Oral Sex – What You Should Know…

If you can’t get pregnant through oral sex, then it must be safe…right?

Here are the facts. Judge for yourself whether it is a “big deal” or not.

But first, let’s define what we are talking about.

What is oral sex?

Oral sex is the contact of on person’s mouth or tongue with the genitals of another person.

Is oral sex really sex?

There is this idea out there that oral sex isn’t really sex. What they say is “real sex” or sexual intercourse, is technically called “coitus” (or vaginal sex – the penetration of the male genital into the female vagina). However, almost any dictionary contains the secondary definition for sexual intercourse: “Intercourse involving genital contact between individuals other than penetration of the vagina by the penis.”³ In other word, any contact is “sex”. Oral sex is really sex.

Am I still a “virgin” if I have oral sex?

The word dates back to the 13th century and has had many meanings. At one time, it meant simply “an unmarried woman”. Today, certainly one definition is one who has not had sexual intercourse.⁴ Sexual intercourse could include oral, anal and vaginal sex. Other people insist that the term “virgin” applies to anyone who hasn’t had coitus. But maybe it’s the next question that is the most important.

Is oral “sex” practicing abstinence”?

You hear so often that the only way to prevent the spread of sexually transmitted diseases (STDs) is to practice sexual abstinence while you are single. What about  oral sex? Here, the definition is clearer. Recent efforts to decrease teenage pregnancy and disease have resulted in “abstinence only” curriculum. “Abstinence” means “abstaining” from (not participating in) any sexual activity including oral, anal or vaginal sex or mutual masturbation. Anywhere genital contact is involved, a person is not practicing abstinence and puts themselves at risk.

Is oral sex “safe sex”?

On this point, everyone agrees. Oral sex, like other methods of sex, carries with it the risk of serious, untreatable and even life-threatening diseases in both men and women. Oral sex has been found to spread syphilis, gonorrhea, HIV (HIV causes AIDS), HPV, genital herpes, chlamydia and possibly hepatitis C. ^5,6,7 Below is an overview of some of these STDs.

HPV – Human papillomavirus

This is a group of more than 100 different viruses. Most infections clear themselves. However, some HPV viruses are “high-risk_ types, which may lead to cancer of the cervix, vulva, vagina, anus or penis. About 20 million people are currently infected with HPV with 6.2 million new infections each year.⁸ At least 50 percent of sexually active men and women will have genital HPV infection at some point in their lives. HPV spreads primarily through genial contact. Most HPV infections have no symptoms so most people are unaware they are infected. Some people get visible warts on the genitals that can spread to the mouth by oral sex. There may also be changes in cells of the cervix, vulva, anus or penis that could lead to cancer. About 10 of the genital HPV types can lead to the development of cervical cancer. The American Cancer Society estimated that in 2008 in the United States, about 11,070 women would develop invasive cervical cancer and about 3,870 women would die from this disease.⁹ A new vaccine which will protect against four types of HPV viruses was approved by the FDA in June, 2006. But, because the vaccine does not protect against all cancer causing types of HPV, about 30% of the cases of cervical cancer cannot be prevented by the vaccine.¹⁰

Syphilis

In the U.S., over 40,920 cases of syphilis were reported in 2007.⁷ Syphilis is passed by direct contact with sores that occur mainly on the genitals, vagina, anus, in the rectum or on the lips or in the mouth. Syphilis can spread during vaginal, anal or oral sex. Many people infected with syphilis do not have symptoms for years, but are at risk for later complications if they are not treated.

During the primary stage of syphilis one or more sores appears. During the second stage, skin rash and mucous membrane lesions (wounds) occur. In the late stages, it may damage internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones and joints. Syphilis can be cured in the early stages (infected less than a year) by a single injection of penicillin, but this cannot undo damage done before treatment.

Gonorrhea

An estimated 700,000 people in the U.S. are infected each year.⁶ Gonorrhea is spread through contact between the penis, vagina, mouth (oral sex) and anus. In the U.S., the highest rates are among sexually active teenagers, young adults and African Americans. Symptoms in men include a burning sensation when urinating or a white, yellow or green discharge from the penis. In women, the symptoms are often mild or absent.

Untreated gonorrhea can cause permanent health problems. In women, it can cause pelvis inflammatory disease (PID) with very severe abdominal pain, fever and long-lasting, chronic pelvic pain. PID can cause infertility or ectopic (tubal) pregnancy. In men, gonorrhea can cause a painful condition of the testicles that can lead to infertility if left untreated. Several antibiotics can cure gonorrhea, although drug resistance strains are developing world-wide.

HIV/AIDS

HIV (human immunodeficiency virus) is the virus that causes AIDS. This virus may be passed from one person to another through sexual and blood-to-blood contact. The estimated number of AIDS cases through 2006 in the U.S. is 1,106,400¹¹ with 583,298 deaths through 2007.12  The most common ways that HIV is transmitted from one person to another is by having anal or vaginal sex with an HIV-infected person. However, it can also be spread through oral sex. AIDS (Acquired Immunodeficiency Syndrome) is a disease caused by the HIV virus that weakens the immune system. It is a routinely fatal disease.

