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Oral gonorrhea symptoms, causes & treatment

The information provided herein does not constitute an expert or medical advice, nor intended to replace such advice.

Sexual Health



Written by Andrea Pinto on August 8th, 2021

Gonorrhea is a sexually transmitted infection (STI) that commonly affects the genitourinary system of both men and women. However, you may have never heard about oral or pharyngeal gonorrhea, which affects the mouth and throat.

Read on to learn more about oral gonorrhea symptoms, causes, and treatment.

What is oral gonorrhea?

Oral gonorrhea (also known as pharyngeal gonorrhea) is an STI that specifically affects the mouth and throat, and it’s caused by the same pathogen as genitourinary and anal gonorrhea — a bacteria called Neisseria gonorrhea

Gonorrhea is one of the most commonly reported STIs in the United States and across the globe.

According to the Pan American Health Organization (PAHO), gonorrhea is actually the second most common STI in the world, with nearly 80 million new cases per year in teens and adults aged 15 to 49.

Genital gonorrhea is the most common form of the disease, and according to the Mayo Clinic, it can cause symptoms that include:

  • Painful urination
  • Vaginal bleeding between periods
  • Vaginal bleeding after intercourse
  • Pus-like discharge from the penis or vagina
  • Pain and/or swelling in one testicle
  • Lower abdominal pain

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Causes of oral gonorrhea

The most common way of getting oral gonorrhea is through oral sex. Oral sex can spread a significant number of STIs from one partner to another.

  • Giving oral sex to a partner with genitourinary or anal gonorrhea can result in oral gonorrhea.
  • Receiving oral sex from a partner with oral gonorrhea can result in genitourinary or anal gonorrhea.

You can get oral gonorrhea when your mouth, genitourinary, or anal membranes come into contact with the white or yellow-green, thick discharge that is produced by a gonorrhea infection. It’s important to keep in mind that this discharge can be mixed with normal fluids, making it very difficult to detect on plain sight. 

According to a study published by the journal Sexual Health, there’s a 63 percent possibility of getting urethral-to-pharyngeal gonorrhea for each condomless sex act. The study also found a 9 percent risk of pharyngeal-to-urethral transmission per act.

Although there isn’t strong evidence to suggest that gonorrhea can be spread by kissing — as stated by the NHS — it’s possible to transmit the bacteria from the mouth to an object (such as a sex toy), which could then infect another person if it’s not cleaned or covered with a condom. This type of transmission is extremely rare, but not impossible.

Symptoms of oral gonorrhea

Most cases of oral or pharyngeal gonorrhea are completely asymptomatic, which makes the disease even easier to spread.  The American Sexual Organization has found that up to 90 percent of people who become infected with pharyngeal gonorrhea remain asymptomatic. Since people may never realize that they have become infected, they may take fewer precautions during sex and pass the STI to new partners. 

According to the journal of Infectious Diseases in Obstetrics and Gynecology, when gonorrhea does produce symptoms, these can include:

  • A sore throat
  • Discomfort while swallowing
  • Swollen, red throat
  • Swollen lymph nodes on the neck
  • Mouth inflammation

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Treatment for oral gonorrhea

There are certain factors that can make oral STIs, such as oral gonorrhea, harder to treat than their genital counterparts.

Research has found that pharyngeal pathogens may have increased antibiotic resistance, which could be due to the fact that they’re most commonly exposed to antibiotics that are used to treat other infections. This constant exposure allows the bacteria to “learn” how to fight antibiotics, and different pathogens can even pass down antibiotic-resistance genes to other microbes. 

Fortunately, antibiotic treatment is still highly effective against oral or pharyngeal gonorrhea. The recommended treatment for pharyngeal gonococcal infections is an antibiotic called ceftriaxone, which is administered as an intramuscular (IM) injection. The right dosage will vary depending on the patient’s weight — it’s very important to seek medical assistance so you can receive the right dose of antibiotics.

According to the CDC, cases of coinfection with oral chlamydia and gonorrhea should be treated with another antibiotic called doxycycline, which is given orally for 7 days, in addition to IM ceftriaxone. Your doctor will recommend a different treatment if you’re pregnant, or if you suffer from allergies to one of these medications. 

You should always make sure to take the full course of antibiotics as prescribed by your healthcare provider, even if you start to feel better before the treatment has been completed. This benefits you in two different ways: first, it ensures that the disease has been fully cured before you stop taking the antibiotics, reducing your risk of a recurrence. But additionally, completing your treatment helps prevent further antibiotic resistance, which could become a public health issue in the future.

You can learn more about gonorrhea and other oral STIs in these STDWatch articles:


Dr. Andrea Pinto Lopez

Dr. Andrea Pinto Lopez

Dec 11, 2022

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