Monique Rainford - HER HEALTH

At one point in our musical history, there were a number of songs attacking oral sex. Since then, the DJs seem to be quieter on the topic. Is it because it is now more accepted in our society than in the past?

Interestingly, oral sex is practised more frequently among US teenagers than intercourse because it is often viewed as being safer. However, a number of infections can be transmitted in this manner. If a woman receives oral sex, the act performed on her is called cunnilingus. If oral sex is performed on a man it is known as fellatio. It is easier for an infection to be transmitted through fellatio than cunnilingus. A reader has asked a number of interesting questions on the topic.

Dear Dr Rainford,

To settle a discussion, can you answer the following questions? Which STDs can you get by having oral sex? Can you get STDs in the mouth by having oral sex?

If yes, what are the symptoms? How can they be confirmed? Can they be transmitted by kissing, mouth to mouth or mouth to sexual organ?

Dear Reader,

Herpes simplex virus (HSV), HIV/AIDS, human papillomavirus (HPV), neisseria gonorrhoeae and treponema pallidum can all be transmitted through oral sex.

There are two types of herpes, type one (HSV-1) and type two (HSV-2). Traditionally, genital herpes was caused by HSV-2. However, type one, which causes cold sores, can lead to genital herpes through oral sex. HSV-2 does not appear to infect the mouth. Of course, HSV-1 can be transmitted to partners through platonic or intimate kissing.

Infection can be confirmed by a swab at the site, although this is not always accurate. Blood tests can confirm whether or not a person has been infected with HSV-1 or HSV-2.

HIV and HPV infections

The HIV can be transmitted through oral-genital sex but it does not appear that it is transmitted through kissing. Nevertheless, someone is less likely to get HIV through oral sex than through vaginal or anal intercourse. The HIV can be tested through samples of blood, saliva or urine.

The HPV can infect the oral passages (for example, the vocal chords) of someone performing oral sex. The typical symptom is hoarseness. It can be diagnosed by a sample of the lesion in the oral canal.

Gonorrhoea and syphilis

Gonorrhoea can lead to a throat infection in the person performing the act of oral sex or an infection of the urethra (the tube leading urine from the bladder to the outside of the body) of the person receiving oral sex. A person with a gonorrhoea infection of the throat may have no symptoms or they may have a sore throat and/or swollen tonsils or lymph nodes. The infection is diagnosed with a culture of fluid swabbed from the throat.

Syphilis is caused by infection with the bacteria treponema pallidum. The initial infection with this bacteria results in primary syphilis. The initial sign is a chancre which is a painless round or oval ulcer which can occur in the mouth about three weeks after having oral sex. The person may also develop swollen lymph nodes along the neck. Microscopic evaluation of material from the ulcer can help to confirm the diagnosis and this can be followed by blood tests.

Yeast and vaginosis

Some vaginal infections, although not usually considered sexually transmitted, are associated with a woman receiving oral sex. These include yeast vaginitis and bacterial vaginosis.

Persons engaging in oral sex should use barrier methods such as the male or female condoms to reduce the risk of a sexually transmitted infection.

Dr Monique Rainford is a consulting obstetrician and gynaecologist; email: yourhealth@gleanerjm.com.