“In a recent survey, 41% of teens 15-17 years though you couldn’t get HIV from oral sex, or were unsure if you could”¹³

GENITAL HERPES

Genital herpes is caused by the herpes simplex viruses type 1 and 2. Type 1 is often associated with oral herpes infections, type 2 with genital herpes. However,the strains are now intermixed. Oral sex is an important risk factor for Type 1 infections. Most people have few symptoms. Others have one or more blisters on or around the genitals or rectum. At least 45 million people ages 12 and older have had genital herpes infection (1 in 5 adolescents and adults). Most people infected with Type 2 are not aware of their infection. If symptoms do occur during the first outbreak, they can be quite pronounced. In many adults genital herpes can cause painful genital sores that reoccur. Worldwide, herpes may play a role in the spread of HIV.

CHLAMYDIA

Chlamydia can be spread during vaginal, anal or oral sex and can affect men and women. It can also be passed from an infected mother to her newborn during vaginal childbirth.  More than 1,030,911 cases were reported in 2006, with most of the people infected under the age of 25. Many people have no symptoms. Some women might have an abnormal vaginal discharge or a burning when urinating. When the infection spreads, some women may have lower abdominal or back pain, nausea or fever. Chlamydia can be treated and cured with antibiotics. If not treated, the infection can cause an infection called pelvic inflammatory disease (PID) up to 40% of the time. PID can cause permanent damage to the fallopian tubes, uterus and tissues surrounding the ovaries. Chlamydia may also increase the risk of acquiring HIV infection (HIV causes AIDS) from an infected partner.

How Can STDs be Prevented?

While condoms have been shown to reduce the risk of some sexually transmitted diseases during vaginal sex, much less is known about their effectiveness in oral sex. The surest way to avoid infection with any sexually transmitted disease is to practice sexual abstinence (abstain from any sexual contact, including oral sex) while single. If you marry, select a partner who is not infected with an STD and remain sexually faithful during marriage.

 If you have had oral sex and have not been tested for STD’s please call Informed Choices today for STD testing.

Sources and Resources

1.  Mosher, W. et. al., Advance Data from Vital and Health Statistics, National Center for Health Statistics, Number 362, September 15,2005, p. 34, found at :http://www.cdc.gov/nchs/data/ad/ad362.pdf,accessed 6-23-09.

2.  Remez L, “Oral Sex Among Adolescents: Is It Sex or is It Abstinence?” Family Planning Perspectives 32(6) November/December 2000, found at: http://www.guttmacher.org/pubs/journals/3229800.html,accessed 6-23-09.

3.  “sexual intercourse.” Merriam-Webster Online Dictionary. 2006-2007.http://www.merriam-webster.com, accessed 11-24-08.

4.  “virgin.” Merriam-Webster Online Dictionary. 2006-2007.http://www.merriam-webster.com, accessed 11-24-08.

5.  Edwards, S., Carne, C., Oral sex and the transmission of viral STIs, Sexually Transmitted Infections, 1998,74(1)6-10.

6.  Disease information: Centers for Disease Control and Prevention, National Center for HIV,STD and TB Prevention Division of Sexually Transmitted Diseases, Fact Sheets found at: http://www.cdc.gov/STD/HealthComm/fact_sheets.htm,accessed 6-23-09.

7.  Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2007. Atlanta, GA: U.S. Department of Health and Human Services,found at: http://www.cdc.gov/std/stats07/tables/1.htm,accessed 6-23-09.

8.  Centers for Disease Control and Prevention, Department of Health and Human Services, National Center for HIV,STD, and TB Prevention , Division of STD Prevention, Division of Sexually Transmitted Diseases, Fact Sheet, Genital HPV Infection, found at: http://www.cdc.gov/STD/HPV/STDFact-HPV.htm accessed 6-23-09.

9.  American Cancer Society. Cancer Facts & Figures 2008. Atlanta,Georgia: American Cancer Society; 2008. Found at http://www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf, accessed 6-23-09.

10.  Centers for Disease Control and Prevention, National Center for HIV,STD and TB Prevention Division of Sexually Transmitted Diseases, HPV Vaccine Information for Young Women, found at: http://www.cdc.gov/std/hpv/STDFact-HPV-vaccine-young-women.htm, accessed 6-23-09.

11.  MMWR Mortality and Morbidity Weekly Report. October 3,2008, Vol. 57, No. 39. page 1073, found at: http://www/cdc.gov/mmwr/preview/mmwrhtml/mm5739a2.htm, accessed 6-23-09.

12.  Centers for Disease Control and Prevention, National Center for HIV/STD and TB Prevention, Divisions of HIV/AIDS Prevention, Basic Statistics, found at: http://www.cdc.gov/hiv/topics/surveillance/basic.htm accessed 6-23-09.

13.  Centers for Disease Control and Prevention, National Center for HIV/STD and TB Prevention, Divisions of HIV/AIDS Prevention, HIV/AIDS, Update Preventing the Sexual Transmission of HIV, the Virus that Causes AIDS What You Should Know about Oral Sex, found at: http://www.cdcnpin.org/Updates/oralsex.pdf, accessed 6-23-09.