Oral Sex & HPV

Oral sex is a normal part of a sexual relationship. Lots of people find it a fun and intimate way to bond with their partner and give them pleasure. 

One thing to bear in mind is that there tends to be an illusion of safety around oral sex. It’s sometimes seen as a completely risk-free alternative to vaginal or anal sex. But the truth is, oral sex is associated with a few different STIs, as well as HPV. HPV is a viral infection which is usually symptomless but can sometimes cause cancer.

What is HPV?  

Human papillomavirus (HPV) is a very common group of viruses that affect the skin. Most of the strains of the virus are harmless, and you won’t even know you had it. But some strains can cause warts, genital warts and in some cases lead to certain types of cancer. 

Find out more about what is HPV. 

Which STIs can you get through oral sex?

Using your tongue to stimulate your partner’s genitals can put you at risk of a few different infections. Oral sex can spread a variety of different STIs including: 

Gonorrhoea 

Gonorrhoea is an infection causes by a bacteria called neisseria gonorrhoeae. The bacteria tends to be found in discharge from the penis and vaginal fluid.

Around 10% of men and half of women won’t experience any symptoms at all. But if you do have symptoms, they can include unusual green/yellow discharge from the penis or vagina and pain when weeing. Some women will also experience bleeding between periods.  

Genital herpes 

Genital herpes is an infection caused by the herpes simplex virus (HSV). It can cause sores and blisters on the and around the genitals.

Lots of people with genital herpes won’t experience any symptoms when they first catch it. It usually takes up to 12 days for symptoms to appear, but for some people it doesn’t appear for months, sometimes years.

Syphilis 

Syphilis is a bacterial infection. While the symptoms can be mild at first, they can get worse over time, and it can be potentially life-threatening.  

It usually begins with a sore/ulcer where the infection was transmitted, this will then usually disappear. After the sore has disappeared, you’ll likely get a rash, typically on the hands or feet, you’ll feel tired, have headaches and swollen lymph glands.  

After this stage, you’ll likely have no symptoms for many years. But if you have not been treated the infection is still in your body. This means you can still pass it on and you're at risk of getting serious problems later on. At the third stage, if the syphilis hasn’t been treated it can start to affect your brain, nerves, skin, bones, heart and blood vessels. You might be at risk of a stroke and dementia, among other conditions. 

Chlamydia 

Chlamydia is one of the most common STIs in the UK. Typically, most people won’t have any symptoms and don’t know they have it. But if you do experience symptoms you might have pain when peeing and unusual discharge. Women might also experience tummy pain and bleeding in between periods, men might experience pain and/or swelling in the testicles.  

Pubic lice 

Pubic lice are small insects that live on pubic hair. If you come into contact with pubic lice, it can take up to three weeks before you notice any symptoms.  

The most common symptom is itchy red spots, you might also get a dark powder on your skin/underwear and blue spots on your skin where the lice have been. You might even be able see the empty eggshells at the root of your hairs.  

HIV 

Because HIV is transmitted through some bodily fluids, it can be passed through oral se. The risk is relatively low but goes up if the person giving oral sex has cuts or sores in their mouth, or a sore throat.  

It’s thought that up to 3% of HIV cases are down to oral sex. But it’s important you still always use protection when having oral sex.  

How do you get HPV in the mouth? 

Because HPV is passed through sexual contact, sharing sex toys and skin-to-skin contact, so it can be passed through oral sex. The strains of HPV found in the mouth are almost exclusively transmitted through sexual contact, so oral sex is likely to be the cause.

If you have unprotected oral sex with someone who has HPV, there’s a chance they will pass the virus onto you.  

Symptoms of HPV in the mouth

HPV is largely symptomless, so you might not know you have it. In rare cases, some strains of HPV can cause abnormal tissue to grow in the mouth, which can potentially lead to cancer of mouth and throat. 

Oral HPV risks

The label HPV actually refers to a whole family of viruses containing more than 100 different types. It’s a really widespread virus, which means that about 8 in 10 people will have it during their life.

Usually the virus is harmless. It doesn’t cause symptoms, so it’s unlikely that you’ll even know if you’ve had it. According to the NHS, most cases of HPV will be cleared by your body within a couple of years.

