Gonorrhea: Is kissing a risk factor?

Gonorrhea is a sexually transmitted infection or STI that can be transmitted through vaginal or anal sex with an infected person. If you are affected, you may not show any signs or you can experience painful urination and abnormal vaginal discharge. Turns out, the bacterium that causes this infection can survive in various warm, and moist areas of the body. So, it is not just the reproductive tract that can be targeted, but also the mouth and throat. While unprotected sexual intercourse is a risk factor, is kissing also a risk factor of gonorrhea? Let’s find out.

What is gonorrhea?

It is an infection caused by the bacterium Neisseria gonorrhoeae, and mostly affects the mucous membranes of the reproductive tract. “But it can also infect other areas, including the throat and rectum,” says gynaecologist Dr Sriprada Vinekar. It is transmitted through direct contact with infected bodily fluids, typically during sexual activity. Here are some modes of transmission:

• Having vaginal sex with an infected person.
• Engaging in anal sex can facilitate the spread of this sexually transmitted infection.
• Performing oral sex on an infected partner can lead to oral gonorrhea, which affects the throat.
• An infected pregnant woman can pass this STI to their baby during childbirth.

What are the symptoms of gonorrhea?

“Some people may not experience any symptoms of this infection at all, especially in the early stages of the sexually transmitted infection,” says the expert. But some of the symptoms associated with gonorrhea in women include:

• Painful or having a burning sensation while urinating.
• A change in the amount or colour of vaginal discharge.
• Spotting or bleeding even if you are not menstruating.
• Pain in the lower abdomen, which may be accompanied by discomfort during sex.
• Swelling around the vagina or pelvis.
• In case of oral gonorrhea, you may have pain and discomfort while swallowing, white patches or lesions in the throat, and swollen lymph nodes.

Can you get gonorrhea from kissing?

“If there are active infections in the throat, kissing could transmit the bacteria, particularly if there the infected person has cuts or sores,” says Dr Vinekar. Deep kissing, which involves exchange of saliva, may lead to gonorrhoea, as per research published in The Lancet Infectious Diseases in 2019. Another research published in the Sexually Transmitted Diseases journal in 2023 found that tongue kissing may be a risk factor for oral gonorrhea.

This STI can infect the throat, leading to a condition known as pharyngeal or oral gonorrhea. “This usually occurs when the Neisseria gonorrhoeae bacteria enter the throat, typically through oral sex with an infected partner,” says the expert. But if a person has an active infection in their throat, they can potentially spread the bacteria through kissing. The bacteria may be present in saliva or on the surface of the mucous membranes in the mouth and throat.

“While it is possible to contract this STI through kissing, the risk is generally lower than through other forms of sexual activity, such as vaginal or anal sex,” says the expert. The concentration of bacteria is typically higher in genital fluids compared to saliva.

Can sharing food cause gonorrhea?

Neisseria gonorrhoeae is primarily spread through sexual contact with infected mucous membranes. “So, sharing food, drinking from the same straw, or using the same utensils is considered a low-risk activity for transmitting it,” says the expert. It is also not spread by hugging, using toilet seats or sharing towels, cups or cutlery with an infected person. That’s because the bacteria responsible for this infection cannot survive outside the human body for long, according to the UK National Health Service.

How to reduce the risk for oral transmission?

• Use condoms or dental dams during oral sex to reduce contact with infected bodily fluids.
• Regular STI testing for sexually active people, especially those with multiple partners, can help identify and treat infections early.
• Not having multiple sexual partners can decrease the risk of exposure to STIs.
• Talk to your sexual partner about STIs as well as testing history.

How to treat it?

If you suspect you have this infection or have been exposed to it through kissing or any other means, reach out to your doctor. This STI is treatable with antibiotics, typically a dual therapy approach, which may include –

• Ceftriaxone: An injection or oral medication.
• Azithromycin: Usually taken as a single dose.

Antiseptic mouthwash may also help in case of oral gonorrhea. During a 2016 study published in the Sexually Transmitted Infections journal, researchers found that antiseptic mouthwash significantly reduced the amount of Neisseria gonorrhoeae on the pharyngeal (throat) surface.

Gonorrhea from kissing is not the most common way of the infection getting transmitted, but it is possible. If you get affected, complete the full course of your treatment and try not to engage in sexual activity until cleared by doctor to prevent spreading the infection.