Oral Gonorrhea: Symptoms, Treatment, & Prevention

By Alicia Wooldridge, MD
Medically reviewed checkmarkMedically reviewed
March 29, 2022

If you suspect you may have been exposed to gonorrhea, you are not alone.

Gonorrhea was the second most notifiable condition reported to the Centers for Disease Control (CDC) in 2019 and is on the rise in the United States.

It is easily treatable and there’s nothing to be ashamed of; however, STDs are often stigmatized in our society, which can sometimes make it hard to talk about our symptoms or seek help when we suspect there is something wrong.

When many of us think about gonorrhea, we think of it as a sexually transmitted disease infecting just the genitals. However, it can infect other parts of the body as well, including our rectum, eyes, and throat.

In some cases, it can even be passed on from mother to child in childbirth.

Oral gonorrhea can be contracted through any physical activity where the mouth makes contact with an infected area.

Because so many people who test positive for it have no symptoms, it’s particularly important to maintain good sexual health by getting regular STD checkups and communicating with your partner(s) if you suspect exposure.

What is Oral Gonorrhea?

Gonorrhea is a highly contagious sexually transmitted disease caused by the Neisseria gonorrhoeae bacterium, also known as gonococcus.

Usually contracted through unprotected sexual intercourse, you can be infected with the bacterium via anal sex or oral sex with an infected person.

If you have unprotected oral sex without a barrier method, you run the risk of getting it.

It’s important to know that gonorrhea isn’t spread through casual contact.

You can’t contract the disease through things like kissing, sharing foods, coughing, or sitting on toilet seats. It tends to be more common in people under the age of 25 years old.

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Symptoms of Gonorrhea in the Throat

Many people with gonorrhea may not exhibit any symptoms.

It tends to be more prevalent in people with penises, and they tend to exhibit symptoms more frequently than people with vaginas, who often carry it asymptomatically.

Furthermore, oral gonorrhea can be even harder to detect as most people don’t have any symptoms.

If you suspect you may have gonorrhea in the throat, you may have the following symptoms:

  • A persistent itchy or sore throat
  • Redness in the throat
  • Fever
  • Swollen lymph nodes in the neck
  • Difficulty swallowing

Since it’s common not to show symptoms of oral gonorrhea, be sure to check if you have any other symptoms.

Men and those with penises will experience may experience the following symptoms:

  • Frequent urination
  • A change in discharge: white, yellow, beige, or slightly green pus-like discharge (or drip) from the penis 
  • Swelling or redness at the opening of the penis
  • Testicular pain
  • Testicular swelling
  • Persistent sore throat

Common symptoms in women and people with vaginas include:

  • Watery, creamy, or slightly green discharge from the vagina 
  • Pain or burning sensation while urinating
  • More frequent urination
  • Pain during sexual intercourse
  • Heavier periods or bleeding between periods
  • Persistent sore throat
  • Sharp pain in the lower abdomen
  • Fever

Typically, symptoms of gonorrhea will appear within 2-14 days after exposure and tend to be milder in people with vaginas.

This can make it difficult to determine if you are infected as the disease can easily be mistaken for a bladder or vaginal infection. 

If you notice any changes in your genital area, it is advised you get checked out by a healthcare provider. More than likely, they will test you for other STDs as it is common to test positive for chlamydia if you also have gonorrhea. 

How does Oral Gonorrhea Spread?

Oral gonorrhea is spread through unprotected oral sex with an infected person.

Close contact with infected genitals through the following circumstances can lead to oral gonorrhea:

  • Giving oral sex to a partner with an infected penis 
  • Giving oral sex to a partner with an infected vagina or urinary tract 
  • Receiving oral sex on the penis from a partner with oral gonorrhea 
  • Receiving oral sex on the vagina from a partner with oral gonorrhea in the throat could transfer the disease to the vagina or urinary tract
  • Giving oral sex to a partner with an infected rectum
  • Receiving oral sex on the anus from a partner with oral gonorrhea could transfer the disease to the rectum

How is Oral Gonorrhea Treated?

Fortunately, the treatment options for oral gonorrhea are fairly straightforward.

Your doctor will prescribe you antibiotics to clear up the infection, usually ceftriaxone administered as an injection accompanied with oral azithromycin (Zithromax).

This is what the Centers for Disease Control and Prevention (CDC) recommend for the treatment of uncomplicated gonorrhea as new strains of drug-resistant Neisseria gonorrhoeae have emerged. 

