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Oral sex

Oral sex can take place in various ways.

  • The woman can stimulate the man’s penis with her mouth and tongue (fellatio, blow job)
  • The man can stimulate the woman’s vulva with his tongue (cunnilingus)
  • One partner can stimulate the area round the other partner’s anus (rimming) with his or her tongue.

Are there any risks?

It is possible to catch infections by oral sex but, in general, the chances are probably lower than with penetrative sex. The risks also depend on whether you are the partner performing oral sex, or the partner who is having it done to them.

Risks to the partner performing oral sex

Gonorrhoea. It is quite easy to catch a gonorrhoea throat infection by performing oral sex on a man who has it. He will have some discharge from the urethral opening (the ‘pee hole’), and this discharge will be teeming with gonorrhoea bacteria. Unfortunately, the discharge is not always noticeable, so neither partner may be aware that he has the infection. Alternatively, he may have noticed a discharge previously, but may have assumed that the problem had cured itself.
 
Similarly, it might be possible to catch gonorrhoea throat infection by performing oral sex on a woman who has gonorrhoea.
 
Chlamydia. You can catch chlamydia in your throat by performing oral sex on a man who has it. A man who has a chlamydia infection may have pain passing urine and/or a discharge, or he may have no symptoms.
 
Warts. It is not a good idea to perform oral sex on a man who has genital warts. The warts may not be obvious – check around the edge of the head of the penis under the foreskin, and just inside the opening of the urethra (‘pee hole’). Although the risk is not great, a woman can develop a wart on the roof of her mouth as a result of oral sex. The wart may take weeks or even months to appear. If you develop one, go to your local genitourinary medicine clinic.
 
Similarly, it is possible for a man to develop a wart on his lips from performing oral sex on a woman who has genital warts. Again, if this happens, your local genitourinary medicine clinic is the place to go.
 
HIV. It is possible to catch HIV by oral sex. Although the risk is low, it is not absolutely safe, and oral sex with someone who might be HIV positive cannot be described as ‘safe sex’.
 
The body fluids of a person who has HIV (including semen and the natural fluids that lubricate the vagina) will contain the virus. Therefore HIV can infect the cells that line the mouth of the person performing oral sex, and then enter the bloodstream (Journal of Virology 2003;77:3470–6). The risk is likely to be greater for a woman performing oral sex on a man than the other way round. Withdrawing the penis before the man’s orgasm (ejaculation) would lessen the risk; however, when a man is sexually aroused, small amounts of semen leak out before ejaculation so infection could still occur.
 
Syphilis is uncommon in the UK, but is increasing. A study reported in the journal Communicable Disease and Public Health in 2001 found that many of the people infected were homosexual men who had oral sex without using a condom.
 
Mouth and throat cancer. Oral sex can lead to mouth or throat cancer, but the risk is tiny. The reason is that the genital area can be infected with type 16 human papillomavirus (HPV). This type of papillomavirus can cause mouth and throat cancers (New England Journal of Medicine 2007;365:1944–56).

Risks to the partner who is receiving oral sex

Herpes. Apart from being bitten, catching genital herpes from a cold sore on the face is the main risk. Cold sores are also infectious at the tingling stage before the sore has developed. If your partner has recurrent cold sores, he or she will recognize this tingling feeling, and should avoid performing oral sex until the sore has healed completely.
 
Chlamydia and gonorrhoea. In theory, it is possible to catch gonorrhoea or chlamydia by receiving oral sex from someone who has it in their mouth. Chlamydia and gonorrhoea in the mouth tends to be mainly at the back of the mouth (throat) and does not usually cause a sore throat or any other symptoms.
 
HIV. Contact between your genitals and the mouth of someone with HIV means that your genitals are in contact with their saliva, which will contain the virus. The amount of virus in the saliva would be very small and there would probably be a very low risk of infection, but it would not be absolutely safe.

Safe oral sex

  • Do not perform oral sex on a man who has a discharge, or has recently had one that was not treated.
  • Do not perform oral sex on anyone whose genitals look unhealthy or unclean.
  • If your partner has a cold sore on the face or lip, do not let him or her perform oral sex on you. Likewise, do not offer oral sex if you have a cold sore or think you might be getting one, or have any ulcers in your mouth.
  • Some experts say you should avoid mouth-to-genital contact unless you are very sure that your partner is HIV negative.
  • Avoid brushing your teeth beforehand, because this could open up cracks in the gum which would make it easier for infection (such as HIV) to enter.
  • Consider using condoms for oral sex. If you are concerned about infection during oral sex, but do not like the idea of condoms because of their off-putting rubbery taste, try flavoured ones. Textured, knobbed or ribbed condoms are not suitable for oral sex, because they can make the mouth sore.
  • Swallowing semen during oral sex is not harmful. The main risk of infection is in the mouth (see above). Swallowing semen is unlikely to increase the risk of HIV, because the stomach contains acid that destroys HIV.
  • ‘Rimming’ (licking round the anus) is not to be recommended. The lower bowel contains many bacteria and viruses, which could enter the mouth, even if the anal area is washed beforehand.

Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Saturday, February 13th 2010

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Comments on this article

Posted by Optional on 26/02/2010 at 10:45:20 pm

Great helpful information - clear and easy to read

Posted by Optional on 19/02/2010 at 05:27:19 am

Thank you for the insight, I never knew about all the risks that were involved in giving a blow job. My husband loves it too much and sometimes I give it to him without prior hygienic caution taken. Now I know how best I will be giving to him. Continue with the same good spirit.

Posted by Rodreguiz on 28/01/2010 at 04:27:00 pm

last month i took it in the anus from two gentlemen i met at the bus stop, i think one of them had a wart , but i wasnt sure.. what do they really look like?

Posted by mark on 06/11/2009 at 09:15:00 pm

I have had sum warts growing around my anus i have never had anal sex what can i do

Posted by Anonymous on 22/02/2009 at 04:27:00 pm

How long after having oral sex should u wait to get checked out if you think you may av cought a std?

Posted by amir chodhri on 20/02/2009 at 01:42:00 am

u people r doing a great job.God bless u.

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