Oral Sex

Oral sex involves the use of the mouth and tongue to stimulate the partner’s genital or anal area to provide pleasure. It involves licking or sucking the penis, vagina, clitoris and even anus.

Sexual activities, such as oral sex and anal sex, which do not involve penetration are common in teenagers and young adults. There are various non-coital ways in which men and women like to give and receive sexual pleasure. Oral sex is routinely practised by couples who are sexually active. It is seen in any sexual relationship — straight or heterosexual, homosexual and bisexual.

It has been reported that more than 85% of adult couples between 18 and 44 years of age, who were sexually active, have had oral sex with a heterosexual partner at least once. A study conducted between 2007 and 2010 showed that 33% of teenagers between 15 and 17 years of age have had oral sex with a heterosexual partner. There is a very low risk of human papillomavirus infection (HPV) being contracted from oral sex. However, the risk of contracting sexually transmitted infections (STIs), such as gonorrhoea, syphilis and herpes, is still significant.

Depending on the area which is stimulated, oral sex can be divided into:

• Fellatio 
  Oral sex performed on a male, which involves sucking or moving the tongue across the penis to provoke excitement and provide pleasure.
• Cunnilingus 
  Oral sex performed on female genitalia that includes the clitoris, vulva and vagina.
• Anilingus 
  Also known as anal-oral contact in which a person stimulates the partner’s anal region with the mouth, lips or tongue.

How to perform oral sex on a male partner? 

Oral sex can be performed on a male, regardless of whether his penis is erect or not. Adequate foreplay by using your hands for stimulation of the male genitalia is encouraged before oral sex for maximum pleasure. If a person is unsure about how much oral penetration is needed, you may hold the penis to create a point as to how far you want it to go. Once the person is comfortable, the fingers can be slid down slowly until the penis is felt deep within the mouth.

Men are sensitive to oral sex; hence, it is advised to begin gently, and slowly increase the pace. Letting the male ejaculate in your mouth is a choice and not a compulsion It is advised that the male partner wear a condom during the act to protect the partner and himself from STIs. The duration of the act depends on both partners.

How to perform oral sex on a female partner? 

Before giving oral sex to a woman, it is better to indulge in ample foreplay by kissing and touching her. Explore the area around the vagina and thighs to help the woman get aroused. Though the entire pelvic region is sensitive, the clitoris is the most sensitive area of the genitalia in a woman, with more than 8000 nerve endings. Begin by making slow movements with a relaxed tongue and increase the pace as you proceed further. Ask the partner what she enjoys the most and accordingly try giving different strokes with the tongue

How to perform oral-anal sex?

Oral-anal sex can be performed in any kind of sexual relationship – straight, gay or bisexual. For hygiene purposes, ask the partner to wash and clean the anal area. The region between the anus and the genitals, known as the perineum, is stimulated. The anus is then gradually stimulated by licking, sucking, nibbling and finally inserting the tongue. To prevent vaginal infections in females, it is best not to go from the anus to the vagina.

The risk of transmitting the human immunodeficiency virus (HIV) infection from oral sex is very low. However, if the skin or oral mucosa is broken or ulcerated, the person receiving oral sex has sores or other STIs in the genital region or the person giving oral sex has mouth sores or bleeding gums, the risk increases significantly.

The risk of contracting STIs such as, herpes, syphilis and gonorrhoea is still significant through oral sex, along with other infections like hepatitis A or bacterial infections with E. coli, which are passed on through oral-anal sex. Certain infections can be passed on even in the absence of any symptoms. If either person has sores in the mouth, vagina, anus or penis, they must avoid oral sex and get medical help as soon as possible. To protect yourself from sexually transmitted diseases and other infections, use a condom or a dental dam. Speak with your partner about using protection before performing oral sex. Although it may be embarrassing, it is best to discuss this topic completely as it may otherwise lead to intimacy issues.

What are the factors that increase the risk and spread of STIs during oral sex?

Any individual indulging in sexual activity with a partner infected with an STI carries a risk of contracting the infection through the mouth, throat, rectum and genitals. Generally, it is possible to get an STI in the mouth or throat if oral sex is performed on a partner having a genital or anal infection. Similarly, an STI may be passed on to the genitals if a person receives oral sex from a partner with an oral infection. An individual can even get an STI in more than one area because certain STIs are known to infect other areas of the body as well. In many cases, an STI can spread even when the infected partner does not exhibit any signs or symptoms.

