Is oral sex really safe? Science says no

Medically reviewed by: Dr. Kimberly Langdon (M.D) on 13 November 2021.

 

The following material may not be apt for young audiences, since it contains mature information.

 

Oral sex also called rimming or going down, is when your partner’s mouth, lips, or tongue licks, sucks or stimulates your genital area, i.e, your vagina (cunnilingus), penis (fellatio), or anus (anilingus).

 

It is a practice that can spread many STDs¹ including syphilis, herpes gonorrhea, easily, not sparing HIV, HSV, trichomonas, and even cancer.

 

However, using dental dams and condoms can help lower the oral STD transmission rates.

 

The severity of the transmission of the infection depends upon the type of infection that is being passed and the sexual act being performed. However, that may vary from person to person.

Can STDs Be Transmitted by Oral Sex?

 

Many STIs can be transmitted through oral sex. 

 

So, how safe is unprotected oral sex?

 

Anyone who is exposed to risks of receiving or giving unprotected oral sex can get STDs infecting the mouth, genitals, and surrounding areas, throat, or rectum. 

 

However, the risk factors for catching STIs through oral sex depends on various things, including:

 

  • The type of STD/STI
  • The type and number of sex acts practiced during oral sex
  • The commonness of a specific STD
  • Age

Also, the risk of receiving unprotected oral sex can lead to having more than one STD/STI at the same time. 

 

For example syphilis, gonorrhea, and intestinal infections can appear in more than one area at the same time, including the genitals and the throat. 

 

The risks of unprotected oral sex, like anilingus (oral-anal sex), can lead to the spreading of bacterias like Shigella and E. coli, even if you’re symptomatic or not. 

 

So, can you get an STD by receiving oral sex — “much more than you think”.

 

Given all these risk factors, let’s directly jump into the most common STDs you can catch from oral sex. 

HIV

Your partner’s mouth on your genitals less frequently leads to the spread of an HIV infection. 

 

However, that’s not 100% risk-free, if you don’t take mindful precautions like using latex or rubber condoms and dental dams — thin & small square-shaped plastic or latex piece used mouth-to-genital or mouth-to-anus contact when having oral sex, during intercourse, your risk of acquiring the infection is likely more.

 

So, can a man get HIV from receiving oral sex? 

 

Receiving oral sex on the penis (fellatio), on the vulva (cunnilingus), or anus (anilingus) tends to be riskier for those who perform the oral sex than the one who receives it. 

 

However, the chances of STD transmission — HIV during oral sex in males is also possible, though in a lesser percentage as compared to normal sexual intercourse.

 

This is because during oral sex you may come in contact with genital fluids which puts you in danger of catching STDs, including HIV². 

 

However, if you choose not to use protection while having oral sex, you are more likely to catch STDs & other diseases from oral sex, including neurological conditions and cancer, especially if:

 

  • You’re the one performing oral sex
  • Ejaculation takes place inside the mouth
  • Your partner already carries an STD/STI

Herpes

Herpes, which can be caused by two strains of the herpes simplex virus — HSV-1 & HSV-2, leads to oral and genital herpes³ respectively. Both of these can infect either site. 

 

Therefore, unlike HIV, oral sex can readily transmit herpes infection from either partner.

 

If you’re receiving oral sex from your infected partner, this can affect your genitals and the surrounding area, including lips, mouth, buttocks, anus, rectum, and throat.

 

According to a source⁴ published in 2019 by the journal BMC Medicine,  the major chances of getting STD from oral sex come from HSC infections than sexual intercourse. 

 

Herpes comes with a variety of symptoms, including rash, fever, fatigue, pain, and itching, etc, and can be asymptomatic too and is spread via skin-to-skin contact also. 

 

This is when the risk of developing herpes significantly rises, especially when having sex without a condom (unprotected sex).

 

While herpes cannot be cured permanently, but can be well-treated with prophylactic medications, like Zovirax (acyclovir), which can help reduce the frequency of the infection. 

