STIs: what are the symptoms of gonorrhoea and syphilis - as health authority warns of record cases

Last year saw the highest number of gonorrhoea cases in England since records began, while syphilis appears to be making a comeback as cases reached their highest level since the 1940s.

New sexual health data released by the UK Health Security Agency (UKHSA) on Tuesday (6 June) showed record levels of gonorrhoea and syphilis diagnoses in 2022, spurring fresh safe sex warnings from the government body.

There were 82,592 gonorrhoea diagnoses last year, up more than 50% on 2021 - 16% compared to 2019, before the Covid-19 pandemic. UKHSA said this was the highest number of diagnoses in any one year since records began in 1918.

Meanwhile, infectious syphilis diagnoses increased to 8,692, up 15% compared to 2021, and 8% compared to 2019 – the largest annual number since 1948. Britons aged 15 to 24 remained the most likely to be diagnosed with sexually transmitted infections (STIs), the agency said, with more than 400 STIs diagnosed each day among young people.

The UKHSA urged everyone having sex with new or casual partners to wear a condom and get tested regularly, whatever their age or sexual orientation. Testing was free and confidential, the agency said, and people should get tested even if they are not showing any symptoms.

Consultant epidemiologist Dr Hamish Mohammed said large rises in gonorrhoea cases had particularly affected young people. "STIs aren’t just an inconvenience – they can have a major impact on your health and that of any sexual partners," he said.

"Condoms are the best defence, but if you didn’t use one the last time you had sex with a new or casual partner, get tested to detect any potential infections early and prevent passing them on to others. Testing is important because you may not have any symptoms of an STI."

Though STIs are usually easily treated with antibiotics, many can cause serious health issues if left untreated, he said. Chlamydia and gonorrhoea can cause infertility and pelvic inflammatory disease, while syphilis can cause serious, irreversible and potentially life-threatening problems with your brain, heart, or nerves.

Part of the reason there might have been more diagnoses was an increased number of sexual health screenings in 2022, UKHSA said. However, the scale of the increase suggested more transmission of STIs was happening within the population.

What are the symptoms of gonorrhoea?

The NHS says gonorrhoea is a bacterial infection, which can infect the cervix, urethra, rectum and - less commonly - the throat or eyes. The infection can also be passed from a pregnant woman to her baby, causing permanent blindness without treatment.

Symptoms can include a thick green or yellow discharge from the genitals, pain when peeing, and in women, bleeding between periods. Around 1 in 10 infected men and almost half of infected women do not experience any symptoms.

Gonorrhoea is becoming increasingly resistant to antibiotics and at risk of becoming untreatable in the future, UKHSA warned, making it vital that people test early and diagnose the infection so that they can prevent passing it on.

What are the symptoms of syphilis?

Syphilis is also caused by a bacteria, and can become life-threatening if not treated.

The NHS says symptoms often appear about three weeks after infection, and can include small sores on the genitals, or in the mouth, lips, or hands. You can also get grey or white wart-like growths, most commonly around the genitals, and a non-itchy rash on the palms of your hands and the soles of your feet.

Occasionally, people will also get flu-like symptoms, swollen glands, or hair loss. If the disease is allowed to progress, it can cause heart, brain and nerve problems.