Oral Gonorrhea: Symptoms, Transmission, Treatment, Prevention, More

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Is oral gonorrhea common?

We don't know exactly how common oral gonorrhea is in the general population.

There have been a number of studies published on oral gonorrhea, but most focus on specific groups, such as heterosexual women and men who have sex with men.

What we do know is that more than 85 percent of sexually active adults have had oral sex, and anyone who has unprotected oral sex is at risk.

Experts also believe that undetected oral gonorrhea is partly to blame for the increase in antibiotic-resistant gonorrhea.

Oral gonorrhea rarely causes symptoms and is often hard to detect. This can result in delayed treatment, which increases the risk of transmitting the infection to others.

How is it spread?

Oral gonorrhea can be spread through oral sex performed on the genitals or anus of someone who has gonorrhea.

Although studies are limited, there are a couple of older case reports on transmission through kissing.

Tongue kissing, more commonly referred to as 'French kissing,' appears to increase the risk.

What are the symptoms?

Most of the time, oral gonorrhea doesn't cause any symptoms.

If you develop symptoms, they can be hard to distinguish from common symptoms of other throat infections.

Symptoms may include:

  • sore throat
  • redness in the throat
  • fever
  • swollen lymph nodes in the neck

Sometimes, a person with oral gonorrhea can also have a gonorrhea infection in another part of the body, such as the cervix or urethra.

If this is the case, you may have other symptoms of gonorrhea, such as:

  • unusual vaginal or penile discharge
  • pain or burning when urinating
  • pain during intercourse
  • swollen testicles
  • swollen lymph nodes in the groin
How does it differ from a sore throat, strep throat, or other conditions?

Your symptoms alone can't distinguish between oral gonorrhea and another throat condition, such as sore or strep throat.

The only way to know for sure is to see a doctor or other healthcare provider for a throat swab.

Like strep throat, oral gonorrhea may cause a sore throat with redness, but strep throat often also causes white patches in the throat.

Other symptoms of strep throat include:

  • a sudden fever, often 101˚F (38˚C) or higher
  • headache
  • chills
  • swollen lymph nodes in the neck
Do you need to see a doctor?

Yes. Gonorrhea must be treated with prescription antibiotics to fully clear the infection and prevent transmission.

Left untreated, gonorrhea can cause a number of serious complications.

If you suspect that you've been exposed, see a doctor or other healthcare provider for testing.

Your provider will take a swab of your throat to check for the bacteria that causes the infection.

How is it treated?

Oral infections are harder to cure than genital or rectal infections, but can be treated with the right antibiotics.

The Centers for Disease Control and Prevention (CDC) recommends dual therapy due to the increase in drug-resistant strains of N. gonorrhoeae, the bacterium that causes the infection.

This typically includes a single injection of ceftriaxone (250 milligrams) and a single dose of oral azithromycin (1 gram).

You should avoid all sexual contact, including oral sex and kissing, for seven days after completing treatment.

You should also avoid sharing food and drinks during this time, as gonorrhea can be transmitted through saliva.

If your symptoms persist, see your provider. They may need to prescribe stronger antibiotics to clear the infection.

How to tell any partners at risk

If you've received a diagnosis or have been with someone who has, you should inform all recent sexual partners so they can be tested.

This includes anyone you've had any type of sexual contact with in the two months prior to symptom onset or diagnosis.

Talking to your current or previous partners can be uncomfortable, but it needs to be done to avoid the risk of serious complications, transmitting the infection, and becoming re-infected.

Being prepared with information about gonorrhea, its testing, and treatment can help you answer your partner's questions.

If you're worried about your partner's reaction, consider making an appointment to see a healthcare provider together.

Here are some things you can say to get the conversation started:

  • 'I got some test results today, and I think we should talk about them.'
  • 'My doctor just told me that I have something. There's a chance you have it to.'
  • 'Just found out that someone I was with a while back has gonorrhea. We should both get tested to be safe.'

If you prefer to remain anonymous

If you're worried about talking to your current or previous partners, ask your provider about contact tracing.

With contact tracing, your local health department will notify anyone who might have been exposed.

It can be anonymous, so your sexual partner(s) don't have to be told who referred them.

Is mouthwash enough, or do you really need antibiotics?

Mouthwash has long been believed to be able to cure gonorrhea. Until fairly recently, there was no scientific evidence to back the claim.

Data collected from a 2016 randomized controlled trial and an in vitro study found that the mouthwash Listerine significantly reduced the amount of N. gonorrhoeae on the pharyngeal surface.

While this is certainly promising, more research is needed to assess this claim. A larger trial is currently underway.

Antibiotics are the only treatment that's proven to be effective.

What happens if it's left untreated?

If left untreated, oral gonorrhea can spread through your bloodstream to other parts of your body.

This can lead to systemic gonococcal infection, also known as disseminated gonococcal infection.

Systemic gonococcal infection is a serious condition that can cause joint pain and swelling and skin sores. It can also infect the heart.

Gonorrhea of the genitals, rectum, and urinary tract can cause other serious complications when left untreated.

Possible complications include:

  • pelvic inflammatory disease
  • pregnancy complications
  • infertility
  • epididymitis
  • higher risk of HIV
Is it curable?

With proper treatment, gonorrhea is curable.

However, new strains of antibiotic-resistant gonorrhea can be more difficult to treat.

The CDC recommends that anyone treated for oral gonorrhea return to their healthcare provider 14 days after treatment for a test-of-cure.

How likely is recurrence?

We don't know how likely recurrence is in oral gonorrhea, specifically.

We do know that recurrence for other types of gonorrhea is high, affecting anywhere from 3.6 percent to 11 percent of people previously treated.

Retesting is recommended three to six months after treatment, even if you and your partner(s) have successfully completed treatment and are symptom-free.

How can you prevent it?

You can reduce your risk for oral gonorrhea by using a dental dam or 'male' condom every time you have oral sex.

A 'male' condom can also be modified to use as a barrier when performing oral sex on the vagina or anus.

To do this:

  • Carefully cut the tip off the condom.
  • Cut across the bottom of the condom, just above the rim.
  • Cut down one side of the condom.
  • Open and lay flat over the vagina or anus.

Regular testing is also important. Get tested before and after every partner.

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