Is It Just Flu? STI Symptoms You Should Not Ignore

Sexually transmitted infections (STIs, formerly called sexually transmitted diseases, or STDs), are primarily spread through various types of sexual contact. In the United States, one in five people have an STI.

You can reduce your risk of contracting an STI by using a barrier method of protection, such as a condom, during each type of sexual encounter, which includes oral sex. Some STIs can be transmitted orally and cause a sore throat.

Read on to learn more about STIs that can affect the throat and mouth, and how to treat them.

woman getting checked for sore throat
Westend61 / Getty Images.

Gonorrhea in the Throat and Mouth

Gonorrhea, also known as "the clap," is one of the most common STIs in the United States. Gonorrhea is caused by Neisseria gonorrhoeae bacteria, spread during sexual contact. Gonorrhea can affect the genitals as well as the mouth and throat.

Left untreated, gonorrhea can cause a host of serious complications including miscarriage, infertility, septic arthritis, and blindness.

Gonorrhea symptoms present differently in males and females. That said, gonorrhea sometimes causes no symptoms at all. This leaves many people from getting diagnosed and treated, which is why regular STI testing is so important.

For females, gonorrhea may cause:

For males, gonorrhea may cause:

  • A greenish-yellow discharge from the penis
  • Dysuria
  • Testicular or scrotal pain and swelling

In general, those with symptomatic gonorrhea will start experiencing symptoms within 10 to 14 days of exposure.

Oral Transmission

Gonorrhea can be spread through oral sex performed on the genitals or anus of someone with gonorrhea. While oral gonorrhea often presents with no symptoms, it can cause:

  • Sore throat
  • Throat redness
  • Fever
  • Swollen lymph nodes in the neck

Diagnosis and Treatment

Gonorrhea is diagnosed via a urine sample that is analyzed at a lab. It can also be diagnosed by swabbing a potentially infected area, such as the throat. If you are worried you may have been exposed to gonorrhea, talk to your healthcare provider as soon as possible.

Since gonorrhea is a bacterial infection, it is treated primarily with antibiotics, however, it has become resistant to most antibiotics. Reinfection is also common.

To address increasing antibiotic resistance, the Centers for Disease Control and Prevention (CDC) recommends a single 500 mg intramuscular dose of ceftriaxone.

Chlamydia in the Throat and Mouth

As the most frequently reported STI in the United States, around 4 millions cases of chlamydia were recorded in 2018. Chlamydia is a STI caused by the bacterium Chlamydia trachomatis, and is most common among young people between the ages of 15 to 24.

The symptoms of chlamydia will be dependent on the part of the body infected. This can include the vagina, penis, rectum, or throat. However, many people infected with this particular STI experience no symptoms at all.

For those who do have a symptomatic case of chlamydia, frequent symptoms include:

  • Vaginal discharge
  • Penile discharge
  • Dysuria
  • Swelling of genitals
  • Abdominal and pelvic pain
  • Bleeding between periods or during intercourse

Oral Transmission

Oral chlamydia can cause a sore throat, and can include pus on the tonsils or pain while swallowing.

Diagnosis and Treatment

Chlamydia is diagnosed through a urine sample or throat, urine, cervical, and rectal swabs. These are the only ways to confirm infection.

If someone tests positive for chlamydia, treatment options include prescription medications. The most effective is 100 mg of doxycycline orally, twice a day, for seven days. This treatment approach is also used in cases of oral chlamydia. If someone is allergic to this medication or is pregnant, alternative treatments are available.

Syphilis on Tongue and in Throat

Syphilis is an STI caused by the bacterium Treponema pallidum. Syphilis is spread through vaginal, anal, or oral sex with an infected partner.

Syphilis symptoms are based on the stage of infection. There are four stages, each one with distinct signs.

  • Stage 1: The first stage is known as primary syphilis and is marked by chancres (sores). This sore will appear on the point of sexual contact such as the cervix, vagina, penis, rectum, anus, or mouth. After exposure, it takes about 21 days for chancres to appear.
  • Stage 2: If primary syphilis goes untreated, it will progress to stage 2, which is known as secondary syphilis. Stage 2 symptoms will usually appear between four and 10 weeks after the initial infection. The main symptoms of secondary syphilis include rash and hair loss. Other symptoms can include fever, sore throat, weight loss, headache, and more.
  • Stage 3: Stage 3 is latent syphilis, which presents with little to no signs or symptoms.
  • Stage 4: Stage 4, tertiary syphilis, is the most serious stage of infection. If someone progresses to stage 4, multiple organs may be impacted including the heart and kidneys. Stage 4 can be fatal.

Oral Transmission

Syphilis can be transmitted orally and affect the tongue and throat. The primary means of syphilis transmission include oral, anal, and vaginal sex, though the risk of transmission of an infected partner will depend on what stage they are in. If transmitted orally, a sore throat may be possible during stage 2.

Diagnosis and Treatment

Syphilis is diagnosed via an antibody blood test. If antibodies are detected, the main course of treatment for syphilis is penicillin, but other types of antibiotics can be used as well.

Oral Herpes in the Throat and Mouth

Herpes is an umbrella term to describe infections caused by the herpes simplex virus (HSV). Herpes can appear orally or on the genitals. Where infection presents is dependent on the type of HSV involved.

HSV-1

HSV-1 is a strain of herpes that usually causes oral herpes or cold sores. HSV-1 can be spread through oral sex and cause sores on the genitals as well.

HSV-2

HSV-2 is another strain of herpes that commonly causes genital herpes. HSV-2 is primarily spread through vaginal, anal, or oral sex, which causes herpes sores on the genitals. 

