Condom in package to help prevent getting gonorrhea from oral

Can you get gonorrhea from oral?

Written on January 3, 2023 by Sendra Yang, PharmD, MBA. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

What is gonorrhea, and how is it transmitted?

Gonorrhea is a sexually transmitted disease (STD) caused by a bacteria called Neisseria gonorrhoeae [1,2]. The bacteria can infect the mucous membranes of the reproductive tracts, including the cervix, uterus, and fallopian tubes in women, and the urethra in both men and women [2].

Gonorrhea is transmitted through unprotected vaginal, anal, or oral sex [1]. Gonorrhea transmission rates from men to women are higher than from women to men during vaginal sex because ejaculation contains millions of bacteria [2]. Women can also transmit the bacteria to a newborn during vaginal birth, causing conjunctiva [1,2].

Gonorrhea infection is not restricted to the reproductive tracts and can also infect the mucous membranes of the eyes, throat, mouth, and rectum [2,3]. Because of the various routes of infections, gonorrhea is a prevalent infectious disease and is the second most common sexually transmitted bacterial infection [1].

What are the symptoms of gonorrhea?

A gonorrhea infection is often asymptomatic [1,2]. When signs and symptoms of gonorrhea infection are present, they may differ in men and women. Most men with gonorrhea are asymptomatic, but the majority of men with gonococcal urethritis have symptoms [1,2]. In men, the signs of gonorrhea may include white, yellow, or green urethral discharge and can appear anywhere from one to fourteen days after infection [1]. If gonorrhea is left untreated in men, it can lead to epididymitis, which can cause pain in the ducts attached to the testicles that may lead to scarring [3,4].

Most women with gonorrhea are also asymptomatic [1]. When symptoms do appear, they are often mild and nonspecific and can be mistaken for a bladder or vaginal infection [1,2]. Early symptoms and signs of disease in women may include painful vaginal discharge and bleeding [1]. Symptoms and signs of a rectal infection may include discharge, itching, soreness, or a painful bowel movement in both men and women [1,2]. In women, untreated gonorrhea can lead to more severe conditions such as pelvic inflammatory disease, infertility, and ectopic pregnancy [3,4].

Oral gonorrhea, also known as pharyngeal gonorrhea, is usually asymptomatic [1,3,4]. When infection occurs in the mouth, the condition may cause sore throat, burning in the throat, and white spots similar to strep throat [1,3-6]. Treating oral gonorrhea infection is challenging because the individual may not know they are infected and can further transmit the bacterium to their partner [1,4].

Can you get gonorrhea from oral sex?

The answer is yes, you can [1,4]. Giving oral sex to a partner with an infected genital-urinary tract or rectum may cause gonorrhea in the oral cavity [4]. Receiving oral sex from a partner with gonorrhea in the throat may result in a genital or rectal infection [4].

Most gonorrhea infections are reported from urogenital testing, and oral gonorrhea infections are often missed [4,5]. In a recent gonorrhea study, researchers demonstrated that oral gonorrhea goes undetected because, during clinic visits, individuals were most commonly tested for urogenital site infections instead of oral [5]. However, when testing was conducted in the oral cavities, the prevalence of gonorrhea in suspected cases increased. The risk of oral gonorrhea increased threefold if the individual engaged in oral sex with exposure to ejaculate or vaginal fluids. Moreover, oral gonococcal infections are more difficult to eradicate than infections at urogenital sites. The oral cavities serve as a reservoir for the continual transmission of gonorrhea [5].

If left untreated, pharyngeal gonorrhea can last up to 16 weeks and spread to partners who do not have the infection [1,3,4]. Suppose oral gonorrhea is left untreated for a significant amount of time. In that case, it may spread throughout the body, causing skin sores, rashes, and joint pain in a condition known as disseminated gonococcal infection [4]. It can also infect the heart and be life-threatening [4].

How is oral gonorrhea diagnosed and treated?

Since gonorrhea can be transmitted from oral sex, then how is gonorrhea diagnosed? Oral gonorrhea is usually diagnosed with a throat swab [6,7]. The sample is then tested for the presence of the gonorrhea bacteria. If the test is positive for the bacteria, then the oral gonorrhea diagnosis is confirmed. If you test positive, your partner will likely test positive, so it’s worth testing your partner if you have unprotected sex.

Your healthcare provider will treat you with antibiotic medications to eradicate the bacteria causing the infection. The most common treatment for oral gonorrhea is a shot of ceftriaxone and a single dose of azithromycin [5]. Oral gonorrhea has the potential to become resistant to antibiotics and difficult to treat [6,7]. If you do not feel your oral gonorrhea has cleared up after taking your medications, seek further medical advice and speak with your healthcare provider. If left untreated, gonorrhea can spread throughout the body and cause serious illnesses [4].

What are some ways to prevent oral gonorrhea?

There are a few things you can do that may help decrease the risk of getting or transmitting oral gonorrhea, such as consistently using condoms, dental dams, or other barrier methods every time to practice safe oral sex [4].

Consider regularly testing yourself for STDs and encouraging your partner to do the same. There are at-home STD test options for women and men that can help make routine testing easier, including an at-home gonorrhea test.

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  1. Detailed STD facts - gonorrhea. Centers for Disease Control and Prevention. URL. Published December 1, 2022. Accessed December 22, 2022.
  2. Unemo M, Seifert HS, Hook EW 3rd, Hawkes S, Ndowa F, Dillon JR. Gonorrhea. Nat Rev Dis Primers. 2019;5(1):79. doi: 10.1038/s41572-019-0128-6. URL.
  3. Barbee LA, Soge OO, Khosropour CM, et al. The duration of pharyngeal gonorrhea: a natural history study. Clin Infect Dis. 2021;73(4):575-582. doi: 10.1093/cid/ciab071. URL.
  4. STD Facts - STD risk and oral sex. Centers for Disease Control and Prevention. URL. Published December 31, 2021. Accessed December 22, 2022.
  5. Javanbakht M, Westmoreland D, Gorbach P. Factors associated with pharyngeal gonorrhea in young people: implications for prevention. Sex Transm Dis. 2018;45(9):588-593. doi: 10.1097/OLQ.0000000000000822. URL.
  6. WHO guidelines for the treatment of Neisseria Gonorrhoeae. World Health Organization. URL. Accessed December 21, 2022.
  7. Gonococcal infections among adolescents and adults - STI treatment guidelines. Centers for Disease Control and Prevention. URL. Published September 21, 2022. Accessed December 21, 2022.
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