STDs Expert Forum
Oral Transmission of Gonorrhea
About This Forum:

The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

Oral Transmission of Gonorrhea

Here is what I THINK I understand;
- You can catch Gonorrhea in the throat after performing oral sex on an infected lady. This may or may not result in symtoms (symptoms) such as a sore throat.
- I have also read that this ussually resolves itself after some period of weeks (12?) but obviously it would be better to have it treated.
- I believe you can pass the gonorrhea on to another partner by performing oral sex on them... but can you also pass it on to them with just tongue kissing? I have read both that you can't and that you can but only if the gonorrhea is "active" i.e. sore red throat etc... can you clarify this?
- If gonorrhea can exist in the throat with no symptoms, how long can it remain a threat to be passed on to another partner either oral to vagina or oral to oral?
Related Discussions
239123_tn?1267651214
First, the opening premise is not as clear as you state it.  Gonorrhea of the throat is readily acquired by fellatio and is fairly common among men who have sex with men and in women with gonorrhea.  However, gonorrhea of the throat is rare in heterosexual men; and is no more common in men who do or do not say they have performed cunnilingus on a woman in the past few weeks.  Thus, acquiring throat gonorrhea by cunnilingus probably happens, but it is rare.  

Oral gonorrhea can be transmitted to a male partner by fellatio, but has never been shown to be transmitted to a woman by cunnilingus.  Likewise, gonorrhea has never been documented to be transmitted by kissing, french or otherwise.  The anatomic site of infection is the back of the throat, and most likely there aren't many GC bacteria in saliva or the front of the mouth.  If transmission of oral infection occurs at all by cunnilingus or kissing, it is rare.

As you correctly state, most throat gonorrhea is asymptomatic.  The proportion who complain of sore throat or other symptoms is identical among persons with and without postive gonorrhea tests from the throat.  However, a few cases are associated with the same sort of symptoms seen in strep throat, with severe throat pain and appearance of pus in the back of the throat or on the tonsils.  

So in heterosexual men, gonorrhea of the throat isn't a signficiant issue, either in terms of their own risk or, in the rare oral infection, in terms of transmission risk to a female partner.  Thus, the duration of infection in a heterosexual man probably doesn't matter much.  The entire issue is important primarily for MSM and women, not straight men. Most STD clinics don't even test straight men for gonorrhea of the throat; that test is pretty much limited to gay men, and even then is not routine in most clinics.

Finally, the 12 week duration statement is correct.  However, it is based on a single small study done 30 years ago, in which a small number of infected persons (12 or 13, as I recall) were followed without treatment.  All of their throat cultures became negative within 12 weeks, most within 8 weeks.  But those numbers are too small to know the truth; a few percent of infections might last quite a bit longer.

I hope this helps.  Best wishes--  HHH, MD
4 Comments
Blank
Avatar_m_tn
This does help but also adds some confussion for me. Bottom line; I have had oral sex with a particular lady two times seperated by maybe three months. Both times I developed a moderately severe sore throat about 2 days afterwards. In both cases I had no other symtoms (symptoms) of a cold.. I did have swollen glands more on one side than the other. I had sex with her maybe 2 other times inbetween but with no oral sex and did not get a sore throat. The first time the sore throat lasted about three weeks. I have had this most recent sore throat only about a week. -- So I am assuming I most likely do not have anything to wrooy about myself but I am thinking perhaps I should ask her to be tested. -- Thanks for this advice.
Blank
239123_tn?1267651214
Gonorrhea almost certainly is not the problem.  You raise an interesting related question, but one without clear answers.  During the early work on oral gonorrhea in the 1970s, it was found that STD clinic patients who had recently performed fellatio complained of sore throat more commonly than people who had not performed oral sex.  Cunnilingus also was associated with the symptom, as I recall, but less frequently.  Enlarged lymph nodes were not usually present.  (Your self-assessment of enlarged nodes probably is not reliable.  Sometimes it isn't clear even to a trained provider, and self-assessment that nodes are enlarged is usually wrong, in my experience.)

A few research studies were done in those old days to try to identify an infectious cause, with negative results.  It is possible the outcome would be different using more sophisticated technologies available today, but for now it remains a mystery.  We continue to see people with such complaints in the STD clinic, and throat testing for STDs always is negative.  Most experts believe it's sometimes (often? usually?) an emotional reaction, but I'm not convinced that explains most cases.  However, it is clear that no harm comes from it.  As you apparently have noted, the pain seems to go away with no long term consequences.

Bottom line:  I believe you have nothing to worry about.  Of course check it out if the symptoms persist more than a few days, or if you have severe throat pain, white spots on the tonsils, etc.
Blank
239123_tn?1267651214
Clarification:  The information above is an accurate reflection of common knowledge and the informaiton currently in the research literature.  However, I checked with Dr. Hook.  It turns out he is aware of new research, not yet published, suggesting that gonorrhea of the throat may be contracted more frequently by cunnilingus than previously believed.  

Gonorrhea is not a common problem in most heterosexual populations, and the chance your partner has it probably is low.  However, given the circumstance, it might make sense for you to see a provider and be tested for gonorrhea of the throat, and for your partner to be tested for genital gonorrhea.  The only test available for gonorrhea of the throat is culture, which misses up to half the cases.  So if your test is negative, it will still leave a possibility that you are infected.  However, if both you and your partner's tests are negative, you can be sure gonorrhea isn't the problem.

The information above about sore throat and oral sex is accurate.
Blank
Avatar_n_tn
A related discussion, wondering was started.
Blank
Avatar_m_tn
A related discussion, std dieases was started.
Blank
Continue discussion Blank
This Forum's Experts
239123_tn?1267651214
H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
300980_tn?1194933000
Edward W Hook, MDBlank
University of Alabama at Birmingham
,
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
242532_tn?1269553979
Blank
The 3 Essentials to Ending Emotiona...
Sep 18 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Control Emotional Eating with this ...
Sep 04 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating Control: How to St...
Aug 28 by Roger Gould, M.D.Blank