Be sure to discuss your medical history with your doctor.

Inform them if you have any known allergic reactions to cephalosporin antibiotics, such as ceftriaxone.

Your doctor may prescribe you oral gemifloxacin, or injectable gentamicin and oral azithromycin.

Oral Gonorrhea vs. Strep Throat 

Since oral gonorrhea is already hard to detect, the only way to know for sure if you have it is to visit a doctor and have them do a throat swab.

Both oral gonorrhea and strep throat can present as a persistent sore throat.

However, redness often accompanies your sore throat with oral gonorrhea and white patches often appear in the throat with strep throat. 

Other symptoms that may indicate you have strep throat include:

  • A sudden fever, often 101˚F or higher
  • Chills
  • Headache
  • Swollen lymph nodes in the neck

Let your healthcare provider know all symptoms you are experiencing and they will be able to do a physical examination and run some tests to determine what is wrong.

Can Mouthwash Treat Oral Gonorrhea? 

While there is speculation that mouthwash can treat oral gonorrhea, there is no scientific evidence to support this claim fully.

Over-the-counter mouthwashes such as Listerine can kill harmful bacteria in the mouth, but ultimately it is not an alternative treatment option for oral gonorrhea.

You may wish to gargle with it to reduce the prevalence of Neisseria gonorrhoeae bacterium, but you should not use it as an alternative treatment method to antibiotics.

What Happens if Oral Gonorrhea Goes Untreated?

If you have oral gonorrhea and don’t receive proper treatment, it can spread through your bloodstream to other parts of your body and create more complications.

Untreated gonorrhea can lead to systemic gonococcal infection, also known as disseminated gonococcal infection. You may then develop joint pain, swelling, and skin sores.

In severe cases, it can also infect the heart.

Getting regular checkups from your healthcare provider or at an STD clinic can ensure that gonorrhea doesn’t go undetected in your body and is cured with antibiotics.

Preventing Oral Gonorrhea

Since gonorrhea is spread through sexual fluids like semen (cum), pre-cum, and vaginal fluids, abstinence from sexual contact is the best way to prevent it.

However, that’s not a realistic prevention method for a lot of us.

Practicing safe sex with a barrier method such as condoms and dental dams can minimize your risk of contracting gonorrhea and other sexually transmitted diseases.

Additionally, you should get tested regularly if you have a new sex partner or your partner has a new sex partner. This will lower your chances of getting an STD as well as spreading it.

Telling Your Partner(s)

The first thing you should do if you suspect you have gonorrhea is to abstain from any sexual contact until you get proper treatment.

Secondly, you should let your partner(s) know what signs and symptoms you are experiencing. That way they can arrange to get tested.

If you are treated for gonorrhea and your partner doesn’t get treated, you run the risk of contracting it from them again so it is important to both get tested.

As a general rule, it’s important to get regular STD checkups.

That way if you do have an infection and are showing no symptoms, it can be detected and treated immediately. 

When to See a Doctor 

You should visit a doctor or STD testing facility if you have any of the symptoms listed above or have recently had unprotected sex with a partner of unknown STD status.

Changes including unusual discharge, burning sensations, or pain while having sex could indicate an STD. A persistent sore throat accompanied by redness can also suggest you have oral gonorrhea.

If left untreated, gonorrhea can spread throughout the body and cause greater health complications including:

  • Pelvic inflammatory disease
  • Pregnancy complications
  • Infertility
  • Eepididymitis
  • Higher risk of HIV

Getting tested for gonorrhea is simple and painless and the treatment for most infected persons is straightforward. Take care of your health and get regular STD checkups for you and your partner(s).

How K Health Can Help

Did you know you can get affordable primary care with the K Health app? Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes.

K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

How common is gonorrhea in the throat?
Oral gonorrhea tends to be more prevalent in people under the age of 25 years old, infecting both people with vaginas and people with penises. It is often transmitted through oral sex and manifests as a persistent sore throat. Get regular STD checkups and practice safe sex to avoid contracting or spreading the disease.
How likely is oral gonorrhea to recur?
Once you have had oral gonorrhea, you can still get it again. Your antibiotic treatment will only cure the gonorrhea you have today but cannot prevent you from contracting the disease again in the future.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Alicia Wooldridge, MD

Dr. Alicia Wooldridge is a board certified Family Medicine physician with over a decade of experience.

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