A sore throat is a common symptom of many types of infections, including some sexually transmitted diseases (STDs). The most common STD that causes a sore throat is gonorrhea. Gonorrhea is a bacterial infection that can infect the throat and cause a sore throat along with other symptoms.
Gonorrhea
Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. It is spread through unprotected oral, vaginal or anal sex with an infected partner. Gonorrhea can infect the urethra, cervix, rectum, eyes, and throat.
When gonorrhea infects the throat, it causes a condition called pharyngeal gonorrhea. The bacteria infect the back of the throat, including the tonsils and pharynx. Pharyngeal gonorrhea often does not cause any symptoms. When symptoms do occur, they include:
- Sore throat
- Swollen tonsils
- White or yellow discharge in the throat
- Pain when swallowing
- Swollen lymph nodes in the neck
- Fever
Gonorrhea can spread from the throat to other parts of the body if left untreated. It poses a particular risk for pregnant women, as it can spread to the eyes of a newborn during childbirth, causing blindness.
Diagnosing Pharyngeal Gonorrhea
A throat culture or nucleic acid amplification test (NAAT) are used to diagnose pharyngeal gonorrhea. During a throat culture, a health care provider will use a long Q-tip to swab the patient’s throat to collect a sample. This sample is sent to a lab where it is placed in a petri dish to see if gonorrhea bacteria grow.
NAAT is a molecular test that detects the genetic material of the gonorrhea bacteria. It is more accurate than a throat culture. A throat swab is obtained and tested for the DNA of the bacteria. NAAT produces faster results than a culture.
Treatment
Antibiotics are used to treat pharyngeal gonorrhea. Treatment is important to prevent the spread of infection to other body parts and sexual partners. The current CDC-recommended treatment is an intramuscular injection of ceftriaxone plus oral azithromycin or doxycycline. It is critical to abstain from sexual activity until treatment is complete and symptoms resolve.
All sexual partners from the past two months should be notified, tested, and treated as well since gonorrhea can infect multiple sites. This helps prevent reinfection and further spread.
Prevention
Gonorrhea, including pharyngeal gonorrhea, can be prevented by:
- Using condoms or other barriers for oral, vaginal and anal sex
- Limiting sexual partners and avoiding partners with unknown STD status
- Getting tested regularly, especially if sexually active with new or multiple partners
Practicing safe sex is crucial, as gonorrhea can spread even when no symptoms are present. Getting tested and treating any infection found quickly can help prevent complications.
Chlamydia
Chlamydia is another common bacterial STD that can infect the throat and cause a sore throat. It is caused by the bacteria Chlamydia trachomatis. An estimated 2-6% of pharyngeal infections are due to chlamydia.
Symptoms
Most people with chlamydia in their throat have no symptoms. When present, the symptoms are similar to gonorrhea and can include:
- Sore throat
- Painful swallowing
- Swollen tonsils
- Fever
- Swollen lymph nodes
Symptoms usually appear 1 to 3 weeks after exposure. Even without symptoms, chlamydia can spread to the genitals and eyes.
Diagnosis and Treatment
Chlamydia is diagnosed using NAAT on a throat swab. Treatment involves oral antibiotics, usually azithromycin or doxycycline. All sexual partners should also be notified, tested, and treated.
Prevention
Same as gonorrhea, chlamydia can be prevented by:
- Using protection during oral, vaginal and anal sex
- Routine STD testing
- Limiting sexual partners
Other STDs Causing Sore Throat
While gonorrhea and chlamydia are the most common culprits, other STDs can occasionally cause pharyngitis (sore throat) as well:
Herpes Simplex Virus
Oral herpes is a viral infection caused by herpes simplex virus type 1 (HSV-1). It causes cold sores around the mouth and lips. It can also infect the throat and tonsils leading to pharyngitis symptoms like pain and difficulty swallowing.
HIV
Acute HIV infection can cause a sore throat in the first few weeks after exposure before antibodies develop. While an HIV sore throat is possible, it is an uncommon symptom.
Syphilis
The bacterial STD syphilis very rarely infects the throat. When it does, it can cause patchy ulcerations and pain with swallowing.
Sore Throat from Oral Sex
Having oral sex with someone who has an oral infection like gonorrhea or herpes can lead to a sore throat. Practicing safe oral sex by using condoms or dental dams can help reduce this risk.
Here is a summary of how STDs can cause a sore throat:
| STD | Cause | Symptoms |
|---|---|---|
| Gonorrhea | Bacteria Neisseria gonorrhoeae | Sore throat, pain swallowing, fever, swollen tonsils/lymph nodes |
| Chlamydia | Bacteria Chlamydia trachomatis | Sore throat, painful swallowing, fever, swollen lymph nodes |
| Herpes | Herpes Simplex Virus Type 1 | Sore throat, pain swallowing, cold sores |
| HIV | Human Immunodeficiency Virus | Sore throat (uncommon) |
| Syphilis | Bacteria Treponema pallidum | Painful ulcers in throat (rare) |
Testing for STDs
If you have a sore throat that could be a sign of an STD, see your doctor or visit a sexual health clinic. Throat swabs and blood tests can check for gonorrhea, chlamydia, herpes, HIV, and syphilis.
Testing is important since most STDs do not show symptoms but can still be transmitted. Getting tested regularly and asking partners to get tested can prevent these infections from silently spreading.
Throat Swab
A throat swab is used to collect a sample from the back of the throat. This is tested for gonorrhea and chlamydia using culture or NAAT. HSV-1 can also be detected from a throat swab.
Blood Tests
A blood sample can be tested for:
- HIV – HIV antibody/antigen tests can detect HIV infection
- Syphilis – A non-treponemal test like RPR screens for syphilis, while a treponemal test like TPPA confirms diagnosis
- Herpes – Blood tests detect HSV antibodies (IgG)
A combination of throat swab and blood tests can determine if a sore throat is related to an STD or not.
Preventing STDs
STDs are common but taking precautions can reduce your risk of getting infected:
- Use protection (condoms, dental dams) when engaging in oral, anal or vaginal sex
- Limit sexual partners and avoid partners with unknown STD status
- Get tested regularly if sexually active, at least yearly
- Ask partners to get tested before having unprotected sex
- Get treated promptly if diagnosed with an STD
- Notify partners immediately if you have an STD so they can also get tested and treated
Although most STDs do not show any symptoms initially, they can still be transmitted. Staying safe sexually and getting routine STD screening is important to stop the spread of these infections.
Conclusion
Gonorrhea is the most common STD causing a sore throat. Chlamydia, HSV-1, HIV, and syphilis may also rarely cause pharyngitis. See a doctor if you have a sore throat combined with risky sexual exposure to get tested and treated. Using protection during oral sex can help prevent transmission of throat infections. Routine STD testing and prompt treatment of any infections found is key to slowing the spread of STDs.