Gonorrhea
(Neisseria gonorrhoeae)

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Risk of infection from oral sex:

• Giving oral sex to a partner with an infected penis can cause gonorrhea in the throat.

• Giving oral sex to a partner with an infected vagina or urinary tract might cause gonorrhea in the throat.*

• Giving oral sex to a partner with an infected rectum might cause gonorrhea in the throat.*

• Receiving oral sex on the penis from a partner with gonorrhea in the throat may cause gonorrhea of the penis.

• Receiving oral sex on the vagina from a partner with gonorrhea in the throat might cause gonorrhea of the vagina or urinary tract.*

• Receiving oral sex on the anus from a partner with gonorrhea in the throat might cause gonorrhea in the rectum.*

* Statements with an asterisk (*) need more research.

Areas of initial infection:

• Throat

• Genitals

• Urinary tract

• Rectum

Initial signs and symptoms of infection:

• Most gonorrhea infections in the throat have no symptoms. When symptoms are present, they can include a sore throat.

• Symptoms of genital, urinary tract, or rectal infection may include:

  • Discharge from vagina or penis (discharge from the vagina may be bloody)

  • Burning feeling when peeing

  • Painful or swollen testicles

  • Rectal pain or discharge

Treatment:

• Gonorrhea infections in the throat are harder to cure than genital or rectal infections but are treatable with antibiotics.

• Genital and rectal infections are curable with the right medicine.

• Sex partners of a person with gonorrhea should also receive testing to ensure there is no infection. Those with gonorrhea should not have sex until 7 days after they and their sex partners receive and complete treatment.

If left untreated, throat infections:

• Can be spread to sex partners who do not have the infection.

• Might spread through the body causing a rash and joint pain. This condition is disseminated gonococcal infection. A heart infection can also occur, which is a serious and potentially life-threatening condition.

If left untreated, genital, urinary and/or rectal infections:

• Can be spread to other sex partners.

• In women:

  • Can cause pelvic inflammatory disease (PID), which can lead to

    • chronic pelvic pain,

    • infertility, and ectopic pregnancy (a pregnancy in the fallopian tube or outside of the womb)

• In pregnant people:

  • Might result in premature birth or low birth weight in babies.

  • Can spread to the baby during delivery, and can cause blindness, joint infection, or a life-threatening blood infection in the baby.

• In men:

  • Can cause epididymitis, a painful condition of the ducts attached to the testicles that may lead to ductal scarring.

• In everyone:

  • May increase risk of getting HIV infection.

  • Might increase risk of spreading HIV to sex partners.

  • May spread through the body causing skin sores and joint pain. This condition is disseminated gonococcal infection. A heart infection can also occur, which is a serious and potentially life-threatening condition.

Is Oral Sex Safer than Vaginal or Anal Sex?

• It is difficult to compare the risks of getting specific STDs from specific types of sexual activity.

• • Most people who have oral sex also have vaginal or anal sex.

  • Few studies look at the risks of getting STDs, other than HIV, from giving oral sex on the vagina or anus, compared to the penis.

• Studies show the risk of getting HIV from oral sex (giving or receiving) with a partner who has the infection is much lower than the risk of getting HIV from anal or vaginal sex. This may not be true for other STDs.

• • In a study of gay men with syphilis, 1 out of 5 reported having only oral sex.

  • Getting HIV from oral sex may be extremely low, but it is hard to know the exact risk. If you are having oral sex you should protect yourself.

• It is possible that getting certain STDs in the throat like chlamydia or gonorrhea may not be as harmful as getting an STD in the genital area or rectum. Having these infections in the throat might increase the risk of getting HIV. Having gonorrhea in the throat also may might lead to the spread of disease throughout the body. In addition:

  • Having infections of chlamydia and gonorrhea in the throat may make it easier to spread these infections to others through oral sex. This is especially important for gonorrhea, since throat infections can be harder to treat.

  • Infections from certain STDs, such as syphilis and HIV, spread throughout the body. Therefore, infections acquired in the throat may lead to the same health problems as infections acquired in the genitals or rectum.

  • Mouth and throat infections by certain types of HPV may develop into oral or neck cancer.

What May Increase the Chances of Giving or Getting an STD through Oral Sex?

Certain factors may increase a person’s chances of getting HIV or other STDs during oral sex if exposed to an infected partner. Factors like:

• Poor oral health, which can include tooth decay, gum disease or bleeding gums, and oral cancer.

• Sores in the mouth or on the genitals.

• Exposure to the “pre-cum” or “cum” (also known as pre-ejaculate or ejaculate).

However, there are no scientific studies that show whether these factors increase the risk of getting HIV or STDs from oral sex.

What Can You Do to Prevent STD Transmission During Oral Sex?

You can lower your chances of giving or getting STDs during oral sex. Use a condom, dental dam or other barrier methods every time you have oral sex.

• For oral sex on the penis:

  • Cover the penis with a non-lubricated latex condom.

  • Use plastic (polyurethane) condoms if you or your partner is allergic to latex.

• For oral sex on the vagina or anus:

  • Use a dental dam.

  • Cut open a condom to make a square and put it between your mouth and your partner’s vagina or anus.

The only way to avoid STDs is to not have vaginal, anal, or oral sex.

If you are having sex, you can lower your chances of getting an STD by:

• Being in a long-term mutually monogamous relationship with a partner who does not have an STD (e.g., a partner with negative STD test results).

• Using latex condoms the right way every time you have sex.

It’s important to remember that many people with an STD may be unaware of their infection. STDs often have no symptoms and are unrecognized.

If you are having sex, ask your healthcare provider to test you regularly for STDs and HIV. Talk openly with your provider about activities that might put you at risk for an STD, including oral sex. You also should talk to your partner(s) about STDs. Free and low-cost options for testing are available in your area.