[Question #6013] Oral Transmission Risk

71 months ago

Good evening. A week ago, I performed cunnilingus on a woman. Today, I have a bit of a sore throat and maybe a swollen gland in the neck and a mild headache. Is there a good possibility I contracted an STI such as gknorrhea or chlamydia? If so, what are the chances I could transmit it by performing cunnilingus on someone?

H. Hunter Handsfield, MD

71 months ago

Welcome back to the forum.

Cunnilngus is very low risk for bacterial STD transmission, including gonorrhea and chlamydia. I have never seen or heard of oral chlamydia acquired by cunnilingus, and gonorrhea is also extremely rare from such an exposure. And oral gonoprrhea almost always (>95% of the time) causes sore throat or other symptoms, and oral chlamydia is not known to cause symptoms at all. Therefore, your "sore throat and maybe a swollen gland...and headache" almost certainly are not caused by any STD from the cunnilingus event a week ago. Your risk is low enough that testing really isn't necessary, althoug of course you are free to be tested if you would gain additional reassurance from the negative result. In addition, oral gonorrhea or chlamydia are almost never transmitted to female partners by cunnilingis: here too, there are NO reported cases to suggest this has ever happened. That's not to say it cannot happen, but if it can, it is extremely rare. If somehow I were personally in your situation, I would not be tested and I would not worry about infecting my sex partner(s).

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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71 months ago

Thanks for your answer. What STI risks are presented by cunnilingus?

H. Hunter Handsfield, MD

71 months ago

There's probably some risk for all STDs, at least in theory.l See above about gonorrhea and chlamydia. Perhaps the main risk is herpes, if the female partner has currently active genital herpes. However, I have never seen or heard about any patient with oral herpes acquired by oral sex with a female partner, so it's obviously rare. Syphilis is possible, but here too I am unaware of any cases. HIV probably zero risk or very close to zero. Probably similar for viral hepatitis.---

71 months ago

That is very interesting. I had thought syphilis was super contagious. Just for the sake of clarity, are you indicating that genital herpes does not (or seldom) transmit(s) via cunnilingus to the mouth? Thanks for your time, attention, and education.

H. Hunter Handsfield, MD

71 months ago

Syphilis certainly is highly contagious, but still you must be exposed to an active infection. Syphilis is currently very rare in even the most sexually active women in the US, outside certain settings (e.g. inner city ethnic minorities); and even in women with syphilis, at any point it time, most do not have active, transmissible genital lesions.

Herpes simplex virus also can be transmitted genital to mouth, but here too, the large majority of sexually active women do not have genital herpes; and among those that do, the virus is actively transmissible only a minority of the time.

That completes two follow-up comments and replies, included with each question, and so ends this thread. Thanks for the thanks. I'm glad to have helped -- that's why we're here!

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