Oral sex used to be a taboo subject, but these days it’s a common form of sexual activity. Oral sex means using your mouth, lips or tongue to stimulate your partner’s genitals or anus. Both men and women can give their partner oral sex.
You’ve probably heard oral sex called many names – ‘going down’, a ‘blow job’, ‘giving head’, a ‘69’ or ‘rimming’ (plus plenty more).
But oral sex has official medical names too: oral sex on a woman (the vagina, vulva and clitoris) is called cunnilingus, and oral sex on a man (the penis) is called fellatio. If oral sex involves the anus, it’s called anilingus.
Oral sex can be a natural and enjoyable part of sex between partners if both of you enjoy it and consent to it. You can give or receive oral sex as part of other sexual activity (like vaginal or anal intercourse) or on its own. But unprotected oral sex does come with risks.
The risks of oral sex
Many experts say oral sex is not safe sex. It may be ‘safer sex’ than unprotected genital sex in that you won’t get pregnant from oral sex alone, but unprotected oral sex still carries the significant risk of catching or passing on sexually transmissible infections (STIs).
Because oral sex usually involves sucking or licking your partner’s genitals or anus, you’re likely to come into contact with genital fluids or faeces and this puts you at risk of many STIs:
Generally, you’re more at risk of catching an STI from oral sex if:
- you give rather than receive oral sex – because you’re more likely to be exposed to genital fluids
- you have cuts, sores or ulcers in your mouth at the time
- you don’t use protection.
Another risk of oral sex is strain on your relationship, particularly if one of you doesn’t enjoy it or has concerns about it. One partner may have anxiety about their oral sexual performance or what their partner will think of them during oral sex. Or oral sex may make one partner feel under the other partner’s control. These are all important issues to resolve before introducing oral sex into your relationship.
STIs from oral sex
A range of sexually transmissible infections (STIs) can be associated with oral sex. Here are some of the most common ones.
Human papilloma virus (HPV) or genital warts
HPV is known as the virus that can cause cervical cancer in women. But HPV can lead to a range of other cancers too – such as throat or oral cancer or cancers of other parts of the genitals – and other serious diseases.
HPV is a common virus that can affect both males and females. It’s passed on through either genital or oral sex. HPV affects both heterosexual and same sex partners.
Some strains of HPV result in genital warts – soft growths that occur on the genitals – although it’s rare for genital warts to be passed to the mouth and lips through oral sex. Genital warts are very common, but can’t be cured. They may be treated with medications or surgery.
Sometimes HPV shows no signs or symptoms at all.
Your risk of HPV is higher the more partners you have. Contracting HPV doesn’t guarantee cancer, but US studies have shown more than 50 per cent of cases of oral cancer can be linked back to HPV, for instance. Men are more at risk than women.
If you suspect you have HPV or genital warts, talk to your doctor.
Herpes is a common STI that has two types: oral herpes (blisters and cold sores around your mouth or nose) and genital herpes (pain, itching and small sores on the genitals that turn into ulcers and scabs). You can catch either type of herpes from unprotected oral sex (and unprotected vaginal or anal sex too).
If your partner has cold sores around their mouth (oral herpes), they can pass these on to your genitals during oral sex. If your partner has herpes blisters around their genitals, they can pass these on to your mouth if you give them unprotected oral sex.
Sometimes you can have herpes but not have any symptoms. You can still pass on the disease through skin to skin contact.
Gonorrhoea, chlamydia, hepatitis B, hepatitis C
All of these STIs are caused by viruses or bacteria that can be passed on in the same way: through contact with infected bodily fluids, such as semen, pre-ejaculatory fluid, blood, or vaginal secretions. So oral sex puts you at risk for these diseases. HIV is also in this category (see more below).
You may be infected with one of these STIs if infected fluids come in contact with any sores, cuts, or ulcers you may have. The fluids can also get into inflamed cells on the lips, mouth, genitals or anus, the membrane of your eye, or the cells of your throat. This contact can allow the fluids to get into your bloodstream and make you sick.
Hepatitis A is a gut infection that’s passed on through contact with infected faeces. If oral sex includes licking or touching your partner’s anus, even if it looks clean, you may be at risk of this disease.
Experts say the risk of contracting HIV/AIDS from an HIV-positive person during oral sex is extremely low, but it’s difficult to know exactly because people often participate in vaginal or anal sex at the same time as oral sex (which, when unprotected, both offer a much greater risk than oral sex). The form of oral sex posing the greatest risk is mouth-to-penis oral sex.
