Can STIs Be Transmitted By Cunnilingus?

Cunnilingus – oral sex on female genitals – is a common practice.

Over 80% of adults report having done it at least once. But is it safe? Or are there risks from sexually transmitted infections? We look into the risks and what you can do to protect yourself and your partner.

Last updated: 19 Feb 2020



The bad news is that nearly all sexually transmitted infections can be transmitted through cunnilingus. Fortunately, infections like HIV, syphilis, hepatitis B & C are not easily transmitted orally. Penetrative sex – especially anal – is of much higher risk.

Generally speaking, cunnilingus is considered a low risk activity. Dr. Bishop explains: 

"The partner performing oral sex is mainly at risk from STIs that live on the skin or lining of the vagina, rather than those present in the blood or deeper in the cervix. This does mean that there is significant risk from HPV (Human papillomavirus), chlamydia and genital herpes via mouth to genital contact”.

HPV & Throat Cancer


HPV (Human papillomavirus) is a very common viral infection. In fact there are many types (over 40) which live on mucous membranes. Certain high-risk strains can cause cancers of the cervix, anus, vulva, penis or throat, so it can be a serious condition. 

Other types of HPV can cause genital warts – small lumps or skin changes around the genitals or anus. These are the most common viral sexually transmitted infection in the UK. HPV can also cause skin warts elsewhere on the body, even in the throat.

Importantly, HPV infections can have no visible symptoms. In fact, most strains do not.

When HPV is present in the vaginal mucosa of the carrier, there is a risk of transmission during oral sex. The person doing cunnilingus can then contract HPV infection of the oral mucosa and pharynx. Under certain conditions – such as smoking – this can develop into throat cancer.

Men are more susceptible than women to the transmission of oropharyngeal cancer through oral sex, particularly those with multiple sexual partners.

How to protect yourself? 
 

Since September 2019, all 12- and 13-year-olds (school Year 8) in the UK have been offered the human papillomavirus (HPV) vaccine free on the NHS. The vaccine, called Gardasil, has led to a significant reduction in the number of cases of HPV.

As with all other infections, the risk of transmission can be prevented by using a dental dam, a square latex film that prevents direct contact with the mucous membranes.  

Note that while dental dams reduce the risk of infection, they don’t eliminate it completely. This is because HPV doesn’t just spread through bodily fluid, but also through skin to skin contact.

 

Chlamydia

Giving oral sex to a woman with an active chlamydia infection – i.e an infected vagina or urinary tract – can lead to getting chlamydia in the throat.


Many genital – or throat - chlamydia infections have no symptoms, so you may not know that this has occurred. If left untreated, throat infections can be spread to uninfected sex partners. If left untreated, chlamydia can lead to serious health complications, especially in women.

Fortunately chlamydia can be easily treated with antibiotics, and home chlamydia test kits are readily available, so you should get yourself tested if you are at risk.

 

Herpes

There are two types of the herpes simplex virus. Type 1 (HSV-1) typically causes cold sores around the mouth, and type 2 (HSV-2) most commonly causes genital herpes. 

But the two viruses can infect both the mouth or gentials, and in fact their transmission is also a two-way risk. Herpes can be transmitted by either:

 

  1. Giving oral sex to a partner with herpes on the genital area can lead to getting herpes on the lips, mouth, or in the throat. These are typically known as cold sores.
  2. Receiving oral sex from a partner with herpes on the lips, mouth, or in the throat can lead to herpes on the genital or anal areas.

There is no cure for a herpes, although antiviral medication can reduce the symptoms. Even with treatment, oral infections can be spread to your sexual partners.

To reduce the risk of contamination, you should therefore not practice cunnilingus during the outbreak of herpes, whether labial or genital, unless you use a dental dam.


How To Avoid STI Transmission During Cunnilingus?


If you or your partner have symptoms of an STI the obvious choice is to avoid cunnilingus until these are treated. Avoid oral sex if there are cuts, sores or bleeding in and around your mouth or genitals.


Likewise, if you are eligible for vaccination against HPV this is also highly recommended if you are sexually active.

On an ongoing basis, the best form of protection for cunnilingus is the dental dam. This small square of latex – known as a barrier prophylaxis - is widely available and is easy to use. You can also cut a condom to size if that’s all you have available. It does cut down on the sensation, but it’s a sensible choice.  To make cunnilingus more pleasurable put a drop or two of lubricant to the side of the barrier you are using that is touching the recipient’s genitals. 

Overall, note that having multiple partners increases the risk of transmitting infections, and most importantly, that having sex does come with risks. 

So, if you have had unprotected sex, or if you notice abnormalities on your genitals, you should always get yourself tested for STIs.


Similar home testing articles:

Everything You Need To Know About STIs

Essential Health Checks

Can STIs Be Transmitted By Cunnilingus?: References & Citations

Checchi M, Mesher D, Mohammed H, et al Declines in anogenital warts diagnoses since the change in 2012 to use the quadrivalent HPV vaccine in England: data to end 2017 Sexually Transmitted Infections 2019;95:368-373.

Edwards S, Carne C Oral sex and transmission of non-viral STIs. Sexually Transmitted Infections 1998;74:95-100.

Vries HD S03.2 The role of oral-anal transmission in persistence of chlamydial infection Sexually Transmitted Infections 2019;95:A10.

Hawkins DA Oral sex and HIV transmission Sexually Transmitted Infections 2001;77:307-308.

Schneider A Pathogenesis of genital HPV infection. Sexually Transmitted Infections 1993;69:165-173.

Kundu A, Wade AA Warts in the oral cavity. Sexually Transmitted Infections 1995;71:195.
 

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