A Guide to Oral Gonorrhea: How It’s Caused, Symptoms, and More

Medically reviewed by Jordan Stachel, MS, RDN, CPT on November 26, 2023. 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 Oral Gonorrhea?
• Who Is At Risk of Oral Gonorrhea?
• Symptoms of Oral Gonorrhea
• How to Diagnose Oral Gonorrhea
• Health Risks Associated With Untreated Oral Gonorrhea
• Seeking Medical Treatment for Oral Gonorrhea
• Preventing Oral Gonorrhea
• Make STI Testing Convenient with Everlywell
• Related Content

As rates of gonorrhea continue to rise, it’s more pressing than ever for sexually active adults to take a conscious approach to their sexual well-being. [1] Gonorrhea is best known for infecting the reproductive organs, but oral gonorrhea can be just as damaging to reproductive and overall health.

Oral gonorrhea is most commonly transmitted through unprotected oral sex—but because it rarely presents with symptoms it can be difficult to know whether you have it. Understanding its causes, how it can manifest, and how to reduce your chances of contracting it can be an important measure of proactive, protective healthcare.

What Is Oral Gonorrhea?

Gonorrhea is a sexually transmitted infection caused by a bacteria called Neisseria gonorrhoeae. [2] The CDC reports gonorrhea cases have been on the rise in the US for the past several years, with 710,151 reported in 2021 alone. [1]

Oral gonorrhea (also called pharyngeal gonorrhea) occurs when the bacteria causing the infection attacks the tissues of the throat, rather than the areas of the genitals, urinary tract, or rectum. [3]

Oral gonorrhea is most commonly transmitted through unprotected oral sex. You can contract oral gonorrhea through [3]:

• Giving oral sex to a person with infected genitals or rectum
• Receiving oral sex from a person with an infected oral cavity

Who Is At Risk of Oral Gonorrhea?

According to research, gonorrhea disproportionately impacts young, sexually active adults. [2] Gonorrhea is also the second-ranking cause of bacterial STIs in the world. [2] It’s thought escalating rates of transmission are partly linked to growing rates of antibiotic resistance. [2]

Symptoms of Oral Gonorrhea

In most cases, oral gonorrhea presents with no noticeable symptoms. Importantly, transmission can occur even if no symptoms are present in the person who first had the infection.

Among people who do experience them, the most prevalent sign is gonorrhea symptoms, throat-related in nature. This may involve a persistent sore throat, as well as [4]:

• Swollen, tender glands in your throat
• Difficulty swallowing
• Flu-like symptoms
• Visible irritation, redness, or lesions in the back of the throat

Visible symptoms of gonorrhea in throat are uncommon. But when gonorrhea infects the throat, it can produce symptoms that look similar to strep throat. If you notice an unusual redness, white spotting, or pale-colored discharge in your throat, it could actually be throat gonorrhea symptoms—and it’s a good idea to see your healthcare provider for an evaluation.

It’s also possible to have a pharyngeal gonorrhea infection as well as an infection of the genitals, urinary tract, or rectum. In this case, you might notice symptoms like:

• A whitish, yellow, or green discharge
• Burning sensation during urination
• In women and IFAB people, spotting between periods
• Difficult or painful bowel movements
• Itchy or soreness around the anus

So, does gonorrhea go away on its own? No. While symptoms may fluctuate (if they occur), gonorrhea must be treated with medication to fully dispel the infection-causing bacteria.

How to Diagnose Oral Gonorrhea

It’s important to remember oral gonorrhea is predominantly asymptomatic. Moreover, apparent gonorrhea throat symptoms can overlap with those of many other infections and health conditions. The only way to know whether you have it—or another STI that can cause throat symptoms, like syphilis—is to take an STI test. Ideally, you’ll make STD testing a regular part of your sexual hygiene routine. [5]

National health bureaus recommend at least yearly gonorrhea screenings for [6]:

• Men and people assigned male at birth (AMAB) who have sex with other men and people AMAB
• Sexually active women and IFAB people under 25 years old
• Sexually active women over 25 years old who have multiple sexual partners, or have had more than one sex partner in a single year
• Sexually active people with HIV

Health Risks Associated With Untreated Oral Gonorrhea

Some STIs aren’t treatable, but oral gonorrhea is. Left untreated, oral gonorrhea can spread to the bloodstream, where it can more easily infect other areas of the body. [7]

When gonorrhea migrates to other parts of the body, it’s referred to as a disseminated gonococcal infection (DGI) or disseminated gonorrhea. [7] Symptoms of DGI include [7]:

• Joint infection, pain, or swelling (septic arthritis)
• Inflammation or swelling of the tendons (tenosynovitis)
• Skin sores and lesions

More rarely, DGI can travel to infect and cause inflammation of the heart (endocarditis) or brain (meningitis). [7] At this stage, gonorrhea infection can lead to significant damage to the heart and even result in heart failure. [8]

Fortunately, disseminated gonorrhea is rare—but it does demonstrate the importance of diagnosing and treating oral gonorrhea of any kind when it surfaces. Throat gonorrhea can easily be passed on to a sex partner if it isn’t treated quickly. [8]

Other health conditions that can result from untreated gonorrhea include:

