Oral sex

What is oral sex?

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Oral sex used to be a taboo subject, but these days it’s a common form of sexual activity. Oral sex means using your mouth, lips or tongue to stimulate your partner’s genitals or anus.

All genders can give their partner/s oral sex. You’ve probably heard oral sex called many names – ‘going down’, a ‘blow job’, ‘giving head’, a ‘69’ or ‘rimming’ (plus plenty more).

Oral sex also has medical names. Oral sex on the vagina, vulva and clitoris is called cunnilingus. Oral sex on the penis is called fellatio. If oral sex involves the anus, it’s called anilingus.

Oral sex can be a natural and enjoyable part of sexual contact between partners if you consent to it.

You can give or receive oral sex as part of other sexual activity (like vaginal or anal intercourse) or on its own.

Unprotected oral sex comes with risks.

Consenting to oral sex

Before introducing oral sex into your relationship, it is important to talk openly about how you feel. Oral sex can put strain on relationships, particularly if one of you doesn’t enjoy it or has concerns about it.

Common issues about oral sex include:

• anxiety around oral sexual performance
• feeling judged by your partner and what they will think
• being or feeling controlled by your partner.

Oral sex, like all types of sex takes practice. If you don’t feel ready to have sex or someone is pressuring you, tell them.

Sex should be enjoyable. Being intimate in your sexual relationships may make you feel vulnerable and can take time. You need to be able to trust each other and discuss openly what your needs are.

Remember, by law, sex must be consensual, which also means respecting others’ decisions when they say ‘no’ or if they are too out of it to consent. Any sex that occurs without your consent is sexual assault, and it is a crime. Call the Sexual Assault Crisis Line on Tel:1800 806 292.

What are the risks of oral sex?

Although you can’t get pregnant by just having oral sex, it still carries the possibility of catching or passing on sexually transmissible infections (STIs) and some other infections.

Sucking and licking the genitals or anus, means you are more likely to have contact with genital fluids and faeces, which puts you at risk of infection.

Generally, you’re more at risk of catching an STI from oral sex if you:

• don’t use barrier protection (such as external or internal condoms and dams)
• have cuts, sores or ulcers in your mouth when you have oral sex
• give rather than receive oral sex – because you’re more likely to be exposed to genital fluids.
• engage in sex that causes tiny abrasions on or in the genitals (such as rough sex or using sex toys).

STIs and oral sex

STIs can be passed from one person to another during oral sex. Vaginal fluids, blood or semen from one person can make contact with the mucous membranes (the skin inside the vagina, mouth or anus) of another person.

Certain sexually transmitted infections (STIs) and other viruses are linked with oral sex. Some of these include:

• human papilloma virus (HPV) and genital warts
• genital herpes
• gonorrhoea
• chlamydia
• hepatitis A, B, C
• shigella gastroenteritis
• syphilis
• mpox
• pubic lice (crabs).

HIV and hepatitis C would usually be considered an STI risk only in the presence of blood or open wounds. For example, if you have sex with someone who is menstruating or has an open, bloody sore.

Hepatitis B transmission via oral sex is also low risk.

Human papillomavirus (HPV) and genital warts

HPV (or human papillomavirus) is very common – the majority of sexually active people will be exposed to HPV in their lifetime. Most HPV infections are cleared by the immune system without treatment.

HPV is passed on through either genital, anal or oral sex. In many cases, HPV shows no signs or symptoms so you can pass it on without knowing it.

Sometimes HPV is responsible for genital (and mouth) cancers. However, this is uncommon and not caused by the HPV types that cause genital warts.

A vaccine for protection against HPV is available. It can prevent infection from 9 HPV types which cause most genital warts and genital cancers.

Genital warts

Some strains of HPV cause genital warts – soft growths that occur on the genitals. It is rare for genital warts to be passed to the mouth and lips through oral sex.

Most genital warts clear without treatment.

Although visible genital warts can be treated, they may reappear. For most people, the body’s natural immunity will get rid of the virus over time. That’s why it’s important to use condoms and dental dams during sex.

If you suspect you have HPV or genital warts, see your doctor or make an appointment with a sexual health clinic.

Herpes

Herpes is a common STI caused by the herpes simplex virus (HSV).

There are 2 types:

• HSV 1 usually causes oral cold sores, but can also cause genital herpes
• HSV 2 causes genital herpes only (pain, itching and small sores on the genitals that turn into ulcers and scabs).

You can catch either type of herpes from unprotected oral, vaginal and anal sex.

HSV 1 is commonly passed on when someone with the cold sore virus (with or without symptoms) performs oral sex on someone who has not had previous exposure to the virus.

