Protect Yourself, Before You Wreck Yourself: Safe Oral Sex

Q. My boyfriend and I haven’t had sex, but we have done oral. I was talking to a friend recently about a female condom she had gotten as a joke-gift and I commented that it seemed like it would less effective and she said that it would be good for oral probably. I was surprised. You need protection for oral sex? I feel dumb for not knowing this or realizing this but seriously? You need protection for oral? Or is it, as my friend put it, “Just something that’s strongly suggested by doctors?” And if you do… and he and I haven’t been doing anything about that, with us both never having gotten this far before anyway, is there a risk of something? What’s the danger?

A. Much like eating oysters, sky-diving, and just getting out of bed in the morning, risk is associated with every activity that we engage in. This risk changes with each context, each event bringing about either the obvious or not so obvious as far as what the downfalls are. There are things you can control as far as lessening your risk; however, one of the prices of being an adult and being involved in things like sex is that you do take on a measure of risk.

This isn’t to say throw the baby out with the bathwater, or to expect the worst to happen, but I would like to highlight the fact that as far as risk goes, there can be a gap in what we can control and what we cannot. We can control our birth control and barrier methods; however, we might not be able to control the small chance of either of those failing. We might be able to control not risking pregnancy by engaging in oral sex, but we might not be doing it properly. We might be safe sexing it to the nines and still get a huge broken heart. Risk is part of everything we do and there is only so much we can actively take steps in doing to prevent things from happening. This shouldn’t dissuade you, as the benefits you can reap can be so much better than staying at home under the covers and scaring yourself about the risks.

So, is oral sex safe sex and should you be using protection? Well, that all depends. I think more conservative folks might immediately leap to yes, and they have great points to back that up. However, many would also jump to no, with equally valid points, and just as much evidence. Oral sex is a relatively low-risk activity in comparison to vaginal and anal sex. It doesn’t mean it is risk free, just that you are less likely transfer infections, though you can absolutely pass on infections. Most infections are found in blood, semen, vaginal fluids, and freshly infected soft skin, which is normally how HPV or herpes can be passed. Infections can be transmitted through the more obvious: cuts, openings, sores, but also, through mucous membranes (think mouth, vagina, anus). So what do I think is the best thing you can do ?

Get tested.

Get tested for everything – HIV, herpes simplexes (these tests have to be specifically requested), your regular STI testing (gonorrhea, chlamydia, Trich), syphillis. Then there are the more fickle ones that are a bit more difficult to test, but I’d still recommend getting them done: HPV, hep-b, and hep-c. Each test for each STI has a different timeline, as well as when it is recommended you get tested. Herpes can be hard, because it can hide in your body for years, leaving you living with an undetected viral load that pops up when you are 35. It’s unlikely, but it can happen. Most HIV or holy trinity STI tests are pretty immediate, though HIV can take up to three months to register in your body. Testing is a great way to feel out where you and your partner are at as far as being infection-free, and can help you decide where to go from there. You can always start the conversation by just asking your partner if they have been tested. This is usually the ball that gets everything rolling, including questions about sexual history, health, and where the two of you stand on protection.

Okay, so let’s say you get tested, but what about now? You and your partner have had unprotected oral sex a few times – what is your risk? Go meet with your physician and ask them to take a gander at your throat – if you do happen to have been exposed to something, chances are it is hanging out in your throat or mouth, though more than likely, you might have already noticed this. So while you two are waiting for results or even just waiting to figure out what to do, it isn’t going to hurt if say, you both take a few more precautions until you know more about each others state of health.

One of my favorite sex educators and all around lovable ladies, Dr. Ruth, says the following about protection during oral sex:

Simply stated, diseases can be transmitted orally. In fact, doctors are finding cases of genital herpes that were caused by the virus for oral herpes, something that had not been noted before. One of the factors in the rising number of STDs transmitted through oral sex is unexpected: virgins with STDs. So many teens who consider themselves virgins have had oral sex and may have already gotten an STD. As such, protection is always necessary.

A partner performing fellatio can protect herself or himself by making sure that a condom is placed on her or his partner’s penis. This is relatively reliable.

For oral sex on a woman, preventing the transmission of disease is much more difficult. Some people recommend using dental dams, which are small squares of latex, or a sheet of plastic wrap held over the woman’s vagina during oral sex. But the odds of keeping the dental dam in place, so no bodily fluids are exchanged during passionate sex, seem pretty remote. And plastic wrap, which is so thin, seems likely to break, although some brands are stronger than others. Very thin underwear (you can even get an edible variety that comes in flavors) can also act as a barrier.

Using either dental dam or plastic wrap may actually be worse than nothing. If you think you’re protected when you’re not, you’re much more likely to do something that you shouldn’t. The only way to make sure that you won’t get a disease when performing cunnilingus is to only do it with a partner who has been tested for STDs and given a negative result.

Lastly, don’t feel ashamed or stupid for not knowing that oral sex requires protection. There really isn’t a whole lot of cultural emphasis on protection; indeed, there is barely any on regular protection information out there for vaginal/anal sex. Just move forward with your decision making with the knowledge you have now. We all make mistakes, we all miss information, and we all have had sex in not the best way. It happens – life happens. I’m not interested in why or how or what, only that moving forward, you can think about how the knowledge you have gained here will impact your decision making on what is best for you and your partner. You have the power and the information. What will you do with it?


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2 replies on “Protect Yourself, Before You Wreck Yourself: Safe Oral Sex”

I was never told in sex ed that you could get STD’s through oral sex. Because well, peen in vag is the only thing that ”counts” as sex, obviously. So when I got to my GP for my yearly STD-check, I had to ask ”when you haven’t slept with men lately, does that mean…?” and get a very suprised look.
I would love to change the program of sex ed into something more… complete.

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