[Question #2471] Cunnilingus Risk

44 months ago
I am a woman and had oral sex performed on several times over a few months by a bi male. I don't know if he has chlamydia or gonorrhea.

Now I'm worried he may have passed it on to me.

Assume he has one or both: What is the liklihood of mouth-to-vagina transmission of either bacteria? Can it live on tongue/front of the mouth, or is only in the back of the throat?

Also, if he's had it undetected for a long time, are there health complications like there would be if it was in his urethra?

thanks
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago
Welcome to our Forum.  You are asking good questions.  There are no formal studies of the risk for acquisition of gonorrhea or chlamydia from the receipt of cunnilingus.  Case reports clearly indicate that this does happen but also indicate that it is a relatively rare occurrence.  Mechanistically, as you indicate, gonorrhea and (even more rarely) chlamydia are present in the back of the throat, and, if present at all in saliva are present in low concentrations.  Thus, in answer to your specific questions:

1. Statistically it is unlikely that he has either infection in his throat.
2. Even if he does, it is statistically unlikely that he transmitted it to you.
3. If he were infected in his throat, as best we can tell, the major threat is of him transmitting infection to others and not for leading to complications of the sort that occur with genital tract infections.

So, as far as what to do, my advice would be not to worry.  If you are concerned, you could ask your own doctor to test for you. 

Hopefully I have addressed your questions.  Please let me know if any of this is unclear.  EWH
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44 months ago
Thanks for your responses. A few follow ups. 

- if it's present in the saliva what part of my vagina needs to be exposed for me to get it? I've read the cervix, which no tongue is long enough to reach, but I worry about other areas. 

- which is a greater risk in this scenario: chlamydia or gonorrhea?

- a few weeks ago in the middle of my cycle I had some dull abdominal pain and some brown discharge after sex. Was first time I'd had sex in several months.  Not a lot of discharge and it went away very quickly.  Am I being paranoid or is this a sign I have an std?


Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago
The vagina does not get infected with gonorrhea or chlamydia.  These are infections of the cervix which, as you point out, cannot be reached by anyone's tongue.  Further, it is not the tongue that gets infected with gonorrhea or chlamydia. 

The risk for gonorrhea is higher than the risk for chlamydia because chlamydia is very rare as a pharyngeal infection.

I suspect your transient abdominal discomfort is unrelated to the sexual activity that you describe.  My sense is that you are overthinking this a bit.  EWH
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44 months ago
Thanks doctor. I've just seen that WSW are particularly at risk for these diseases, and wonder how they are getting it if not through oral sex. 

My concern is increased not only because of my unusual abdominal discomfort and discharge, but also because I have been very very tired. Just worried, is all. 
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago
Actually, we have studied this and the WSW who get these infections most often either also have male partners or have female sex partners who have male partners.  Further, sex toys may play a role in transmission of infection between women. 

I really think you are worrying too much about this.  I also think that because of this, it would be a good idea to see your doctor or go for a sexual health check up and get tested.  When you do, I am confident that your tests will be negative. 

This is my 3rd reply to your questions.  As per Forum Guidelines, this thread will be closed later today.  I wish you the best.  EWH
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