HSV 2 infection can happen when someone with the virus (with or without symptoms) has oral, vaginal or anal sex with someone who has not previously been exposed to the virus.

The infections can develop into mouth, genital or anal blisters or sores.

Sometimes you can have herpes without any symptoms and still pass on them on through skin-to-skin contact (asymptomatic shedding).

HSV is well managed with medication by diagnosis from a doctor.

Gonorrhoea and chlamydia

Gonorrhoea and chlamydia can be passed on during oral sex through infected body fluids – such as semen, pre-ejaculation (cum), blood, or vaginal discharge.

These STIs can enter any sores, cuts, or ulcers you may have. Infection can also occur when fluids get into inflamed cells and into the bloodstream via the:

• lips and mouth
• genitals or anus
• membrane of the eye
• cells of the throat.

Hepatitis A

Hepatitis A is a gut infection that affects the liver. It can be passed on through contact with infected faeces (poo).

You may be at risk of this disease during oral sex when licking or touching your partner’s anus, even if it looks clean. Infection can also occur by not washing hands after contact with the anus..

Immunisation is the best protection against hepatitis A and is recommended for people in high-risk groups (including people who have anal sex).

Shigella gastroenteritis

Shigella gastroenteritis is a bowel infection caused by bacteria that is passed on through contact with infected faeces (poo).

It can also be spread through sexual contact (mouth to anus sex). Men who have sex with men can be at risk.

Syphilis

Syphilis can be cured but it is a very serious condition if it is not treated.

It is highly contagious when the sore or rash is present. Sores may be present on the genitals, anus or lips or in the rectum or mouth.

You can catch syphilis by having unprotected oral, vaginal or anal sex and sharing sex toys with someone who is infected.

The following symptoms may occur in the early stages:

• a single genital, anal or oral sore (often painless)
• rash on hands, feet and the upper body (can be mild, not usually itchy or painful).

Syphilis then becomes asymptomatic (without symptoms). It needs to be diagnosed by a blood test.

If left untreated, syphilis can cause organ damage and be very serious.

The late stage of syphilis may not develop for 10 to 30 years from the time of infection.

Syphilis is very treatable with antibiotics. See a doctor for diagnosis. Treatment may vary from person to person depending on the stage of infection.

It is important to treat your sexual partners. Reinfection can occur if you have sex with someone with a syphilis infection.

Pubic lice (‘crabs’)

Pubic lice or ‘crabs’ are tiny insects, found in the genital area. They feed on blood and can cause intense itching.

Pubic lice can spread during sex.

They can be treated with over-the-counter medications.

Mpox

Mpox is a viral infection. It is transmitted between people through close contact.

Mpox can spread through:

• direct or intimate contact (such as during sex)
• infected clothing or linen (such as bedding or towels)
• respiratory droplets (such as coughs and sneezes).

Symptoms may include:

• rash with small lumps that blister and crust over (with pustules or pus-filled pimples) – that may go through different stages like chickenpox that eventually scab and fall off
• fever and chills
• muscle aches
• swollen lymph nodes
• fatigue.

People with mpox develop a painful rash that may occur on the:

• genitals and around the anus
• inside the mouth
• face
• palms of the hands
• soles of the feet.

If you have symptoms avoid close contact with others (including sex and sharing beds).

If you develop a rash, isolate from others, and seek medical care. Call your clinic in advance to let them know you will be attending. The doctor will take a swab to confirm that it is mpox.

Wear a mask at your appointment and if you have a rash or blisters, make sure they are covered.

Most people with mpox have a mild illness and recover within a few weeks.

Occasionally, mpox may require medical or hospital care if:

• skin lesions are painful and cannot be relieved by over-the-counter pain relief
• pain prevents you from going to the toilet to pass urine or open your bowels
• lesions are extensive or become infected with bacteria.

Preventing mpox

Condoms are not effective at preventing the transmission of mpox.

Prevention includes:

• practise safe hygiene by washing hands with soap and water or alcohol-based hand sanitiser
• avoid contact with someone who is infected
• do not share bedding or towels with some who is infected
• be aware of exposure cases when travelling overseas
• immunisation for eligible people.

Reducing your infection risk during oral sex

There are some things you can do to reduce your risk of infections during oral sex. Like any type of sex, practise safe sex by using protection, having regular medical check-ups, watching for symptoms, and avoiding sex when you’re at risk.

Ways to make oral sex safer include:

• Use condoms (external or internal) – check their expiry date and use only water-based lubricants to avoid tears and breakage.
• Wear dental dams – a small thin sheet of latex that acts as a barrier between the mouth and vagina or anus.
• Avoid getting semen or vaginal fluid in your eyes.
• Talk openly with your partner about your sexual desires and what you want to explore sexually.
• Get tested for STIs.
• If you have an STI, get treated. Avoid sexual contact until you receive medical advice that you are no longer infectious.

