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If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
Oral sex, whether mouth-to-penis, mouth-to-vulva, or mouth-to-anus, may have garnered a reputation as being a “safer” form of sex, but in reality, you can still get and give STDs (sexually transmitted diseases) during oral sex. Luckily, there are measures you can take to prevent STDs (or STIs, if we’re being accurate) no matter what type of sex you’re having.
Can you get an STD from oral sex?
Sexually transmitted diseases can pass from one person to another through semen, vaginal secretions, saliva, and direct contact with exposed lesions, and that includes contact during oral sex.
While every type of infection is different, it is possible to catch or transmit herpes, HPV, chlamydia, syphilis, and other sexually transmitted infections when giving or receiving oral sex.
Sometimes the likelihood of infection changes based on gender and practice, for example, the risk of transmitting HIV from oral sex is very low, but the risk is highest from mouth-to-penis oral sex. Still, even with low risks of transmission, it’s always a good idea to practice safe oral sex using a dental dam or condom and get tested frequently if you or your partners have other partners or you haven’t each been tested since you became exclusive.
What STDs can you get from oral sex?
There are types of STDs passed through oral sex that affect the mouth or throat. But there are also STDs that cause systemic infections that can affect your whole body, and you can also get through oral sex. These STIs include:
Chlamydia is a bacterial infection that can spread through vaginal, anal, and oral sex. Both the person giving and the person receiving oral sex can contract chlamydia. When someone acquires oral chlamydia, the infection can affect the cavity behind the nose and mouth, causing a sore throat (Mohseni, 2021). A person with oral chlamydia can transmit it, too, resulting in a genital infection for their partner.
STI vs. STD: what’s the difference?
Common symptoms of chlamydia include pain during sex, changes in vaginal discharge, and symptoms of a urinary tract infection (like a burning sensation when peeing, a feeling like you need to pee even when you don’t, and more).
The real danger with chlamydia is that around 85% of people who have the infection may have no symptoms at all. That can result in long-term complications like pelvic inflammatory disease, which can affect fertility and can be difficult to prevent without regular testing to diagnose the condition.
Luckily, though, treatment is relatively straightforward once it’s detected and involves a simple course of antibiotics.
Human Papillomavirus (HPV)
While HPV has made a name for itself as the agent that causes cervical cancer in women, both men and women can carry and transmit HPV. There are over 100 types of HPV, and certain kinds more predominantly cause genital warts or oral (pharyngeal) warts, while others are associated with different types of cancer.
But many people with HPV have a latent infection, which means the infection is dormant and doesn’t cause any visible symptoms (Luria, 2021). The best defense against HPV is getting vaccinated and getting annual cervical examinations and pap smears if you have a uterus. If you have anal sex and are positive for HIV, there’s also value in getting evaluated periodically for the presence of anal cancer (Palefsky, 1998).
Herpes Simplex Virus Type 1 (HSV-1)
HSV-1 is commonly referred to as “oral herpes” and is known for causing cold sores on the mouth and lips, but it can affect the genitals, as well. This infection passes through contact with herpes sores which can appear on the mucosa, which are the wet surfaces that include your lips and nostrils, as well as the vulva, penis, and anus.
Once a person has herpes, there is no cure, but for the most part, our immune systems can keep the infection under control. During times of physical or emotional stress, a person with herpes might notice an increase in the frequency of outbreaks.
If you have herpes, it’s best to avoid sexual contact during outbreaks since it can be transmitted through oral sex, penetrative sex, and kissing (Saleh, 2021). If you have frequent or severe outbreaks, there are medications available that can reduce the frequency and keep herpes at bay, such as oral valacyclovir tablets.
Is there a cure for herpes?
Herpes Simplex Virus Type 2 (HSV-2)
HSV-2 is often the virus that causes genital herpes, but like HSV-1, it can affect your mouth and lips as well as your genital area. Just like HSV-1, HSV-2 is spread through close contact (vaginal, anal, or oral sex) with someone who has a herpes lesion. But even someone with herpes who is asymptomatic can pass the virus through sexual contact (CDC-b, 2021).
Much like HSV-1, getting your outbreaks under control using medications and mitigating triggers can help.
Gonorrhea is the second most commonly spread STI in the United States, with roughly 500,000 cases diagnosed each year. Like chlamydia, gonorrhea can infect the cavity behind the nose and mouth when transmitted through oral sex. People with oral gonorrhea may experience no symptoms (Springer, 2021).
If a person has oral gonorrhea, they can also transmit it to a partner resulting in a genital infection. Symptoms of gonorrhea include foul-smelling discharge from the vagina or penis, genital itchiness, and if the infection spreads to the urethra (the tube that carries urine from your bladder out of your body when you pee), it can cause symptoms of a urinary tract infection as well.
Like with chlamydia, the treatment for gonorrhea is luckily very straightforward, and the infection typically resolves quickly with antibiotics.
