Let’s recap the facts about syphilis and gonorrhea

Gonorrhea should be tested from throat if there has been oral sex.

Gonorrhea and syphilis infections are on the rise. In Finland, 500–600 gonorrhea infections are usually diagnosed annually, but last year (2022) nearly 1000 cases were detected. Thus, gonorrhea infections have doubled in a year. The number of confirmed syphilis infections has also doubled. In general, fewer than 200 cases of syphilis have been diagnosed in Finland every year, but last year there were almost 400 confirmed cases of syphilis. The majority of gonorrhea and syphilis infections are diagnosed in men, and a large proportion of these have been contracted during sex between men.

In this article we will recap (1) what gonorrhea is and how it is transmitted, (2) how gonorrhea is tested and (3) how it is treated, and (1) what syphilis is and how it is transmitted, (2) how syphilis is tested and (3) how syphilis infection is treated. 


What is gonorrhea and how is it transmitted?

Gonorrhea is a sexually transmitted infection caused by a bacterium. Gonorrhea can be transmitted during sex without a condom: during intercourse, oral sex or licking the anus, and infection can also occur through the hands if bacterial secretion gets on the mucous membrane. The risk of infection during intercourse and oral sex is for both parties. 

How is gonorrhea tested? 

Like all sexually transmitted diseases, gonorrhea can be asymptomatic or have so few symptoms that it is not possible to know when to get tested based on the symptoms. It is worth getting tested if you have had occasional sex partners and had sex without a condom. It is advisable to get tested for sexually transmitted diseases after a possible risk situation at the earliest after 5 days.  

Gonorrhea is usually tested with a combination test, in which chlamydia is also tested on the same sample (urine or stick sample). It is important that gonorrhea is tested on the mucous membranes in accordance with the method of sex. That is, in addition to the urine sample, if there has been anal sex as a receiving party, the sample is taken from the anus and if there has been oral sex, the sample is taken from the mouth and so on. 

STI testing is free of charge at a health centre, at an outpatient clinic for sexually transmitted infections and at student health care.

How is gonorrhea treated?

Gonorrhea is treated with an antibiotic, usually an injection and a combination of oral antibiotics. When treatment is in progress, new infections must be prevented by refraining from sex for the first week of treatment and condom use is recommended until the post-treatment check-up, which is 4 weeks after the end of treatment. It is important to inform sexual partners of the infection so that they know how to get tested and the chains of infections can be broken. 


What is syphilis and how is it transmitted? 

Syphilis is a sexually transmitted infection caused by a bacterium. Syphilis is a generally dangerous infectious disease, and it is especially important to ensure that all partners exposed to syphilis infection are getting tested and, if necessary, treated. Syphilis has different stages (primary, secondary, latent and late stages) and its adhesion varies depending on which stage it is. Syphilis transmits easily in the primary and secondary stages. It can be transmitted during oral sex, licking anus and during intercourse when a condom is not used. 

How is syphilis tested?

Syphilis infections are important to be diagnosed because left untreated, syphilis can cause troublesome symptoms even years after infection. Syphilis is tested from a blood sample and can be tested no earlier than 3 weeks after sex. A negative test result is reliable after 6 weeks from sex. Testing and treatment of syphilis is free of charge in public health care. 

Syphilis is tested from a blood sample.

How is syphilis infection treated? 

Syphilis is usually treated with an antibiotic injected intramuscularly. The length of treatment and the number of injections depend on the stage of syphilis infection. Syphilis is treated primarily in an outpatient clinic specializing in STIs, or a specialist is consulted for treatment. Treatment practices vary depending on municipality. 

During treatment new infections must be prevented: Sex should be withheld for the duration of treatment and condoms should be used until the first follow-up examination. 

Finally, when STIs are on the rise, it is worth to get tested if you have had sex with a random partner and the condom has not been in use.