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Oral Sex

Truths and myths of oral sex
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Truths and myths of oral sex 

Is it true that oral sex is generally safe and one no longer has to worry about spreading germs and infections? Do I need to consider any testing for sexually transmitted diseases (STDs) if I engage in oral sex?

According to the Centers for Disease Control and Prevention (CDC) [1], more than 80% of sexually-active adults between the ages of 18-44 years old, reported having oral sex at least once with a partner of the opposite sex, suggesting a common sexual orientation in our current population. 

oral sex
More than 80% of sexually active adults have engaged in oral sex at least once.

What are my risks if I engage in oral sex?

The risks of acquiring sexually transmitted diseases (STDs) through oral intercourse depend on the type of sex, number of sexual activities/partners, and what type of STDs (certain STDs may have a higher risk of transmission).

As everyone has different sexual lifestyle habits, it is worthwhile to pay a visit to your doctor to discuss your lifestyle and understand your risk factors. If there are risks involved, your doctor can guide you further to consider screening for infections.

A few facts worth reminding ourselves when engaging in oral sex:

  • STDs CAN occur without any symptoms. 
  • People CAN live with STDs for years without symptoms and testing. 
  • Hence, it is always possible of acquiring STDs from a sexual partner even if the person is without any symptoms.
  • You CAN get STDs in the oral/throat region if you give oral sex to a person who has genital/anal STD.
  • You CAN get STDS on the genital region if you receive oral sex from a person who has oral/throat STDs.
  • You CAN get STD in the vagina/penis or anus or throat/mouth (more than 1 region) simultaneously.

What STDs can be spread during oral sex?

Types of STDsTransmission through oral intercourse
HSV (Herpes Simplex Virus)Yes
ChlamydiaYes
GonorrhoeaYes
HPV (Human Papillomavirus)Yes
SyphilisYes
TrichomonasYes

You are advised to discuss with your doctor to consider screening for the above STDs if you do engage in oral sex and there is a possibility of acquiring STDs. Prompt treatment can be offered for most of the STDs above, hence do not hesitate to reach out to your trusted doctor.

STD counselling
Sexually transmitted diseases must be treated promptly to prevent serious side effects from occurring.

Am I at risk of acquiring incurable STDs with oral sex?

Although the risk of acquiring incurable STDs such as human immunodeficiency virus (HIV) and HSV from oral intercourse is low, one is not completely safe from acquiring these infections.

In the case of HSV transmission, HSV can be transmitted through direct contact.

In the case of HIV transmission, the general consensus is that the risk of transmission is low (in comparison to vaginal or anal penetrative sex) however due to a lack of studies, the risk cannot be fully eliminated. 

If you are at risk of acquiring STDs from oral intercourse, you are encouraged to reach out to your doctor for early testing and treatment.

Is oral sex safer than other types of sex?

The safety comparison of different sexual practices is not fully studied in the medical literature. Most people who engage in oral intercourse are also involved in other penetrative intercourse such as vaginal and anal sex. The risk of a person who engages in oral sex depends on the number of sexual activities/partners and the risk of the sexual partner as well.

Oral STDs such as chlamydia and gonorrhoea have higher risks of systemic disease as they are less often tested and hence delayed in their treatment. To further exacerbate things, persistent untreated STDs including chlamydia and gonorrhoea generally increase the risk of contracting HIV.

Engaging in high-risk oral intercourse can also possibly lead to cancer. It is clinically proven that HPV infection in the oral/throat region increases the risk of mouth and neck cancer [2,3].

safe sex
Sex, in general, is a risk factor for STDs especially if you engage in risky behaviour such as having multiple sexual partners and not practising safe sex.

What are the risk factors for acquiring STDs through oral sex?

Risk factors for developing STDs through oral intercourse include:

  • Poor oral or dental hygiene (gum disease, periodontal disease, tooth caries, etc.)
  • Open wound/sores in the mouth or genital region
  • Exposure to body fluid 
  • Sexual partner’s risk factor

What can I do to reduce the risk of acquiring STDs from oral sex?

The best way of preventing STDs is abstinence, other ways in which you can reduce your risk include:

  • Barrier contraception such as condoms
  • Long-term monogamous relationship 
  • Reduce the number of sexual partners
  • Regular STD testing/screening/treatment
  • HPV immunisation vaccination

Key take-home message

Oral sex may not be as safe as you wish. It is imperative to note that STDs can go unrecognised and hence untreated for years as most people have no symptoms and are unaware of their infectious status.

Speak to your doctor today. Understand your sexual risks, screen for infection, consider immunisation vaccines for prevention, and seek early treatment if required.

References

  1. National Center for Health Statistics. (2017, August 14). Key Statistics from the National Survey of Family Growth - S Listing. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/nchs/nsfg/key_statistics/s.htm
  2. N. Sathish, X. W. (2014). Human Papillomavirus (HPV)-associated Oral Cancers and Treatment Strategies. Journal of Dental Research, doi: 10.1177/0022034514527969.
  3. Luca Giraldi, G. C. (2021). Infection with Human Papilloma Virus (HPV) and risk of subsites within oral cancer. Cancer Epidemiology, doi: 10.1016/j.canep.2021.102020.

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