 

However, to prevent the likelihood of developing the infection, the following must be followed:

 

  • Having a safe, secure, and understanding relationship with your better half
  • Don’t accept the penis-to-mouth ejaculation⁵
  • Use dental dams and condoms to avoid transmitting the bacteria way before climax occurs
  • Use a new condom if you’re switching to penetrative sex after having oral sex
  • Maintain a proper hygiene⁶ before having oral sex

Human Papillomavirus (HPV)

The spread of human papillomavirus (HPV) during oral sex is very common. It is believed that the transmission of HPV is the major cause of throat and oral cancers and is the risk factor for recurrent respiratory papillomatosis⁷.

 

HPV can also transmit from mother to child during pregnancy.

 

As with herpes, it might seem that using dental dams or condoms while having oral sex should lower the risk of infection, but they’ll not entirely stop its transmission. 

 

This is because HPV transmits via skin-to-skin contact, not via bodily fluids. It can cause lung, neck, and head, and other HPV-related cancers⁵

Gonorrhea

If you’ve gonorrhea, you may have experienced a throat infection. While some individuals may be asymptomatic, it doesn’t mean one is immune to catching the infection. 

 

Yes, gonorrhea can easily spread through oral sex! 

 

Surprisingly, it can transmit in both directions when a penis receives oral sex, and the infection is infamously difficult to cure. 

 

However, in females, the spread of the infection is relatively less since the part that’ll get infected is the cervix, which is not normally contacted during cunnilingus. 

 

So, is unprotected oral sex safe?

 

It is not 100% risk-free without using dental dams and condoms — which are highly effective in preventing the spread of the disease during oral sex. 

Chlamydia

Among many STDs that are spread through oral sex, chlamydia — which is usually spread when receiving oral sex on the penis (fellatio), can affect both the partners, i.e, the recipient and the doer. 

Whether the infection is spread through cunnilingus has little evidence, however, gonorrhea being similar to chlamydia likely exhibits similar features.

 

Syphilis

The easiest one to spread via oral sex — yes you heard that right! 

 

Risks of giving or receiving unprotected oral sex to your better half who has syphilis can infect you.

 

This holds whether your partner has a rash or sore on the genitals and the surrounding area or the mouth and its surrounding area, respectively.

 

While some may show no symptoms in the primary and secondary stages of the infection or may have easy-to-miss painless sores, it is advised to get tested, especially if you’re sexually active. 

 

In the meantime, it is recommended to use dental dams and condoms during oral sex. However, if you’re infected, nothing is safer than refraining from any sexual activity.

Hepatitis B

Hepatitis B supports little evidence as to whether oral sex transmits the disease or not. However, oral-anal contact poses risk for hepatitis A infection. It may also pose a risk for hepatitis B.

 

Favorably, we’ve got vaccines⁶, for both hepatitis A and B, to prevent them. If you practice anilingus, talking to your doctor about getting vaccinated is a good idea. Vaccination is favorable in any case.

 

Currently, it is recommended to get all children and many groups of adults vaccinated for hepatitis B. 

Is oral sex safe to practice?

There is nothing 100% safe than avoiding oral sex, especially if you’re carrying an STI already to prevent its spread.

 

However, if you are sexually active, barrier methods are the only ways to save you against STIs during oral sex.

 

You may opt for using condoms (latex or rubber), and dental dams to prevent any penile, vaginal, or anal fluids enter your mouth. 

 

Since fluids are the carriers of the infection, ingesting the fluids is a big no-no, including semen, pre-seminal fluids, vaginal discharge, urinary or fecal matter. 

 

Also, it is mandatory to maintain proper hygiene before and after indulging in any sexual activity, including oral sex. 

 

It is also recommended to consult your doctor for STI prevention. 

 

They can help you diagnose, treat and prevent the spread of STIs effectively. 

 

Any over-the-counter medications might help, but you never know how many potential STIs you could be carrying at the same time. 

 

Thus, getting tested for multiple STIs would be the next best option.

 

How to reduce the risks related to oral sex

Like normal sexual intercourse, the best way to lessen the risk of oral sex is by abstaining from it (not having oral sex).

