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Fitness and body

Have we found a new weapon in the fight against gonorrhea?

What’s something you can get at the supermarket for a few dollars, which can reduce your risk of acquiring or passing on gonorrhea?

‘Condom’ is the correct answer. But don’t leave the personal care aisle just yet — we may have found a new weapon in the fight against gonorrhea, and it’s right there next to the dental floss.

Get ready to gargle, but never swallow, as we look at current Australian research into the potential gonorrhea-busting powers of humble mouthwash.

What’s the study?

To get the facts, we spoke to Dr Eric Chow, Associate Professor at the Central Clinical School at Monash University and the Melbourne Sexual Health Centre (MSHC), Alfred Health.

“The OMEGA study currently nearing completion is a multi-centre double-blind randomised controlled trial based in Sydney and Melbourne,” explains Chow. “It has involved 530 men who have sex with men (MSM), each using mouthwash every day for a three-month period.”

Mouthwash could prevent gonorrhea? It sounds too good to be true. How did this all start?

It’s actually not as weird as it sounds; mouthwash was actually created as a sterilising agent. “Over 100 years ago, when mouthwash was first being used as an antiseptic, there were claims that it could kill gonorrhea, but there has been no scientific evidence to prove this,” says Chow. “So we looked at that idea and started testing it in the lab, with promising results.”

“With gonorrhea becoming increasingly antibiotic resistant, new forms of prevention are really important to help stop it from spreading.”

This led to a small, randomised controlled trial being conducted at MSHC in 2015/16. “Within a group of 58 untreated MSM who tested positive for pharyngeal (throat) gonorrhea infections, we found gargling a particular mouthwash for 60 seconds — even just once — could inhibit the growth of the bacteria in the throat immediately. The current study asks the question of whether daily use could be an effective prevention measure.”

Why is this study particularly important for men who have sex with men?

“We have been seeing rising gonorrhea diagnoses in gay and bisexual men in Australia,” says Chow. “Of the MSM who present at MSHC, eight percent test positive for gonorrhea infections of the throat. Most cases of gonorrhea are actually throat infections, which are usually asymptomatic — and sexual contact in this population frequently involves oral sex.”

No surprises there, but blowjobs can’t take all the blame. “We believe — and studies are increasingly confirming — that gonorrhea is being transmitted from throat infections via saliva, far more commonly than previously assumed. Even kissing may be a way to pass on the infection. With gonorrhea becoming increasingly antibiotic resistant, new forms of prevention are really important to help stop it from spreading.”

How did the current study work?

“We gave half the participants a mouthwash which we know from lab tests kills gonorrhea, and the other half a mouthwash which we know does not,” explains Chow. “The men rinsed and gargled the mouthwash for 60 seconds every day for a period of three months. We then tested saliva samples every three weeks, and took throat swabs after six and 12 weeks. At week 12, we did a full STI test as well.”

“We believe – and studies are increasingly confirming – that gonorrhea is being transmitted from throat infections via saliva, far more commonly than previously assumed.”

It’s not just a simple swish-and-spit, either. “Participants were instructed to rinse and gargle the mouthwash all the way at the back of the throat at the pharynx, where a gonorrhea infection would reside. Rinsing just the mouth would not be effective for a pharyngeal infection.”

So it’s only specific types of mouthwash? Can you tell us which ones, and why?

Unfortunately, the specifics are still under wraps. “Yes, only a certain type of mouthwash is effective against Neisseria gonorrheae, the bacterium which causes gonorrhea,” says Chow. “We are still investigating the active ingredient which targets it.”

And the results…?

While previous studies are reason enough to be optimistic, the results of the current study are still being finalised, and Dr Chow isn’t giving anything away just yet. “Final testing analysis is happening right now,” he says. “We’re expecting the full results to be published mid-2019.”

No need to set a reminder — follow Emen8 on Facebook and we’ll keep you updated.

Is there any chance the results might apply beyond just gonorrhea infections of the throat?

While other STIs were included in the final round of tests, the study is only looking at gonorrhea — there’s no evidence either way for other STIs like chlamydia, which can also reside in the throat.

“…getting tested frequently (and treated if necessary) is another effective way to help take new infections out of circulation before they have a chance to spread.”

And before you go priming your douche bulb — Dr Chow is very clear that using mouthwash anywhere other than your mouth is NOT RECOMMENDED. “This is preliminary data analysis at this point, and we’re not making any recommendations until the final results of the trial is released. But I can definitely say that you shouldn’t apply mouthwash to your penis or your anus.”

Just so we’re all clear.

So in the meantime, what should we be doing to help stop the spread of gonorrhea?

“It’s important to remember that this research focusses on mouthwash as prevention, not treatment,” says Chow. “Its effectiveness, if proven, would be in helping to prevent you acquiring or passing on gonorrhea, NOT curing it.”

There are other ways to help prevent gonorrhea as well. Condoms are still the best way to protect you and your partner(s) from a bunch of STIs, including gonorrhea. And getting tested frequently (and treated if necessary) is another effective way to help take new infections out of circulation before they have a chance to spread.

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