How to Identify, Treat, and Prevent Oral Gonorrhea

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 percentTrusted Source 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. Pharyngeal gonorrheaTrusted Source is often asymptomatic and may elude antibiotics even with appropriate treatment

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.

It can also likely be transmitted through kissing, but more studiesTrusted Source are underway to substantiate this claim.

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 develop 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 professional for a throat swab and ask specifically to be tested for gonorrhea.

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
pain
fatigue
rash
red spots on the back of the throat

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 professional for testing. If you don’t already have a doctor.

The healthcare professional 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 treating uncomplicated gonorrhea with a single 500-milligram (mg) intramuscular dose of ceftriaxone. People who weigh 330 lbs. (150 kg) or more should receive a single 1-gram (g) dose of ceftriaxone.

The recommendation applies to infections around the urinary tract, genitals, anus, rectum, and pharynx. Previously, the CDC recommended ceftriaxone plus oral azithromycin. The recommendations were changed because azithromycin resistance is an increasing concern.

If it’s possible that you have chlamydial infection, the CDC recommends 100 mg of doxycycliwork twice a day for 7 days.

If you have a cephalosporin allergy, a 240-mg intramuscular dose of gentamicin plus a 2-g oral dose of azithromycin may be considered.

You should avoid all sexual contact, including oral sex and kissing, for 7 days after completing treatment.

If your symptoms persist, see your healthcare professional.

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 sexual contact with in the 2 months before your symptoms started or your diagnosis.

Talking with 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 developing the infection again.

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 professional 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, too.”
“I just found out that someone I was with a while back has gonorrhea. We should both get tested to be safe.”

In some states where it is legally permitted, clinicians will offer expedited partner therapyTrusted Source as it helps prevent re-infection if both partners are treated simultaneously.

If you prefer to remain anonymous

If you’re worried about talking with your current or previous partners, ask your doctor 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 (the bacteria that causes gonorrhea) on the pharyngeal (throat) 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 rarely 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 cause an infection in the heart. However, this is very rare.

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

Possible complications include:

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 professional 7 to 14 days after treatment to make sure the infection is gone.

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 3 to 6 months after treatment, even if you and your partner(s) have successfully completed treatment and are symptom-free. You should consider returning for other STI testing, as well.