However, some types are associated with the following risks: 

Genital warts

Some strains of HPV cause genital warts. This is a condition where painless, fleshy growths develop on and around the genitals and anus. Genital warts can be treated, but the symptoms can come back again. Over time, though, your body should fight and clear the virus.

Cancer

Types of HPV that can cause cancer are known as “high-risk”. Even if you’re exposed to this type of HPV, it doesn’t automatically mean you’ll get cancer – it just means your risk is increased.

How does HPV cause cancer? 

If you catch a high-risk strain of HPV and it’s not cleared naturally by your body, it can start to cause changes to the DNA inside the infected cells. These changes can cause the cells to start growing out of control – this is what can then lead to cancer.  

What types of cancer can be caused by HPV?

High-risk types of HPV can cause cancer of the:  

• Cervix 
• Anus 
• Penis 
• Vulva 
• Vagina 
• Head and neck e.g. the mouth, lips, throat and voice box 

Cervical cancer is the cancer most commonly associated with HPV. However, this is relatively uncommon – it’s only the 14th most common type of cancer in women. The other types of cancer listed above are even less common.

What increases my risk of cancer from HPV?

You’re more likely to be at risk of cancer from HPV if you smoke. This is because smoking damages cells in the skin, which prevents the body clearing the virus. In smokers, high-risk types of HPV are more likely to persist and cause problems.

Another risk factor may be number of sexual partners. This recent study published in the journal CANCER showed that having a higher number of oral sex partners can increase your risk of oropharyngeal cancer. This is cancer that affects the area of the throat at the back of the mouth.

How to reduce the risk of HPV

You can reduce your risk by getting the HPV vaccine. The HPV vaccine is routinely given to school children in the UK. It’s also free on the NHS to people under 25 who missed out on the vaccine at school. You’ll also be eligible for a free HPV vaccine if you’re a trans man or a trans woman, or a man who has sex with other men.

People who aren’t eligible for a free vaccine can order one through our HPV vaccination clinic. 

HPV can be spread through intimate skin-to-skin contact, and vaginal, anal and oral sex. It can also be spread by sharing sex toys. In short, it’s not always easy to avoid passing HPV on, or catching it from someone else.

Whenever possible, try to use barrier protection when you’re having oral sex. For oral sex on someone with a penis, use a condom. For oral sex on someone with a vagina, use a dental dam – this is a thin, soft square of latex or plastic that you can put over the genitals when you’re having oral sex. Dental dams can also be used on the anus. 

How can I have safe oral sex?

The main way to make oral sex safer is to use barrier protection.

If you notice any rashes, sore, growths or unusual discharge in yourself or your partner, it’s best to avoid oral sex and speak to a doctor. You should also avoid brushing your teeth or flossing before oral sex – this can open up small tears in the mouth, making infection more likely .

How to get tested for STIs with Online Doctor

If you think you might have been exposed to an STI, it’s a good idea to get tested. This is the case even if you aren’t having any symptoms. 

You can get tested for free on the NHS, or you can order a home test kit from a trusted service like LloydsPharmacy Online Doctor. Visit our STI testing clinic to browse our test kits and learn more about how they work.

References 

https://www.nhs.uk/common-health-questions/sexual-health/what-infections-can-i-catch-through-oral-sex/
https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/infections-eg-hpv-and-cancer/does-hpv-cause-cancer
https://www.nhs.uk/conditions/human-papilloma-virus-hpv/
https://www.nhs.uk/conditions/genital-warts/
https://www.nhs.uk/live-well/sexual-health/can-oral-sex-give-you-cancer/
https://www.cancerresearchuk.org/about-cancer/mouth-cancer
https://www.nhs.uk/conditions/vaccinations/hpv-human-papillomavirus-vaccine/
https://www.nhs.uk/live-well/sexual-health/
https://pubmed.ncbi.nlm.nih.gov/33426652/
https://www.nhs.uk/conditions/gonorrhoea/
https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/genital-herpes
https://www.nhs.uk/common-health-questions/sexual-health/can-hiv-be-transmitted-through-oral-sex-fellatio-and-cunnilingus/
https://www.tht.org.uk/hiv-and-sexual-health/sexual-health/improving-your-sexual-health/oral-sex