiencing an increase in syphilis, gonorrhea and chlamydia. Some regions have also seen a re-emergence of Mycoplasma genitalium.

“Chlamydia, gonorrhoea and Mycoplasma genitalium are three key genital infections that can produce Pelvic Inflammatory Disease (PID). This is essentially wide-spread inflammation in the uterus and fallopian tubes driven by the underlying infection, which results in infertility.”

Symptoms of PID include:
• Pain around the pelvis or lower tummy
• Discomfort or pain during sex felt deep inside the pelvis
• Pain when peeing
• Bleeding between periods and after sex
• Heavy periods
• Painful periods
• Unusual vaginal discharge.

While a common infection among women, men can still experience severe symptoms of STIs, including mycoplasma genitalium, an STI that differs from syphilis and gonorrhoea in more than one way.

As well as symptomatic differences, mycoplasma gentialium also differs because the NHS does not test for it. Dr Malu said: “The danger with Mycoplasma genitalium is that routine NHS STI tests screen for chlamydia and gonorrhoea but not for Mycoplasma genitalium. Considering these serious consequences, we recommend testing for Mycoplasma genitalium as a matter of routine.”

Symptoms of the condition in men according to the Terrence Higgins Trust include:
• Pain when urinating
• A discharge
• Pain the testicles
• Proctitis – anal inflammation which causes anal pain and discharge.

Meanwhile, women are more likely to experience:
• Vaginal discharge
• Pain in the lower abdomen
• Abnormal vaginal bleeding
• Bleeding after sex.

While mycoplasma genitalium is of concern to Dr Malu, it isn’t the only STI currently under review as one which could cause serious disruption.

What is becoming of greater worry among the scientific community is the rise of super gonorrhoea, a form of the common STI which is resistant to the antibiotics used to treat it.

On this Dr Malu said: “The new strain of “super gonorrhoea” is particularly concerning as it is resistant to the most common antibiotic used for its treatment in the UK: ceftriaxone.

“Ceftriaxone-resistance is more common in Asia and the Pacific regions, but fortunately it is still very rare in the UK. Therefore, super-gonorrhoea is more likely to be seen in those who have travelled abroad or acquired the infection from these higher risk countries than experiencing transmission in the UK.

“But that is not to say that things may not change in the future.” Earlier this year, there were concerns that super-gonorrhoea could be spreading in the UK after three cases were detected.

Although most symptoms of STIs focus around the genitalia of both genders, there are some symptoms which can appear in other areas of the body.

Some STIs, for example, can cause impaired vision such as gonorrhoea, chlamydia, and syphilis. Dr Malu said: “Gonorrhea in your eyes can destroy your eyesight, this is particularly dangerous for pregnant carriers as they can pass the infection on to their baby.

“There have been about 70,000 cases of syphilis in the UK in the last 10 years, requiring urgent medical treatment to prevent complications which can range from loss of hearing to loss of vision on one side, and even long-term damage to the heart and nervous system.”

Meanwhile, a few people affected by STIs go onto develop arthritis. Dr Malu said this happens “because the lining of our joins have some antigens very similar to ones found in these bacteria”.

Furthermore, STIs can also cause syphilis in some cases. Dr Malu said: “Syphilis in its second stage, which can occur any time from a couple of months up to two years after infection can commonly cause hair loss. This distressing side effect can affect hair on the whole body, the scalp, eyes brows, eyelashes, armpits as well as arms, legs and the trunk.”
Alongside this, STIs can also cause a sore throat if one engages in oral sex. However, during the cold and flu season this symptom can cause a few problems with Dr Malu warning:

“There is no easy way of distinguishing between a sore throat related to cold and flu symptoms and a sore throat which is a result of an STI. The real clue is in sexual contacts you or your partner may have had.

“If your symptom is confined to the throat, and you have given oral sex, chlamydia and gonorrhoea in the throat are possible causes, apart from the usual causes of sore throat including tonsillitis and viral infections.

“If one has other general symptoms like headaches, fevers, night time sweating and skin rash, then syphilis and HIV are the key considerations amongst STIs as they can produce a sore throat in combination of general symptoms.”

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