Oral Gonorrhoea: Risks, Symptoms & Ways to Stay Protected

What Is Oral Gonorrhoea?

Oral gonorrhoea, also called pharyngeal gonorrhoea, is a bacterial infection of the throat caused by Neisseria gonorrhoeae – the same bacterium responsible for genital and rectal gonorrhoea. It's contracted through oral sex with an infected partner.

While many people associate gonorrhoea with genital symptoms, throat infections are increasingly common and present unique challenges for diagnosis and treatment.

How Common Is Oral Gonorrhoea?

Oral gonorrhoea is more prevalent than many people realise:

• Studies suggest 5-10% of gonorrhoea cases involve the throat
• Among men who have sex with men (MSM), rates are significantly higher – up to 25% of those with gonorrhoea may have throat infections
• Prevalence has been increasing in the UK, particularly in urban areas

Public Health England data shows that gonorrhoea diagnoses overall have risen substantially over the past decade, with throat infections representing a growing proportion.

How Do You Get Oral Gonorrhoea?

Oral gonorrhoea is transmitted through:

Primary Routes

• Performing oral sex on someone with genital or rectal gonorrhoea
• Receiving oral sex from someone with oral gonorrhoea (less common but possible)
• Deep kissing – emerging research suggests this may be a transmission route, particularly among MSM

Risk Factors

Certain factors increase your risk:

• Multiple sexual partners
• Unprotected oral sex
• Having other STIs
• Previous gonorrhoea infection

Symptoms of Oral Gonorrhoea

Here's the challenge: **most oral gonorrhoea infections cause no symptoms at all**. When symptoms do occur, they're often mild and easily mistaken for other conditions:

Possible Symptoms

• Sore throat (often mild)
• Redness in the throat
• Swollen lymph nodes in the neck
• Difficulty swallowing
• Occasionally, fever

Why Symptoms Are Misleading

These symptoms are nearly identical to:

• Common cold or flu
• Viral pharyngitis
• Strep throat
• Allergies

This means oral gonorrhoea is often missed or misdiagnosed. Many people never suspect an STI when they have a sore throat, leading to ongoing transmission.

Why Oral Gonorrhoea Matters

Even without symptoms, untreated oral gonorrhoea poses several risks:

Transmission to Partners

• Can spread to partners' genitals or rectum during oral sex
• May spread through deep kissing
• Contributes to ongoing community transmission

Antibiotic Resistance

Oral gonorrhoea is a significant driver of antibiotic-resistant gonorrhoea:

• The throat is a natural reservoir for bacteria
• Exposure to antibiotics for other conditions (like sore throats) at sub-therapeutic doses can promote resistance
• Some strains are now resistant to multiple antibiotics

Potential Complications

While rare, untreated gonorrhoea can occasionally spread:

• Disseminated gonococcal infection (DGI) affecting joints, skin, and blood
• This is uncommon but serious

Testing for Oral Gonorrhoea

Because symptoms are unreliable, testing is the only way to know if you have oral gonorrhoea.

How It's Tested

• Throat swab – a quick, painless swab of the back of the throat
• Results typically available within a few days
• Can be done alongside genital and rectal testing for comprehensive screening

Who Should Get Tested

Consider throat testing if you:

• Have given oral sex to someone with gonorrhoea or unknown STI status
• Have multiple sexual partners
• Are experiencing persistent sore throat
• Are a man who has sex with men (higher risk group)
• Have been notified by a partner

Testing Frequency

For those at ongoing risk:

• Every 3 months if you have multiple partners
• After any unprotected oral sex with a new partner
• As part of routine sexual health screening

Treatment for Oral Gonorrhoea

Oral gonorrhoea is treatable, but requires specific antibiotics:

Current UK Treatment Guidelines

• Ceftriaxone injection – the first-line treatment
• A single intramuscular injection is usually sufficient
• Treatment is the same regardless of infection site (throat, genital, or rectal)

Important Considerations

• Don't rely on oral antibiotics alone – due to resistance concerns
• Complete the full treatment – even if symptoms improve
• Avoid sexual contact for at least 7 days after treatment and until partners are treated
• Get a test of cure – recommended 2 weeks after treatment to confirm clearance

Partner Notification

All sexual partners from the past 2 weeks (or your last partner if longer) should be notified and tested.

How to Protect Yourself

While no method is 100% effective, you can significantly reduce your risk:

Use Barrier Protection

• Condoms for oral sex on a penis – reduce transmission risk significantly
• Dental dams for oral sex on a vulva or anus – provide a barrier against infection
• These aren't commonly used, but they do work

Reduce Risk Factors

• Limit number of partners – fewer partners means lower exposure risk
• Discuss STI status – open communication helps
• **Get tested regularly** – know your status and encourage partners to do the same

Stay Informed

• Recognise that oral sex carries STI risks
• Don't assume that oral sex is "safe sex"
• Be aware of your partners' sexual health

The Bigger Picture: Oral Sex and STIs

Oral gonorrhoea is just one of several STIs that can be transmitted through oral sex:

This doesn't mean you should avoid oral sex – but it does mean being informed and proactive about testing.

Take Action: Get Tested

If you've had oral sex and haven't been tested recently, now is the time. Oral gonorrhoea usually causes no symptoms, spreads easily, and contributes to antibiotic resistance – but it's completely treatable when detected.

Our comprehensive STI screening includes throat swabs for gonorrhoea (and chlamydia if indicated), ensuring you have a complete picture of your sexual health. Book your confidential test today.