In a troubling development, Melbourne researchers suspect gonorrhea is being spread by kissing, overturning years of conventional wisdom.

Although it's early days and not cause for alarm, there is evidence to suggest 'throat-to-throat transmission' may be driving the spread of gonorrhea in inner-city Australia.

Gonorrhea is a bacterial infection that can cause infections in the genitals, rectum and throat of men and women. It's very common for a sexually transmitted disease, especially among 15-24 year olds, and the rate has recently spiked in Australia.

It's painful to have, and, if untreated, it can make men and women infertile.

It's been generally understood you could only get gonorrhea by having vaginal, anal or oral sex with someone who has gonorrhea.

Dr Vincent J Cornelisse, a sexual health physician and PhD candidate at Monash University, has been conducting research that challenges this idea.

He told Hack the assumption that people get gonorrhea because they're having sex without condoms was "really simplistic".

"It doesn't explain the gonorrhea transmission patterns that we see," he said.

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Dr Vincent and other researchers at the Melbourne Sexual Health Centre have created a mathematical model that shows kissing is the main driver of gonorrhea transmission.

Gonorrhea throat infections have few symptoms, meaning people can have the sexually transmitted disease (STD) without realising and seeking treatment.

Then if a person with throat gonorrhea performs oral sex, the gonorrhea can spread to their partner's genitals, Vincent said.

"If they rim someone it can get in the anus," he said.

So to summarise: you may get gonorrhea from kissing, and then if you have oral sex you may spread the gonorrhea to the genitals or anus.

That's when it starts causing problems.

The modelling has not yet been confirmed in observational studies, partly because it's hard to find couples who have oral sex but not genital sex.

The modelling focused on men who have sex with men because this demographic has the highest rates of gonorrhea in inner-city Melbourne.

Vincent said the results would also apply to heterosexual couples.

"Gonorrhea doesn't discriminate," he said.

"But the reality is you're only going to get gonorrhea from someone who has gonorrhea."

Does mouthwash help?

Vincent and the Melbourne Sexual Health Centre are conducting a large randomised control trial to see if mouthwash can reduce throat gonorrhea.

Participants are being given either mouthwash that kills gonorrhea or one that doesn't. Vincent said results may be published in early 2019.

"If we can show this works, then this is a really cheap and easily available prevention strategy," Vincent said.

Don't panic

Vincent said there was only "early evidence" of gonorrhea being spread by kissing.

"I don't want to be too alarmist, I don't want to create the impression if you go out and kiss someone you can get throat gonorrhea," he said.

Professor Basil Donovan, head of the Sexual Health Program at the Kirby Institute, told Hack the finding was "highly tenuous".

"You'll need a lot more science before you put out a warning," he said.

Why are gonorrhea rates going up?

Figures released this week by the Kirby Institute show a spike in the number of heterosexual couples who have contracted gonorrhea.

There has been a 63 per cent increase in gonorrhea rates - from 62 to 101 infections per 100,000 people in the last five years.

Rates among young women living in the city went up 126 per cent.

Professor Rebecca Guy from the Kirby Institute said sexual behaviour was changing.

"People are having more partners in their lives, they're also delaying marriage and also people are having more oral sex as well," she told Hack.

About 80 per cent of people who have gonorrhea don't realise they are infected.

Gonorrhea symptoms can clear up within days with drug treatment, even with the much-hyped new strains of 'drug-resistant super gonorrhea'.

"The levels of resistance are creeping up a bit but still the gonorrhea we have at the moment can still be treated with antibiotics," Professor Guy said.

The main point is: get tested. You may have gonorrhea without knowing.

Only 20 per cent of young women ask their GP for a chlamydia or gonorrhea test and the rate is even lower among young men: 10 per cent.

Vincent said people should get tested on a regular basis.

"Live in a normal way and have sex without getting stressed," he said.