Gonorrhea and Oral sex

[bldrbldr2010]

I am a female and performed unprotected oral sex on a man with unknown status about a 1.5 years ago.  About three months after I went to Planned Parenthood where I got tested for HSV 1 and 2, Syphilis, HIV, Chlamydia and Gonorrhea.  All came back negative.  The Chlamydia and Gonorrhea were administered through a urine test.  Later, I learned that gonorrhea acquired orally would not show up on a urine test.  I returned to Planned Parenthood and they said they do not do throat swabs for gonorrhea and they didn't know anyone in town who did.  And that they would not worry if I didn't have symptoms.  I have not had any symptoms (that I know of) but lately have felt a pressure in my stomach that I need to urinate frequently (even though I don't) and occasional sudden discomfort in my vaginal opening.

My questions are:
1. Should I be concerned that I did not get a throat swab for Gonorrhea.  If so, should I get one now after so much time has passed?
2. Is it possible for gonorrhea in the throat to travel and cause Pelvic Inflammatory Disease?

[H. Hunter Handsfield, M.D.]

Yes.  All is well.

[bldrbldr2010]

Thanks Dr. HHH.  I went to the nurse practitioner and tested negative for UTI.  She gave me 3 days of Cipro as a precaution and my symptoms went away.  I have had sex with a new partner who tested negative for chlamydia and gonorrhea (and all of the other STDs) prior to engaging in intercourse with me. Am I covered?

[H. Hunter Handsfield, M.D.]

Welcome to the STD forum.

There are a number of reasons that you should be having no concern whatsoever about having gonorrhea of the throat.  First, gonorrhea in men is uncommon without symptoms.  If your partner 1.5 yr ago had it, you probably would have noticed the pus dripping from his penis.  Second, oral gonorrhea is uncommon in women, which is why Planned Parenthood doesn't usually test for it.  Third, oral gonorrhea clears up on its own within 3 months, even without treatment.

That answers question 1.  As for question 2, the answer is no:  gonorrhea is limited to the site where it is acquired.  Oral gonorrhea doesn't travel to the genitals, or vice versa; and therefore it cannnot cause PID.

You definitely should see a health care provider for your current symptoms, which suggest you might have a urinary tract infection.  If you have been at risk for STDs in the past couple of months, they could be due to an STD like chlamydia or gonorrhea.  So definitely get checked out. But whatever the cause, it has nothing to do with the oral sex event over a year ago.

Good luck--  HHH, MD