Oral herpes symptoms include:

  • Cold sores
  • Itchiness surrounding the sores
  • Pain while chewing, swallowing, or speaking

If herpes affects the throat, this is known as herpes esophagitis. This can be caused by HSV-1 or HSV-2, and lead to a sore throat.

Oral Transmission

HSV-1 can be transmitted through skin-to-skin contact, including during oral sex. Herpes is most contagious with open cold sores.

Diagnosis and treatment

Herpes can be diagnosed through blood tests as well as viral cultures. Self-checks can be performed as well if skin lesions are present. If you believe a cold sore could be the result of herpes, see a healthcare provider to get a confirmed diagnosis.

While herpes is not a curable STI it is treatable. The main goals of herpes treatment include:

  • Symptom relief and management
  • Lessen outbreak durations
  • Prevent recurrences
  • Lower risk of spread

Herpes is treated by:

  • At-home remedies
  • Pain relievers
  • Antiviral medications

HPV in the Throat and Mouth

Human papillomavirus (HPV) are a group of more than 200 viruses that cause warts. Of these 200 viruses, 40 variants can be transmitted through sexual contact and affect someone's genitals, anus, mouth, or throat.

HPV is often an asymptomatic infection. However, HPV symptoms can include:

  • Genital lumps or bumps
  • Genital itchiness
  • Warts

Oral Transmission

HPV can also impact the mouth. While this type of HPV is less common, it can still happen and cause warts in the mouth or throat. This may lead to sore throats.

Diagnosis and Treatment

HPV diagnosis involves detecting that HPV is present and determining which type is involved. It is important to diagnosis the specific type of HPV because 14 are strongly correlated with cancer.

Many cases of HPV resolve on their own. Currently, no treatment is available to cure HPV. Management strategies include monitoring for potential complications and resolving symptoms.

HIV and Oral Transmission

Human immunodeficiency virus (HIV) causes acquired immunodeficiency syndrome (AIDS). HIV can be transmitted orally.

HIV symptoms will vary based on the phase of infection someone finds themselves in. There are three stages:

  • Acute HIV: Acute HIV is the first stage of HIV infection. Symptoms mimic those seen in the flu such as fever, sore throat, headache, fatigue, swollen lymph nodes, etc.
  • Chronic HIV: During this stage, symptoms seen in the acute phase largely resolve. Chronic HIV is mostly without symptoms.
  • Symptomatic HIV: The last stage of HIV is when the infection has progressed to AIDS. Symptoms during this stage are mostly related to opportunistic infections.

Oral Transmission

HIV can be transmitted orally but poses little risk in actually doing so.

Diagnosis and Treatment

HIV is diagnosed through a blood or saliva test. If HIV is detected, the main course of treatment is antiretroviral drugs. These medications work to prevent HIV from replicating by blocking a stage of the virus's life cycle.

When to See a Healthcare Provider

If you suspect you've been exposed to an STI, contact your healthcare provider as soon as possible to set up a screening. Many STIs are treatable but still need to be addressed in order to lower the risk of any complications.

Sexually active adults should get screened regularly for chlamydia, gonorrhea, herpes, and HPV. It is also recommended everyone ages 13 to 64 be tested at least once for HIV.

When it comes to STI testing, various methods are used including urine and blood tests. Swabs may also be performed, as well as a physical examination.

At-home STI kits are also available for those who feel uncomfortable going to a clinic or their healthcare provider.

Summary

There are various types of STIs that can cause a sore throat. The only way to know for sure if the sore throat you are experiencing is an STI is to get tested. Sexually active individuals should get tested regularly, especially before starting a relationship with a new partner or sleeping with someone new.

While STIs are nothing to be ashamed of, it is important to know if you have one to take charge of your sexual health and prevent spreading infection to others. Talk to your healthcare provider about getting tested and about any concerns you may have.

Frequently Asked Questions

  • What STI starts with a sore throat?

    Chlamydia, gonorrhea, syphilis, herpes, and HPV may cause a throat infection following oral sex.

  • How do you know if you have an STI in your throat?

    The only way to truly know if you have an STI in your throat is to get tested. If you suspect you've been exposed to an STI orally, have your healthcare provider perform a swab on your throat to test for a potential infection.


12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Sexually transmitted infections prevalence, incidence, and cost estimates in the United States.

  2. Centers for Disease Control and Prevention. Gonorrhea.

  3. Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelinesMMWR Recomm Rep. 2021;70(4):1-187. doi:10.15585/mmwr.rr7004a1

  4. U.S. Centers for Disease Control and Prevention. Chlamydia – CDC fact sheet (detailed).

  5. Karlsson A, Österlund A, Forssén A. Pharyngeal Chlamydia trachomatis is not uncommon any moreScand J Infect Dis. 2011;43(5):344-8. doi:10.3109/00365548.2011.553243

  6. Centers for Disease Control and Prevention. Syphilis - CDC fact sheet (detailed).

  7. Centers for Disease Control and Prevention. National overview - Sexually transmitted disease surveillance.

  8. U.S. National Library of Medicine: MedlinePlus. HPV.

  9. World Health Organization. Human papillomavirus (HPV) and cervical cancer.

  10. Centers for Disease Control and Prevention. HIV risk behaviors.

  11. Centers for Disease Control and Prevention. Which STD tests should I get?.

  12. Mouthhealthy.org. Sexually transmitted diseases and your mouth.

By Molly Burford
Molly Burford is a mental health advocate and wellness book author with almost 10 years of experience in digital media.