Oral sex refers to oral (mouth and/or tongue) stimulation of the genitals. Fellatio is the Latin term for oral stimulation of the male genitals. Cunnilingus is the Latin term for oral stimulation of the female genitals. Anilingus (sometimes called “rimming”) refers to oral-anal contact.
Historically, oral sex was perceived among heterosexual couples as not only more intimate than intercourse but also to be reserved for those who were married. Kinsey’s landmark sex studies revealed a greater prevalence of oral sex. It wasn’t until the 70s that societal attitudes began to perceive it as acceptable for unmarried couples as well. For women (78.6%) and men (77.9%) pleasure for the receiver was the most popularly endorsed option for giving oral sex.
One study indicated that about 60% of undergraduates did not regard oral sex as “sex.” Other studies have indicated that a range of 10–30% of virgins surveyed (defined as having not engaged in intercourse) had engaged in oral sex or perceived oral sex as a way to maintain virginity. One third of college students believed that oral sex was abstinent behavior. It all depends on how you personally define sex. If sexual activity is defined as bodily contact meant to give or derive sexual gratification, then oral sex is sex.
Many people feel safe engaging in oral sex because there is no risk of pregnancy. There are, however, other considerations. Many sexually transmitted infections (STIs) such as gonorrhea, herpes, hepatitis B, HIV, syphilis, Chlamydia, chancroid, and HPV can be transmitted through oral-genital contact. In addition, while herpes virus type 2 has historically been found to infect the genital region, herpes virus type 1, most commonly found in the region of the mouth, is now appearing in the genital region. Oral sex has been identified as a significant factor in this transmission. HIV transmission is possible via oral sex, but is extremely rare. There is no data to indicate how often hepatitis B is transmitted through oral sex. Hepatitis B is transmitted in the same manner as HIV and is considered 100 times more contagious. It is difficult to determine exact rates of transmission of STIs through oral sex since many sexually active individuals practice oral sex in addition to other, higher risk activities, such as vaginal and/or anal sex. In addition, if a male ejaculates during oral sex, then the risk to his partner becomes higher.
Despite the possibility of contracting an STI via oral sex, a national survey of teens indicated that only 30% used protection all of the time. Forty-two percent never used any protection.
There are ways to protect yourself and your partner from STIs. Use a non-lubricated condom for oral sex on a man. There are usually complaints (from men and women) about using a condom during oral sex. Men say that it reduces the sensations on the penis, resulting in less pleasure. Another complaint is that it can also lead to taking much longer to orgasm. Women often complain that there is a distinct rubbery taste when using a condom for oral sex. There are solutions to both of these problems. For men, sensation can be increased with a condom by putting a small amount of lubricant inside the condom before you put it on. Flavored condoms are available. This can make the idea of using a condom more appealing to women. For oral sex on a woman, cover the genitals with a latex dam, a condom cut open to make a square, or plastic food wrap (saran wrap). Any barrier between your mouth and your partner’s genitals is what you’re looking for. Avoid condoms with spermicide, as they can numb the tongue. If a condom is not being used, avoid ejaculating in your partner’s mouth. If ejaculate does enter the mouth, spitting out the semen immediately can reduce your risk of STIs.
Regardless of the sex of your partner, if there is a sore or discharge on your partner’s genitals or an unusual odor, avoid any type of contact with the genitals. If a partner’s mouth has a sore, avoid oral sex. Do not brush or floss your teeth right before you perform oral sex. Flossing and brushing may cause small tears in the lining of the mouth, increasing exposure to any viruses that may be present.
Oral is a lower-risk sexual activity, but it is not risk free. Unless you are in a mutually monogamous relationship with a partner who has been tested and you know is uninfected, there is no way to be completely free of STI risk. Talk to your partner before having oral sex. Both of you should disclose if you’ve ever had an STI. You should discuss whether you have both been tested for STIs. Once again, this may be an uncomfortable conversation, but if you are going to engage in oral sex with someone, you should be able to talk about it openly. Prevention comes down to trust and the relationship you have with that person. If you are committed to one another and you know that neither one of you have had an STI, then you are probably safe from catching one from your partner. This does not mean that you don’t have to use protection. Bacterial infections can occur even if there are no STIs present. Being clean is the most important thing to avoid a bacterial infection. After each sex act, oral or otherwise, clean off your genitals so that any bacteria left behind is washed away. Protecting yourself may not seem practical and it may seem like a lot of work, but it is far less work to prevent STIs than to treat them.
There are gender differences in giving and receiving oral sex. Although the evidence is anecdotal, it does indicate a potential trend of women giving oral sex more frequently to men as opposed to an equal interchange between partners. The fact that women endorsed performing oral sex more often than men might be due to the fact that they were also more likely to perceive oral sex as less intimate than men.
The New England Journal of Medicine recently reported that cancer of the tonsils and base of the tongue are rising annually. The evidence that oral HPV infection can cause these tumors is compelling. Having more than five oral-sex partners increased the risk of these malignancies by 250%. Widespread oral sex practices among adolescents may be a contributing factor in this increase.
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