 

Avoiding oral sex specifically holds for the following conditions:

  • If your better half has an STI 
  • Has sore or blistered anus, mouth, or genitals
  • Has unhealed or active lesions inside the mouth
  • Carried a throat infection
  • (Most important) don’t ingest the genital discharge, including penile and vaginal fluids

 

However, if you suspect an STI, go to a doctor immediately. 

 

There they’ll recommend you use dental dams and condoms while having oral sex (or abstaining from it). 

 

STD/STI testing

“I just had unprotected oral sex”, what next? 

 

Testing is the next best option after abstinence, especially if you’re sexually active. 

 

The risk of contracting or spreading STDs isn’t uncommon through oral sex, just like with normal sexual intercourse. 

 

Examples: gonorrhea, herpes, chlamydia, and HPV. The risk of getting exposed to the infection involves the stage and maturity of a specific infection, and whether the infection exhibits any symptoms or not. 

 

For all these reasons, individuals need to go through regular testing for STDs. 

 

That way you’ll not only benefit yourself and your partner but also your overall sexual wellness. Be responsible. Get tested.

 

What May Boost the Chances of getting STDs Transmitted through Oral Sex?

Practically, some factors may increase a person’s exposure to getting HPV, HIV, or other STDs during oral sex with an infected partner.

These may include:

 

  • Having sub-standard oral health like gum disease⁷, tooth decay, or oral cancer
  • Having sore mouth or genitals or their surrounding area respectively 
  • Exposure to the pre-cum (pre-ejaculate) or cum (ejaculate) of the infected partner

 

However, there is little evidence to prove that these factors increase the exposure to catching anything like— HIV or STDs from oral sex. 

 

Common signs and symptoms of STIs

If you have had oral sex with your infected better half and suspect an STI, seek medical diagnosis if any of these symptoms or signs come under your notice:

 

  • Itching, bumps, sores, or blisters on or around genitals, mouth
  • Foul vaginal or penile discharge
  • Burning sensation while urinating
  • Painful sexual intercourse or bleeding while having sex
  • Prolonged periods in women
  • Testicular pain
  • Sore throat

 

For hepatitis A, which mostly affects the liver, you should watch for: 

 

  • Fever, flu-like symptoms, headaches, overall body pain, fatigue, and feeling unwell
  • Dark-colored urine
  • Yellowing of the skin and eyes (jaundice)
  • Pale feces
  • Diarrhea and vomiting, etc.

 

Sometimes these symptoms may go unnoticed, thus may not be treated on time, including sore throat after unprotected oral sex — which is often mistaken for a normal infection. 

 

However, all this can lead to long-term complications including infertility, blindness, mother-to-child spread of STIs, and even cancer⁸.  

 

Therefore, it is necessary to get treated and tested on time for your overall sexual health and wellness.

 

When to see a doctor

When it comes to STDs, they can be both symptomatic as well as asymptomatic. Also, catching STD/multiple STDs from oral sex is very common. 

 

Thus, an individual must go through testing whether or not they carry an STD, especially if they’re sexually active. 

 

One can go testing at a doctor’s clinic, a local health clinic, or via a home testing kit. 

 

The process commonly includes urine, a swab sample, or a blood sample collected by your nurse or by yourself.

 

Results often come up before 3 weeks on your registered email address or mobile number.

 

Now, would you advocate for exposure to oral sex? We don’t give a green light to this. 

   

References:

  1. https://www.hiv.gov/hiv-basics/staying-in-hiv-care/other-related-health-issues/sexually-transmitted-diseases

 

  1. https://medlineplus.gov/hivaids.html

 

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1871807/

 

  1. https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-019-1285-x

 

  1. https://www.google.com/search?q=HPV+.gov&oq=HPV+.gov&aqs=chrome..69i57j0l2j5l2.2298j0j4&client=ms-android-samsung-gj-rev1&sourceid=chrome-mobile&ie=UTF-8

 

  1. https://www.cdc.gov/vaccines/hcp/vis/vis-statements/hep-b.html

 

  1. https://www.mouthhealthy.org/en/az-topics/s/sexually-transmitted-diseases

 

  1. https://www.ashasexualhealth.org/stis-and-cance

 

 

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