A guide to oral gonorrhea: how it’s caused, symptoms, and more

Medically reviewed by Rosanna Sutherby, PharmD on February 3, 2020. Written by Laura Kleist. 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.

In this quick overview, we’ll highlight some key points to know about oral gonorrhea—so keep reading to learn what it is, symptoms it can cause, health risks it’s linked to, and more.

Oral gonorrhea: what it is

Gonorrhea is a sexually transmitted infection caused by the Neisseria gonorrhoeae bacterium. In the United States, approximately 820,000 new gonorrhea cases are reported to the Centers for Disease Control and Prevention (CDC) each year.

Oral gonorrhea (also known as pharyngeal gonorrhea) is when the infection affects the tissues of the throat—instead of the genitals or rectum, for example.

Oral gonorrhea is most commonly transmitted through oral sex. Either giving oral sex to a person with infected genitals or receiving oral sex from a person with an infected oral cavity may transmit the bacteria (recent research has also suggested the possibility that kissing can transmit oral gonorrhea from one partner to another). Significantly, transmission can occur even if no symptoms are present in the person who first had the infection.

Oral gonorrhea symptoms

In most cases, oral gonorrhea produces no noticeable symptoms. Among people who do experience symptoms, however, the most prevalent sign is a persistent sore throat. Other possible symptoms include:

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

If you believe you’re suffering from symptoms of oral gonorrhea, talk with your healthcare provider so they can offer guidance on the next steps to take. (A sore throat can also be a symptom of other STIs, like syphilis, though this condition is often accompanied by other symptoms such as fever, headaches, fatigue, and more. An at-home syphilis test can help you check for this STI.)

Disseminated gonorrhea: a health risk associated with untreated oral gonorrhea

If it isn’t treated promptly, oral gonorrhea may eventually spread to the bloodstream, where it can then infect other parts of the body. When gonorrhea spreads in this way, it’s referred to as a disseminated gonococcal infection (DGI) or disseminated gonorrhea. Skin sores, rashes, joint pain, joint swelling, fever, chills, and generally feeling unwell are among the common symptoms of this type of infection.

But disseminated gonorrhea does more than just trigger symptoms: left unchecked, it can cause serious harm to some of the body’s key systems. Gonococcal arthritis may develop, for instance—involving severe inflammation of one or more joints in the body—if gonorrhea bacteria infect that joint(s).

Gonococcal endocarditis is another possible (though quite rare) complication of disseminated gonorrhea. This condition develops when gonorrhea infects the endocardium, an important part of the heart. The infection can lead to significant damage to other parts of the heart, as well, like heart valves. Tachycardia and—more severely—heart failure may develop due to this damage.

Fortunately, disseminated gonorrhea isn’t all that common: studies suggest that it occurs in just 0.5% to 3% of gonorrhea cases. But due to its severe nature, immediate medical treatment is recommended if someone does have disseminated gonorrhea.

Other health conditions related to oral gonorrhea

Though oral gonorrhea affects the mouth and throat in someone who has it, the infection can spread to other areas of a partner’s body (like their genitals) through sexual contact. If that happens, one’s partner may be at risk of several health conditions, such as the following.

Pelvic inflammatory disease

Pelvic inflammatory disease is a painful condition characterized by inflammation of the organs of the female reproductive system. In most cases, PID stems from an active infection of the female reproductive organs. Lower abdominal pain, pelvic pain, heavy vaginal discharge, foul-smelling discharge, abnormal vaginal bleeding, pain during intercourse, and difficult or painful urination are common symptoms of the condition.

Female and male infertility

Urogenital gonorrhea infections can cause infertility in both women and men. In women, the infection can spread to the uterus and fallopian tubes, where it often causes pelvic inflammatory disease. Because PID is strongly associated with fallopian tube scarring, the condition can greatly increase your risk of infertility, as well as complications during pregnancy..

In men, the infection can cause inflammation of the epididymis (the tube that connects the testicles to the sperm duct). If left untreated, epididymal inflammation affects the sperm’s ability to mature, which can lead to infertility.

Seeking medical treatment for oral gonorrhea

If you believe 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, which involves a quick swab of your mouth or throat. They may also suggest testing for gonorrhea in other sites of the body—like the genitals and rectum. Additionally, because gonorrhea and chlamydia often infect someone at the same time, your healthcare provider may recommend a chlamydia test.

In most cases, antibiotics—often taken orally—can effectively treat a gonorrhea infection.

You can conveniently test for urogenital gonorrhea and chlamydia (the most common kind of infection they cause) with the Everlywell at-home Chlamydia & Gonorrhea Test. Note that this test cannot detect oral gonorrhea.

Preventing oral gonorrhea

There are a few steps you can take that may help reduce the risk of getting or transmitting oral gonorrhea, including:

• Practice safe oral sex by consistently using condoms or dental dams
• Regularly test for STDs, and encourage your partner to do the same (the at-home STD Test for men and women makes routine testing easy).

Common questions about oral gonorrhea

What does oral gonorrhea look like?

Though visible symptoms are uncommon, when gonorrhea infects the throat, it can produce symptoms that bear a striking resemblance to those of strep throat. If you notice unusual redness, white spotting, or pale-colored discharge in your throat, this may be an indication of oral gonorrhea—and it’s a good idea to see your healthcare provider for an evaluation.

Can you get gonorrhea from oral sex?

Yes, you can contract gonorrhea through oral sex. Transmission of the bacteria can occur either by giving oral sex to a partner with infected genitals or receiving oral sex from someone with an oral infection.

References

1. Gonococcal Infections. Centers for Disease Control and Prevention. URL. Accessed February 3, 2020.

2. Chow EP, Fairley CK. The role of saliva in gonorrhoea and chlamydia transmission to extragenital sites among men who have sex with men: new insights into transmission. J Int AIDS Soc. 2019;22 Suppl 6(Suppl Suppl 6):e25354. doi:10.1002/jia2.25354

3. de Campos FP, Kawabata VS, Bittencourt MS, Lovisolo SM, Felipe-Silva A, de Lemos AP. Gonococcal endocarditis: an ever-present threat. Autops Case Rep. 2016;6(2):19-25. doi:10.4322/acr.2016.037Title.

4. Health Alert Template for Disseminated Gonococcal Infection (DGI). Centers for Disease Control and Prevention. URL. Accessed February 3, 2020.

5. Pelvic inflammatory disease (PID). Mayo Clinic. URL. Accessed February 3, 2020.

6. Gonorrhea. Mayo Clinic. URL. Accessed February 3, 2020.

7. Gonorrhea - diagnosis & treatment. Mayo Clinic. URL. Accessed February 3, 2020.