Woman experiencing sore throat in need of oral gonorrhea treatment

Understanding Oral Gonorrhea Treatment

Written on September 22, 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.

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Sexually transmitted infections are prevalent in the United States, with one in five people having an STI.[1] In 2018, close to 68 million STIs were reported, and direct medical expenses for new infections totaled almost $16 billion. In 2021, there were around 710,000 cases of gonorrhea reported.[2]

Gonorrhea infection can impact different areas of the body and present in various ways. Keep reading to learn more about gonorrhea, oral gonorrhea treatment options, and ways to prevent oral gonorrhea.

About Gonorrhea

Gonorrhea is very common, being the second most reported bacterial sexually transmitted infection in the US.[3] Gonorrhea is caused by infection with the Neisseria gonorrhoeae bacteria. Groups with the highest reported rates of infections are sexually active adolescents, young adults, and African Americans.

The Neisseria gonorrhoeae bacteria can be transmitted sexually through contact with infected mucous membranes of the reproductive tract, including the cervix, uterus, and fallopian tube in women, and urethra and rectum in both women and men.[3] The bacteria can infect other mucous membrane areas of the mouth, throat, eyes, and rectum. When the bacteria infect the mouth and throat, it's known as oral gonorrhea.[3]

Most of the time, gonorrhea infections are asymptomatic. When signs and symptoms of urethral infections appear in men, they include painful urination or white, yellow, or green discharge that may occur 1 to 14 days after the infection. Cases in men can also lead to testicular or scrotal pain in the urogenital area. In women, signs and symptoms, when present in the urogenital region, are often mild and can involve painful urination, increased vaginal discharge, or vaginal bleeding between periods. Serious complications from the infection can also occur in women, such as pelvic inflammatory disease (PID).

What Is Oral Gonorrhea?

Oral gonorrhea occurs when the Neisseria gonorrhoeae bacteria are transmitted to areas of the mouth and throat.[3] The condition can be acquired through oral sex with an infected person.[3,4] Oral gonorrhea is also called pharyngeal gonorrhea. Pharyngeal gonorrhea is specifically an infection of the throat.

Oral gonorrhea often does not cause symptoms and has been reported as a significant source of transmission and a potential cause of antimicrobial resistance.[4] When symptoms of pharyngeal gonorrhea are present, those symptoms usually involve having a sore throat.[3] Testing for oral gonorrhea should be considered by healthcare providers in people with urogenital or rectal gonorrhea infections if oral exposure is confirmed.[3,4]

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Treatment Options For Oral Gonorrhea

Treatment for oral gonorrhea requires an accurate diagnosis of the infection through appropriate testing.[3,4] With proper treatment, oral gonorrhea is curable, although oral infections are more challenging to cure than genital or rectal infections. Since bacteria cause oral gonorrhea, antibacterial drugs are used to treat the condition. Oral gonorrhea treatment recommendation by the Centers for Disease Control and Prevention (CDC) also applies to infections of the urinary tract, genitals, anus, and rectum.[4]

Currently, the CDC recommends treating uncomplicated pharyngeal gonorrhea in adults and adolescents with a single intramuscular injection of a cephalosporin antibiotic, ceftriaxone.[4] You should return to see your healthcare provider 7 to 14 days after treatment to ensure the infection is gone. Since reinfection is typical for gonorrhea, retesting three months after treatment of the initial infection is also recommended.[3] Additionally, it is possible to have a co-infection with chlamydia; therefore, the CDC recommends doxycycline to treat it.[3,4]

Previously, the CDC recommendation for uncomplicated pharyngeal gonorrhea was to treat with ceftriaxone and an oral dose of another antimicrobial, azithromycin.[3] However, the treatment regimen changed because of increased antibiotic resistance to azithromycin.

Preventing Oral Gonorrhea

You can take steps to prevent the transmission of oral gonorrhea and help lower your risk of getting the infection. These include [3]:

  • Refraining from having oral sex
  • Using condoms or dental dams
  • Being in a monogamous, long-term relationship with someone who is not infected (confirmed through appropriate testing)
  • Getting appropriate and regular testing to know your status

Everlywell Can Help With Next Steps

If you have further questions about gonorrhea or oral gonorrhea, consider an online STD consult through Everlywell. These on-demand appointments are available in two hours or less.

You can schedule a discreet 20- to 30-minute video call to discuss your sexual health concerns and get answers to your questions. During your appointment, you will be provided personalized recommendations and next steps based on your symptoms and exposure history. This may include STD tests or prescription medication, if applicable. Everlywell also has at-home lab tests for STDs in men and women. These tests can help detect gonorrhea, chlamydia, hepatitis C, HIV, syphilis, and trichomoniasis.

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  1. Sexually Transmitted Infections Prevalence, Incidence, and Cost Estimates in the United States. Centers for Disease Control and Prevention. January 25, 2021. Accessed September 13, 2023. https://www.cdc.gov/std/statistics/prevalence-2020-at-a-glance.htm.
  2. Sexually Transmitted Disease Surveillance, 2021. Centers for Disease Control and Prevention. April 11, 2023. Accessed September 13, 2023. https://www.cdc.gov/std/statistics/2021/default.htm.
  3. Detailed STD facts - Gonorrhea. Centers for Disease Control and Prevention. April 11, 2023. Accessed September 13, 2023. https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm.
  4. Gonococcal Infections Among Adolescents and Adults. Centers for Disease Control and Prevention. September 21, 2022. Accessed September 13, 2023. https://www.cdc.gov/std/treatment-guidelines/gonorrhea-adults.htm.
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