When to avoid oral sex

Remember, it’s better not to have sex if you or your partner/s has:

• an STI
• sores, cuts, ulcers, blisters, warts or rashes around their genitals, anus or mouth
• unhealed or inflamed piercings in their mouth or genitals
• a throat infection
• their period (is menstruating).

Get tested for STIs

Anyone who is sexually active can get tested for STIs and have a sexual health check. How often you need to get tested and what kinds of tests you require can be related to a few factors.

See your doctor or visit a sexual health clinic when you:

• become sexually active
• start a new sexual relationship
• have sex with someone new
• your sex partner has sex with someone else
• have sex without a barrier (condom or dam)
• think you have any signs and symptoms of an STI
• have been told by someone that you have had sex with that they have been diagnosed with an STI.

All sexual contacts should be tested.

STI signs and symptoms to watch for

If you’ve had unprotected oral sex (or vaginal or anal sex without a condom), seek medical advice if you experience:

• itches, rashes, lumps or blisters in or around the genitals, vagina, anus or mouth
• unusual vaginal discharge
• discharge from the penis
• irritation, pain or burning when you urinate (wee)
• pain or bleeding during or after sex
• bleeding between periods
• pain in the testicles or lower abdomen
• sore throat.

Hepatitis A, B and C affect the liver, so watch for:

• flu-like illness (such as fever, pain and headaches)
• tiredness and feeling sick (sometimes with vomiting and diarrhoea)
• dark-coloured urine or pale faeces, or both
• jaundice (yellowing of the skin or eyes).

It’s important to get treatment for an STI as soon as possible. Some STIs can’t be treated but medications may reduce symptoms.

Untreated STIs may cause serious illness. They can also result in long term health impacts (such as infertility and pregnancy problems).

STIs can sometimes have effects on the health of unborn babies if an infection is present or transmitted during pregnancy or birth.

Where to get help

• Your GP (doctor)
• Your school nurse or school welfare coordinator.
• Your school nurse or welfare coordinator. Some secondary schools provide access to an adolescent health trained GP on site
• Your local community health service
• Your pharmacist
• 1800 My Options – Victoria’s sexual and reproductive health information and phone line service Tel. 1800 My Options (1800 696 784)
• Sexual Health Victoria (SHV) – book an appointment online or call Melbourne CBD Clinic: (03) 9660 4700, Box Hill Clinic: (03) 9257 0100 or (free call): 1800 013 952 (Monday to Friday 9 am – 5 pm). These services are youth friendly.
• Melbourne Sexual Health Centre (Monday to Friday 8:30 am – 5 pm) Tel. (03) 9341 6200 or 1800 032 017.
• Victorian Sexual Health Network – where to get tested – visit Melbourne Sexual Health Centre's GP partner clinics for STI check-ups and treatment
• Thorne Harbour Health (formerly Victorian AIDS Council) Tel. (03) 9865 6700 or 1800 134 840 (toll free)
• The Centre Clinic, St Kilda Tel. (03) 9525 5866
• Equinox Gender Diverse Health Centre (Monday to Friday 9 am – 5 pm) Tel. (03) 9416 2889 or email: equinoxadmin@thorneharbour.org
• PRONTO! Clinic for men who have sex with men. Book online or Tel. Tel. (03) 9416 2889
• Ballarat Community Health Sexual Health Clinic – book online or Tel. (03) 5338 4541
• Bendigo Community Health Sexual Health Clinic – book online Tel. (03) 5406 1200 or (03) 5448 1600
• Gateway Health Sexual and Reproductive Health – Clinic 35, Wodonga (Monday to Friday 9 am – 5 pm) Tel. (02) 6022 8888 and Wangaratta Tel. (03) 5723 2000 or email: info@gatewayhealth.org.au
• Sunraysia Community Health Services, Mildura (Monday to Friday 8:30 am – 5 pm) Tel. (03) 5022 5444 or email to: schs@schs.com.au
• Barwon Health Sexual Health Clinic (no GP referral, walk-in service Tuesdays 2 pm – 6:30 pm) Tel. (03) 5226 7489
• Victorian Aboriginal Health Service Fitzroy: Tel. (03) 9419 3000 and Preston Tel. (03) 9403 3300 (Monday to Friday 10 am – 4 pm) and after-hours locum service Tel. 132 660 or Epping: Tel. (03) 8592 3920 (Monday to Thursday 9 am-5 pm, Friday 9 am-4 pm)
• Sexual Assault Crisis Line Tel.1800 806 292
• Women's sexual and reproductive health hubs (throughout Victoria)