Syphilis is an infection that, without treatment, can progress through different phases and affect multiple systems of the body. When this infection spreads to someone’s mouth or throat, they may experience painless ulcers, called chancres, in their mouth or their throat (Tudor, 2021; Fernández-López, 2017).
Cold sores and oral sex: what you need to know
A person with syphilis in their mouth can spread the infection to another person when giving oral sex. Genital symptoms of syphilis include the same painless sores that can appear in the throat or mouth, as well as body rashes, weight loss, muscle pain, swollen lymph nodes, and more.
Regular testing can lead to prompt treatment, and like chlamydia and gonorrhea, it involves a quick course of antibiotics.
Hepatitis B is a viral infection that can lead to liver damage. It can spread through blood, semen, and vaginal secretions—meaning you can get it (or give it) through oral sex, though the risk is highest with analingus (mouth-to-anus) oral sex.
Many people are vaccinated against hepatitis B. Most people who catch it will have a mild viral illness that will resolve on its own, but a small proportion of people can develop a more serious infection that can cause liver damage or even liver cancer. Someone with this infection may show no symptoms (Tripathi, 2021).
If you suspect you may have been exposed to hepatitis B, you can get tested at a clinic or Planned Parenthood in your area or request a test from your healthcare provider.
Human Immunodeficiency Virus (HIV)
It is possible to spread HIV (the virus that causes AIDS) through oral sex, but the chances are low. If the person performing oral sex has mouth ulcers or bleeding gums, the infection can enter the body through these areas. The risk of transmission is also higher if the person receiving oral sex has genital or anal sores (CDC-a, 2021).
Regular testing for people who engage in high-risk practices, like unprotected sex with multiple partners or intravenous drug usage, is a good idea. You can also take measures to prevent infection, such as using PrEP.
PrEP’s role in reducing HIV transmission rates
How to get tested for an oral STI
Your healthcare provider can test you for orally transmitted STIs. If cost is a concern, there are many free or low-cost testing options through health clinics.
The exact tests a healthcare professional does will depend on what STIs they suspect. Many STIs require a swab of the mouth or throat for testing. If you have lesions or sores, your healthcare provider will swab those. If you have genital sores or systemic symptoms such as fever or joint pain, your healthcare provider may also choose to do additional testing (Garcia, 2021).
Some STIs, such as HIV and syphilis, are diagnosed using a blood test (Garcia, 2021). They may decide to start you on treatment before your results are available if they are confident in your diagnosis, and they may adjust that treatment once the results are available.
When to see a healthcare provider
Frequent STI screening is a good option for some people. You should see a healthcare provider for STI screening if you:
- Have multiple partners or frequently change sexual partners
- Have persistent genital itching, burning, discharge, or discomfort
- Notice bumps, blisters, or sores in your mouth or on your genitals or anus
Can STDs cause infertility in men and women?
Chlamydia, gonorrhea, and syphilis are all curable STIs. Getting an early diagnosis and treatment can help you avoid severe symptoms and prevent the infection from spreading to others. Even if you contract an STI that isn’t curable, early intervention and management can help prevent serious complications.
To reduce your risk of contracting an oral STI, remember to practice safe oral sex by using internal or external condoms or dental dams. Additionally, consider asking your healthcare provider how often they recommend STI screenings.
- Centers for Disease Control and Prevention (CDC). (2021-a). Ways HIV can be transmitted. Retrieved Feb. 15, 2022, from https://www.cdc.gov/hiv/basics/hiv-transmission/ways-people-get-hiv.html
- Centers for Disease Control and Prevention (CDC). (2021-b). Std Facts – genital herpes (detailed version). Retrieved Feb. 18, 2022 from https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm
- Fernández-López, C. & Morales-Angulo, C. (2017). Otorhinolaryngology manifestations secondary to oral sex. Acta Otorrinolaringologica (English Edition), 68(3), 169–180. doi: 10.1016/j.otoeng.2016.04.014. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S2173573517300455
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- Mohseni, M., Sung, S. & Takov, V. (2021). Chlamydia. [Updated Dec. 12, 2021]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK537286/
- Palefsky, J. M., Holly, E. A., Ralston, M. L., Arthur, S. P., Jay, N., Berry, J. M., et al. (1998). Anal squamous intraepithelial lesions in HIV-positive and HIV-negative homosexual and bisexual men: prevalence and risk factors. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology : official publication of the International Retrovirology Association, 17(4), 320–326. doi: 10.1097/00042560-199804010-00005 Retrieved from: https://pubmed.ncbi.nlm.nih.gov/9525432/
- Saleh, D., Yarrarapu, S. & Sharma, S. (2021). Herpes Simplex Type 1 [Updated Aug. 31, 2021]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482197/
- Springer, C. & Salen, P. (2021). Gonorrhea. [Updated April 26, 2021]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK558903/
- Tripathi, N. & Mousa, O. (2021). Hepatitis B. [Updated July 18, 2021]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK555945/
- Tudor, M. E., Al Aboud, A. M. & Gossman, W. (2021). Syphilis. [Updated Oct. 18, 2021]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK534780/
Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.