Pelvic inflammatory disease (PID) – Pelvic inflammatory disease affecting women and IFAB people. [9] It’s a painful condition that causes an inflammation of the female reproductive organs. In most cases, PID originates with an active, untreated infection of the female reproductive organs. [9]

Common symptoms include persistent pelvic or lower abdominal pain, abnormal vaginal bleeding, pain during intercourse, and other symptoms. [9] PID is treatable if caught early, but left untreated it can cause permanent damage to the reproductive system. [9]

Fertility challenges or infertility in women – If gonorrhea spreads to the reproductive organs, it can cause structural damage that can ultimately lead to infertility. [2] For instance, if gonorrhea causes PID, it can result in fallopian tube scarring—a condition that can greatly jeopardize their ability to conceive. It can also lead to complications during pregnancy. [2]

Fertility challenges in men – In men and people AMAB, untreated gonorrhea can cause epididymitis—a condition where the testicular ducts can become scarred. [8] Gonorrhea can also result in prostatitis, which can cause symptoms like pain during urination, genital and testicular swelling, and painful ejaculation. [10]

Seeking Medical Treatment for Oral Gonorrhea

If you believe you’re experiencing gonorrhea in throat symptoms or think you may have contracted oral gonorrhea, early detection of a potential infection is key to keeping your health safe. Your healthcare provider may recommend:

• An oral gonorrhea test– This involves a quick swab of your mouth or throat to screen for the bacteria Neisseria gonorrhoeae.
• Testing for gonorrhea and other STIs – If you think you may have come in contact with gonorrhea orally, it’s a wise idea to rule out the infection in other areas of the body. Additionally, it’s very common to be infected with gonorrhea and chlamydia at the same time. Your healthcare provider may recommend testing for chlamydia to ensure you haven’t been infected.

If your tests show a positive gonorrhea test, your healthcare provider will likely prescribe you a round of antibiotics for treatment. Pharyngeal gonorrhea is typically treated with a single dose of ceftriaxone (totaling 500 mg) for oral gonorrhea without complications. [11]

Follow-up STD testing—also called a “test-of-cure”—is highly recommended to people who’ve contracted oral gonorrhea specifically. This helps to ensure your medication has cleared up your infection. Ideally, you’ll test again 1 to 2 weeks after you’ve taken your medication. [11]

Preventing Oral Gonorrhea

Unfortunately, reinfection rates for gonorrhea are high—up to 12% of people treated for gonorrhea are diagnosed with the same infection within a year of getting it. [11] This, in part, is why a regular screening routine can be an effective, protective measure for establishing sexual health.

Additionally, oral gonorrhea can be prevented by [12]:

• Make use of safe sex practices by consistently using condoms or dental dams during oral sex
• Communicate with your sexual partners about their STI status (and wait to have sex if a partner has an active infection)
• Consider entering into a monogamous relationship or limiting your sexual partners
• Regularly test for STDs, and encourage your partner to do the same

Read up on safe sex practices.

Make STI Testing Convenient with Everlywell

Protecting your sexual health shouldn’t be a hassle. Everlywell offers an at-home std test that screens for five STDs in the privacy of your own home. For even more information on your sexual health, meet with a clinician via Everlywell. They can discuss your symptoms with you and prescribe STD treatment online.

Related Content

Understanding Oral Gonorrhea Treatment

Gonorrhea in Women

Chlamydia in the Throat: Causes, Symptoms, and More

Common STDs That Cause Dry Skin in Some People

References

1. “Sexually Transmitted Disease Surveillance, 2021.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 11 Apr. 2023, https://www.cdc.gov/std/statistics/2021/default.htm.
2. Springer C, Salen P. Gonorrhea. [Updated 2023 Apr 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. Accessed 31 Oct. 2023.
3. “STD Facts - STD Risk and Oral Sex.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 31 Dec. 2021, https://www.cdc.gov/std/healthcomm/stdfact-stdriskandoralsex.htm.
4. “Detailed Std Facts - Gonorrhea.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 11 Apr. 2023, https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm.
5. “Syphilis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 7 Oct. 2023, https://www.mayoclinic.org/diseases-conditions/syphilis/symptoms-causes/syc-20351756.
6. “STD Testing: What’s Right for You?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 14 Apr. 2023, https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/in-depth/std-testing/art-20046019.
7. Health, Department of Public. “Disseminated Gonococcal Infection.” Disseminated Gonococcal Infection, https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Disseminated-Gonococcal-Infection.aspx. Accessed 31 Oct. 2023.
8. “STD Facts - STD Risk and Oral Sex.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 31 Dec. 2021, https://www.cdc.gov/std/healthcomm/stdfact-stdriskandoralsex.htm.
9. “STD Facts - Pelvic Inflammatory Disease.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 18 Apr. 2022, https://www.cdc.gov/std/pid/stdfact-pid.htm.
10. “Prostatitis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 19 Feb. 2022, https://www.mayoclinic.org/diseases-conditions/prostatitis/symptoms-causes/syc-20355766.
11. “Update to CDC’s Treatment Guidelines for Gonococcal Infection, 2020.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 17 Dec. 2020, https://www.cdc.gov/mmwr/volumes/69/wr/mm6950a6.htm.
12. Professional, Cleveland Clinic medical. “Gonorrhea: Causes, Symptoms, Treatment & Prevention.” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/4217-gonorrhea#prevention. Accessed 31 Oct. 2023.