Can you get gonorrhea from oral sex?

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].

Yes, you can get gonorrhea from oral sex [1,4]. Giving oral sex to a partner with an infected genital-urinary tract or rectum may cause gonorrhea in the oral cavity [4]. Likewise, receiving oral sex from a partner with gonorrhea in the throat may result in a genital or rectal infection [4].

Although gonorrhea is commonly diagnosed through urogenital testing, oral gonorrhea infections are often missed during routine screening [4,5]. One recent study found that many individuals were tested only for urogenital infections during clinic visits, while oral infections went undetected [5]. However, when oral cavity testing was included, the prevalence of gonorrhea in suspected cases increased significantly [5].

Research suggests the risk of oral gonorrhea may increase threefold when oral sex involves exposure to ejaculate or vaginal fluids [5]. Additionally, oral gonococcal infections can be more difficult to eradicate than infections at urogenital sites, allowing the oral cavity to act as a reservoir for ongoing transmission [5].

If left untreated, pharyngeal gonorrhea can persist for up to 16 weeks and spread to partners who do not have the infection [1,3,4]. Untreated oral gonorrhea may also lead to disseminated gonococcal infection, a serious condition that can cause: [4]

• Skin sores
• Rashes
• Joint pain

In severe cases, gonorrhea may spread to the heart and become life-threatening [4].

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, signs and symptoms of gonorrhea may include: [1]

• White urethral discharge
• Yellow urethral discharge
• Green urethral discharge
• Symptoms appearing anywhere from one to fourteen days after infection

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 gonorrhea in women may include: [1,2]

• Painful vaginal discharge
• Vaginal bleeding
• Rectal discharge
• Itching
• Soreness
• Painful bowel movements

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].

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].

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.