The risk of contracting HIV/AIDS increases if you have sores in your mouth or on your vagina or penis, bleeding gums, mouth contact with menstrual blood, or other STIs.
Shigella gastroenteritis is a bowel infection caused by bacteria that is passed on through contact with infected faeces (poo). It can also be spread through sexual contact, especially during oral or oro-anal sex. Men who have sex with men are at particular risk.
Syphilis is a very serious condition if left untreated, but can be cured with the right treatment.
Symptoms come in three stages: a single sore (often painless), then a rash or sores (or both), then organ damage and possible death if left untreated. The late stage of syphilis may not develop for 10 to 30 years from when you were infected.
You can catch syphilis by coming into direct contact with a syphilis sore during vaginal, anal or oral sex. Sores may be on your partner’s penis, vagina or anus, in the rectum, or on their lips and in their mouth.
Pubic lice (‘crabs’)
Pubic lice or ‘crabs’ are tiny insects, found in the genital area, that feed on blood. They can cause intense itching. Pubic lice are spread during sex. They can be treated with over-the-counter medications.
How to reduce the risks of oral sex
Like any sex, the best ways to reduce the risks of oral sex are to abstain (not have oral sex) or to use protection.
Avoid oral sex if your partner:
- has an STI
- has sores, cuts, ulcers, blisters, warts or rashes around their genitals, anus or mouth
- has unhealed or inflamed piercings in their mouth or genitals
- has a throat infection
- is a woman and has her period.
You can’t reduce the risks of oral sex by using mouthwash or brushing your teeth – in fact brushing and flossing can cause abrasions on your gums which put you more at risk of contracting an STI. Also avoid getting semen or vaginal fluid in your eyes.
For oral sex on a man, use a condom during oral sex. For oral sex on a woman, or when performing anilingus on a man or a woman, use a dam. A dam is a small thin latex or plastic square that acts as a barrier between the vagina or anus and the mouth. It may prevent the spread of STIs. You can buy dams at some sexual health clinics, online or at your pharmacy.
Australia has high levels of STIs. See your doctor about testing if you become sexually active, change partners, or start a new relationship. Also see your doctor if you think you have any signs and symptoms of an STI, listed below.
Your partner should be tested if you decide to not use protection.
STI signs and symptoms to watch for
If you have had unprotected oral sex (or unprotected vaginal or anal sex), seek medical advice if you notice any of these signs or symptoms:
- itches, rashes, lumps or blisters in or around the genitals, vagina, anus or mouth
- unusual vaginal discharge
- discharge from the penis
- irritation, pain or burning when you urinate
- pain or bleeding during or after sex
- bleeding between periods
- pain in the testicles or lower abdomen
- a sore throat.
Hepatitis A, B and C affect the liver, so watch for:
- flu-like illness, such as fever, general aches and headaches
- tiredness and feeling sick, sometimes with vomiting and diarrhoea
- dark-coloured urine or pale faeces, or both
- jaundice (yellowing of the skin or eyes).
Even if you don’t have any symptoms, you may want to see your doctor if:
- you’ve recently had unprotected sex or oral sex with someone new
- you or your partner have unprotected sex with other people
- your partner has symptoms of an STI.
It’s important to get treatment for an STI as soon as possible. Some STIs can’t be treated but medications may reduce symptoms. Leaving an STI untreated may cause discomfort in the short term, and may harm your health or fertility in the long term.
Oral sex and young people
Many young people do not consider oral sex as sex, so they may take emotional or physical risks. Read more information for young people about safe sex, sexually transmitted infections (STIs) and teenagers and sex.
Lesbian and bisexual woman and oral sex
If you’re a woman having unprotected oral sex with another woman, you are still at risk of STIs, but some infections are more common among women than others.
Bacterial vaginosis (vaginal inflammation caused by bacterial overgrowth) is easily spread from woman to woman, but HIV/AIDS is much less likely to be passed on this way, for example. If you’re a lesbian or bisexual woman who has had sex with men, you’re more at risk of the full range of STIs. Talk to your doctor about testing if you’re concerned you may be at risk.
Homosexual men and oral sex
Sexually active gay, bisexual and other men who have sex with men are at greater risk of contracting or passing on an STI than other people. Men who have sex with men have higher rates of syphilis, and more than half of all new cases of HIV are in this community.
Not using condoms and having regular anal sex increase your risk. Talk to your doctor about testing if you’re concerned you may be at risk.
Where to get help