It is difficult to estimate and compare the types of STIs and the risks from specific acts of sexual intercourse. There have been studies conducted to compare the risks of oral sex on the vagina versus oral sex on the anus or penis. It has been found that oral sex can increase the risk of genital herpes, HPV infection, hepatitis C, gonorrhoea and other such STIs. Certain infections like gonorrhoea and chlamydia can spread to other parts of the body very quickly from oral sex. Certain infections caused by HPV can also lead to neck or mouth cancer.

The risk of infections is higher when one is performing oral sex rather than receiving it as they are exposed to genital fluids. The risk is raised when either partner has oral cuts, ulcers or sores. Hence, flossing or brushing the teeth is not recommended before oral sex, as it may cause gum bleeding and increase the risk of contracting STIs. For freshening the mouth, try using a mouthwash, mint or chewing gum instead.

The risk and spread of STIs depend on the following factors: 

• The type of STI.
• Poor oral health.
• Tooth decay.
• The number of sexual acts performed.
• Diseases of the gums.
• Oral cancer.
• Bleeding gums.
• Oral or genital sores.
• Exposed to pre-cum or pre-ejaculate of an infected partner.
• The particular sexual activity that is practised.
• Prevalence of the STI within the population.
• The number of partners indulging in the act.

What signs and symptoms of STI should one look for?

If a person has performed or received unprotected oral sex or even unprotected vaginal intercourse, they must seek professional advice from a health professional if they show the following symptoms:

• Rashes, blisters and itching around the genital area, vagina, penis, mouth or anus.
• Abnormal discharge from the vagina.
• Unusual discharge from the penis.
• Bleeding or pain after sex.
• Irritation and pain during urination.
• Pain in the lower abdomen or testicles.
• A long-standing sore throat.
• Fever.
• Pain between periods.
• Body ache.
• Jaundice.
• Headache.
• Dark-coloured urine or stools.

Although there may not be any symptoms, it is still advisable to visit the doctor if:

• A person has had unprotected oral or vaginal sex with a new partner.
• If both partners have had unprotected sex with other people.

It is strongly advised to begin treatment as soon as possible, as untreated STIs harm the overall health of a person and may even lead to fertility problems in the future. 

Oral sex is just like other forms of sexual activity. However, there is no risk of pregnancy through oral sex. Pregnancy only occurs when semen enters the vagina. As long as one takes care of not inserting a finger with semen on it or has vaginal sex, pregnancy does not occur.

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Like any other feel-good activity, oral sex also comes with several benefits, such as:

• Stress release.
• Relaxation.
• Releases happy hormones or endorphins in the body.
• Gives a nice glow to the skin.
• Induces sleep.
• Improves cardio.
• Strengthens the bond between couples.
• Prevents prostate cancer when a man regularly ejaculates.
• Helps experience orgasm.
• Burns calories, however, not the best means to do so.

Performing and receiving oral sex is a personal decision, and it is important that both partners be ready to explore sexual pleasure using this method. Neither individual should feel forced into performing or receiving oral sex. Even though the act is completely non-coital, it is still considered to be a sexual act. Any suggestions like, ‘it is not real sex’, ‘it is not as risky as intercourse’ or ‘you won’t lose virginity’ count as pressure and can dampen the relationship in the future.

There is often a misconception that oral sex is not really sex. Traditionally, sexual intercourse means penetration of the penis into the female vagina. But technically, sexual intercourse is an intercourse that involves genital contact between individuals, apart from vaginal penetration. In other words, any genital contact is sex. Hence, oral sex is considered sexual intercourse. 

At one time, a virgin was considered to be an unmarried woman. Today, a virgin means a woman who has never had intercourse. Intercourse includes vaginal, oral and anal sex. Some assume that the term virgin applies to a woman who has never had any coital relationship.

Abstinence means refraining from or not participating in any sexual act at all, be it oral, anal or vaginal sex and even mutual masturbation. If there is any genital contact, it is not considered abstinence.

Before performing oral sex on a man, a condom is helpful in decreasing the risk of the spread of an STI. Partners can try flavoured condoms for a different experience. People who have an allergy to latex can use plastic or polyurethane condoms. For oral sex on a female or before oral-anal sex, a dam is to be used. A dam is a square-shaped, thin latex or plastic sheet, which works like a barrier between the mouth and the vagina or anus, thus reducing the risk of STIs. Dental dams may be available in pharmacies and clinics.