From the Guidelines
The likelihood of transmitting Gonorrhea from a female to a male through oral sex is significant, with the pharynx being a key site for the emergence of antimicrobial resistance and a potential source of continued pathogen transmission 1. The transmission dynamics of Gonorrhea through oral sex are not fully understood, but it is known that N gonorrhoeae can be isolated from saliva and transmitted via kissing, use of saliva as a sexual lubricant, or oral–genital intercourse 1. Key points to consider include:
- The pharynx is a unique anatomical site that might be an important source of continued pathogen transmission, with N gonorrhoeae frequently isolated from saliva 1.
- The prevalence of pharyngeal infections among men who have sex with men is higher than among men who have sex with women and heterosexual women, but scarcity of pharyngeal testing among heterosexual populations could miss between 17% and 70% of cases of isolated pharyngeal gonorrhoea 1.
- Pharyngeal N gonorrhoeae infections tend to be asymptomatic and persist for potentially up to 16 weeks, increasing the opportunity for genetic transformation and the acquisition of genetic determinants of antimicrobial resistance 1.
- The pharmacokinetics of extended-spectrum cephalosporin antibiotics in pharyngeal tissue are complex, and extended-spectrum cephalosporins require a serum concentration 4 times the MIC for a duration of 7–10 h to achieve a sufficient antimicrobial effect 1. To prevent transmission, using condoms during oral sex provides effective protection, and if exposure is suspected, testing is recommended as gonorrhea often causes no symptoms in the throat but can lead to urethral infection in men, typically showing as penile discharge, burning urination, or testicular pain within 1-14 days after exposure. Treatment for gonorrhea requires antibiotics, but the current recommended regimen may not be effective for pharyngeal infections, and longer durations of therapy or higher doses might be required 1.
From the Research
Transmission of Gonorrhea through Oral Sex
- The transmission of Gonorrhea from a female to a male through oral sex is a significant concern, as Gonorrhea is a sexually transmitted infection that can cause serious health complications if left untreated 2.
- Studies have shown that oral sex can be a route of transmission for Gonorrhea, with the bacteria Neisseria gonorrhoeae able to infect the throat and other parts of the body 3, 2.
- The likelihood of transmission through oral sex is not well quantified, but it is thought to be lower than transmission through vaginal or anal sex 2.
Risk Factors for Transmission
- The risk of transmission through oral sex is increased if the infected partner has a high bacterial load, if the oral sex is rough or traumatic, or if the recipient has oral ulcers or other mouth injuries 2.
- The use of condoms or other barrier methods during oral sex can reduce the risk of transmission, but this is not always practiced consistently 4.
- The transmission of Gonorrhea through oral sex can also be influenced by the presence of other sexually transmitted infections, such as Chlamydia or syphilis 5.
Prevention and Treatment
- Prevention of Gonorrhea transmission through oral sex can be achieved through the use of condoms, dental dams, or other barrier methods, as well as through regular screening and treatment for sexually transmitted infections 5, 4.
- Treatment for Gonorrhea typically involves antibiotics, such as ceftriaxone or azithromycin, which can be effective in curing the infection if taken promptly and correctly 6, 5.
- It is essential to note that antibiotic resistance is a growing concern in the treatment of Gonorrhea, and alternative treatment options may be necessary in some cases 6, 5.