On Thursday, the Food and Drug Administration cleared the first diagnostic tests for extragenital testing for chlamydia and gonorrhea. In other words, these are the first gonorrhea and chlamydia tests where doctors can swab for samples somewhere other than your genitals. Options are great, but you might wonder why a doctor would choose to go looking for sexually transmitted infections in the throat or rectum when a urine sample is all you need to detect them. The answer, friends, is that your genitals are not the only places you can get sexually transmitted infections. Yes, it’s that time of year again: the time of year when Rachel Ann Feltman logs on to remind you that throat gonorrhea is a thing.
This isn’t meant to shame or embarrass anyone who had, has, and/or will have throat gonorrhea (or rectal gonorrhea, or good old-fashioned genital gonorrhea). Nay; the point is that so-called sexually transmitted infections can happen to anyone having any kind of sex, even if it involves a condom or doesn’t include penetration.
Here’s everything you need to know about these migrating microbes:
Wait, I can get gonorrhea in my throat?
Yes, and also in your butt. You can also get chlamydia in your throat and butt, but throat chlamydia just doesn’t have the same ring to it. The CDC has a helpful list of all the places on your body you might get an initial infection of various STIs, but the big takeaway is simple: Even people who always use condoms can get STIs, pretty much every STI can (at least in rare circumstances) be transmitted by unprotected oral sex, and STIs can show symptoms on parts of your body you wouldn’t expect.
Why is this important? Well, a lot of people assume STIs are gross—thanks, society—and part of that stigma is a misconception that all STIs produce gnarly and horrific symptoms. In reality, this is pretty rare! Herpes, for instance, is asymptomatic in almost everyone who has it, and gonorrhea and chlamydia can also infiltrate your body’s defenses without making much fuss. They can even go away on their own, but the problem is that they don’t always do so.
That means that you should not wait for an outbreak of oozing sores before getting tested for STIs. If you’re sexually active—and we’re talking about any kind of sex—you need to get tested two to three times a year.
Circling back to throat gonorrhea and the lessons we can learn from it: doctors are people too, and that means they’re influenced by the same STI stigma you are. Even if they’re up-to-date on all the ways STIs can and will present in a patient, they still might think it uncouth or downright unacceptable to suggest your sore throat might be the result of an STI. That’s why it’s crucial for you to know the facts. Don’t expect throat gonorrhea to strike at any moment (it won’t), but if you’ve recently had unprotected oral sex with someone whose STI status is unknown to you or likely to be in flux due to the existence of other partners, and you’ve got a mysterious throat infection, you should raise the possibility to your physician. There’s even a test for it now! They’ll be super impressed with your ability to self-advocate for good medical care. If they’re not, go find a doctor who is (and who will test you for throat gonorrhea).
How the heck does this happen?
A mucus membrane is a mucus membrane. STIs, like all infections, are caused by viral, bacterial, or fungal microbes. While many of these infections have particular parts of the body they’ve evolved to thrive in, most of them aren’t too picky. The risks vary between diseases—a 2016 article from the San Francisco AIDS Foundation really hammers home the message that the bacteria Neisseria gonorrhoeae will take any opportunity to hop off your skin and onto someone else’s, but not all STIs are this industrious.
This doesn’t mean you should spend your next date in a hazmat suit. The solution is actually really simple.
You can even order tests online. So convenient!
How do I know if I have throat gonorrhea?
You probably won’t. As previously mentioned, there often aren’t any symptoms, and if there are, it’s going to feel like any other sore throat. Don’t expect green pus to start oozing out of your tonsils (though if that does happen you should definitely see a doctor because you absolutely have something worse than throat gonorrhea). All you can do is understand the risks of the physical activities you participate in, enjoy them as safely as possible, and connect the dots if you, a person at risk of contracting gonorrhea or chlamydia, have a lingering sore throat.
Gonorrhea can cause life-threatening health problems, but only in rare cases, and only if it’s left untreated for a long time. Yes, it’s scary that an infection that’s unlikely to cause symptoms can really hurt you in the long run—how are you supposed to know if you have it? When it comes to genital infections, of course, the answer is simple: regular testing. If you engage in a lot of oral or anal sex, it could be worth insisting on getting one of the two new tests every once in awhile just to be sure you don’t have microbes making themselves at home in unexpected places. Antibiotic resistance is on the rise for these infections, but most cases will still clear up without any problems if they’re caught early. Take your antibiotics and make sure you’re actually cured before having sex with anyone.
One more time: Get tested
Since most cases of chlamydia and gonorrhea that aren’t in the genitals will be even less obtrusive than the genital infections themselves, the biggest reason to be proactive is so your throat gonorrhea doesn’t turn into someone else’s penis gonorrhea.
Conversely, a lot of the onus is on people with genital gonorrhea to keep it from becoming someone else’s throat gonorrhea. The STI tests you can take by peeing in a cup are always going to be the most routine, and if you’ve got insurance or access to a free clinic, there’s no excuse for not taking these tests regularly, regardless of symptoms or condom use. Be a conscientious, honest, and proactive partner, and expect the same of everyone you have sex with. Talk openly about STI risks so your sexual partners (and friends!) know better than to be too embarrassed to get tested or disclose their status. STIs really can infect anyone, and understanding that is the first step to making them less common.