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For much of our culture, oral sex is a taboo topic—something too private and personal to discuss openly—but that silence has resulted in a dangerous lack of knowledge. When it comes to your health, ignorance isn’t bliss. In fact, it can be costly and painful. For the sake of your health and safety, you need to know the risks of oral sex.
What Is It?
Oral sex is contact of one person’s mouth or tongue with the genitals of another
person.
Who’s Doing It?
Oral sex is fairly common among American adults. In a national survey from the
early 1990s, three out of four adults said that they had tried oral sex. One out
of four said they practiced oral sex the last time they had sex. In this same
survey, unmarried persons, college students, and Whites and Hispanics were more
likely than others to say that they practiced oral sex.
Due to understandable sensitivities, there are fewer data available about how common the practice is among teenagers. Anecdotes from educators and counselors suggest that oral sex is becoming common in both middle school and high school, even among many who consider themselves virgins. In one study of 12- to 15-year-olds, about one of every six students said they had tried oral sex (including many who had never had vaginal sex). In a study of senior high students, more than four out of five nonvirgins and one out of five virgins had tried oral sex. Teens exposed to drugs and alcohol are particularly likely to try oral sex.
Is It Sex?
There is widespread confusion about whether oral sex is sex. In one study, one
third of college students believed that oral sex was abstinent behavior.
However, if sexual activity is defined as bodily contact meant to give or derive
sexual gratification, then it is clear that oral sex is sex.
Is it Safe?
Another misconception about oral sex is that it’s “safe.” This is a
dangerous myth. Although pregnancy is not an issue with oral sex, a wide variety
of STDs (sexually transmitted diseases) can be spread through oral sex. Some of
them are painful. Some of them are untreatable. And some of them can be deadly.
Oral Sex and Syphilis
Syphilis is a highly contagious STD. Transmission usually occurs during
vaginal, anal or oral sex when syphilitic sores or patches come into contact
with slightly abraded skin or mucous membranes. Left untreated, syphilis can
progress from painless ulcers to a rash, heart disease or memory loss, and
death. While penicillin is a highly effective treatment, it cannot reverse
damage already done by the disease. Oral sex is an efficient way to transmit
syphilis, and has played an important role in a number of recent syphilis
outbreaks.
Oral Sex and Gonorrhea
Gonorrhea is a very common, highly contagious STD that is passed through
contact with infectious fluids. Gonorrhea can cause pelvic inflammatory disease
(PID) in women, which can lead to abdominal pain and infertility. Infected
pregnant women are at increased risk for miscarriage and premature births, and
their infants can have serious eye infections. Gonorrhea survives well in the
throat, and gonorrhea throat infections from oral sex are relatively common.
Most people with throat infections have vaginal or penile infections as well.
Although most throat infections from gonorrhea cause no symptoms, you can
develop a sore throat, fever and swollen lymph nodes.
Oral Sex and Genital Herpes
Herpes simplex-1 (HSV-1) and herpes simplex-2 (HSV-2) are very similar
viruses that are transmitted by direct contact. In the past, most cold sores
were caused by HSV-1 and most genital herpes was caused by HSV-2. Genital
infections cause painful blisters, ulcers and difficulty while urinating and can
recur for a whole lifetime. Although ongoing therapy can reduce the number and
severity of recurrent infections, there is no cure. Genital infections acquired
during pregnancy can cause encephalitis (brain swelling), retardation and death
in newborns. Both HSV-1 and HSV-2 can be spread from an infected person to an
uninfected person even if the infected person has no visible sores. Both viruses
are easy to spread through oral sex. Oral sex appears to be changing how many
people get herpes and where they get it. In one study of STD clinic attendees,
those who had oral sex during the preceding two months were three times more
likely to have genital HSV-1 than HSV-2.10 This is the opposite of what used to
be seen, when most genital infections were caused by HSV-2.
Oral Sex & Chlamydia
Chlamydia is the most common bacterial STD in the U.S. It is particularly
common among sexually active youth. In addition to vaginal sex, chlamydia
appears to be transmissible through oral sex. In one study of persons in an
STD clinic, one of every 30 patients had a throat culture positive for chlamydia.
Women who practiced oral sex were three times more likely to have chlamydia in
their throats than other women.
Oral Sex & HPV
Human papillomavirus (HPV) is the most common viral STD and is transmitted by
skin-to-skin contact. Genital warts are caused by some types of HPV and cervical
cancer is caused by other types. Cervical cancer kills more than 4,000 women
each year in the U.S. HPV appears to be transmissible by oral sex. Adults
with recurrent respiratory papillomatosis (a throat condition that causes
hoarseness) were more likely than uninfected adults to have practiced oral sex.
Oral Sex & HIV
HIV is transmitted through contact with infected blood or body fluid.
Infected pregnant women can pass it to their babies. The virus invades the
immune system and destroys it over time. The destruction of the immune system
reduces a person’s ability to fight off infections and cancer. People with HIV
eventually develop AIDS, which is often fatal. When first infected, you may only
have flu-like symptoms (feeling tired, feverish or achy) that last a little
while. You may have no other symptoms for years. If you go on to get AIDS, you
may get multiple infections that other people fight off easily, such as
tuberculosis, pneumonia and yeast infections. Anal sex, multiple partners or
shooting drugs are particularly high-risk activities. Transmission of the
virus also occurs during vaginal and oral sex. Recent estimates of the
proportion of new HIV cases attributable to oral sex range from less than 1
percent to 7 percent.
Conclusion
Despite widespread misconceptions, oral sex is risky sexual activity that
puts participants at risk for a number of STDs.
If you’ve already been sexually active outside a lifelong mutually faithful
relationship (as in marriage), talk to your healthcare provider about getting
you and your partner tested for STDs. Abstinence from sexual activity—including
oral sex—or lifetime faithfulness to one uninfected partner is the only certain
way to avoid being infected.
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