Can I really get something from oral sex?

Published:

Dr. Myrtle,

What are the real STD risks, if any, for a man if a woman performs oral sex on him without a condom? What can he catch from her that she might not know she has, even if she doesn’t have obvious sores, or she lies about knowing.... NEXT: Is there anything she could pass to him and neither of them know.....that he could then pass to someone else IF he had any sexual encounter with a second woman unprotected? What are the REAL risks to him, and then me, as the unprotected second woman? Let’s just get this all cleared up from the professionals once and for all.


Yes, let’s.

First, the real infection risks are that the following infections (listed generally from most common to least) have been documented as transmitted from a woman, performing oral sex without barrier protection on a man, to a man’s genitals:

Viral infections:

  • Human Papilloma Virus (HPV),
  • Herpes Simplex type 1 and 2,
  • Hepatitis A, B, and C,
  • Human Immunodeficiency Virus (HIV).

Non-Viral infections:

  • Chlamydia,
  • Gonorrhea,
  • Syphilis,
  • Strep B
  • different types of mycoplasma,
  • Chancroid (Hemophylis dycreii)

There are more, but that’s just the quick list.

But which one’s of those are transmitted by women who don’t think they’re infected, and have never had any lesions or drainage or smell???

All of them.

You mean, as the second unprotected woman, I am exposed potentially to *ALL* of those infections--even if he doesn’t have any lesions?!?!?

Yes, you are, as any future partner is. Does he know he’s infected? Nope, not unless he is tested, and even then most professionals rely on 2-3 negative tests, because sample collection and laboratory tests are NEVER 100% accurate. Most people do not know that they have sexually transmitted infections, because most infections have no symptoms. Period.

Sexually transmitted infections are at EPIDEMIC proportions in the United States. Our naive willingness to believe that we can diagnose infections by giving a visual scan (“Nope. Looks good to me.”) pushes this ridiculous and dangerous infection transmission ever onwards. I see your unwillingness to believe that there are risks in the way you ask questions, and being closed to the possibility of infection *increases* your risk because you aren’t going to protect yourself from something you don’t think *you’re* going to get.

Well, which ones of those are transmitted from men having oral sex with women’s unprotected genitals?

All of them. This infection transmission stuff isn’t determined by gender--the microbes don’t care about your gender. Sure, women are more likely to be diagnosed with bacterial vaginosis after oral sex than men are, but that has more to do with the nature of women’s sensitive vulvar gardens/natural flora than infection transmission, per se.

So, let’s just get this all cleared up by the medical professionals once and for all.

I couldn’t agree more. You are at risk of becoming infected by a partner who is having unprotected oral sex with someone else. All of the listed viruses and bacteria live comfortably in the mouth and throat just as much as they do in the genitals. Getting tested before or after any unprotected exposure, using barriers when you don’t want to be exposed yourself, and selectively choosing partners and behaviors are your routes to remaining infection free. If the mouth and throat are the area of contact, make sure to tell your health care provider to test your throat (unless the collection is urine or blood).

If you don’t want to be infected by this partner, you can re-design your relationship so that after testing (if he’s already been exposed), you two decide what exposures you’re willing to have. If he wants contact that you don’t want to be exposed to, you have to protect yourself from him either with barriers and lube (to keep the barriers from breaking), or protect yourself by not being intimate with him. If he has oral sex with another person (his mouth), you are at risk for infection just by kissing him.

Get your head out of the sand, and start taking care of yourself. No one can do that for you, except you.

Note to Health Care Providers:

Some people are beginning to wonder whether the increase in oral play (as a direct or indirect result of abstinenence curriculum) is playing a role in the year-by-year increase in STI's. As financial pressures squeeze clinic dollars, many people are never tested in the throat for STI's, even though data shows that more than half of US graduating high school seniors have participated in oral sex. If someone has an infection in their throat/mouth but has never been tested there, the infections continue to be passed between partners. Solutions: Ask about oral play as a part of the sexual repetoire, and test the throat if needed. Step up and be a part of the STI solution.

Dr. Myrtle