Dear Dr G,
I am an inexperienced guy who has just started my sexual journey in life.
I am twenty-five and so far have had three sexual partners.
Like most men, I enjoy being the recipient of oral sex. I confess, on the other hand, I am not keen to offer oral sex to my partners.
I don’t know why, just don’t feel so comfortable about it. Perhaps, I am worried about hygiene and the risk of infection?
In the last two relationships, my girlfriends started getting upset and protested that it is unfair to receive and not give.
I would like to put Dr G on the spot about the topic of oral sex?
What exactly constitutes oral sex?
Is oral sex really necessary in a sexual relationship?
Are men likely to receive oral sex, as equally than giving their partners the same?
If not, is it because the risk of sexually transmitted infection, such as HIV, is higher for men giving oral sex?
Lastly, is there any way for me to overcome my fear of giving oral sex?
Any form of sexual act involving the oral stimulation of the genitalia of a person by another individual is considered oral sex. The performer may use the mouth including lips, tongue or teeth.
Cunnilingus describes oral sex performed on the vulva or vagina. Fellatio is oral sex performed on the penis. Anilingus is associated with oral stimulation of the anus. Oral stimulation of the other parts
of the body, like kissing or licking of the erogenous part of the body such as the nipples, tends not to be considered oral sex, as the oral contact with the skin or mouth is considered less erotic than contacts with genitalia.
Although oral sex tends to be performed as part of foreplay, the oral stimulation of the genitalia is an erotic form of intimate act in its own right. Kissing or oral caressing of the penis, vagina and anus can heighten the sensual feeling and priming the couples prior to penetrative intercourse. Some experts even believe oral sex is the relationship strengthener, as the couples will require total trust and accepting vulnerability.
Like any form of sexual activities, oral sex poses a risk of contracting sexually transmitted infections. However, the risk of transmission is significantly lower than penetrative intercourse. Apart from the infectious risks, oral sex may be regarded as taboo and carries significant stigma. Individuals with sexual inhibitions may consider oral sex unnatural and express psychological barriers in giving or receiving oral sex. Studies also show oral sex causes stress in partners concerned about hygiene and sexual power dynamic, especially when a man is expected to perform oral sex on the labial and vagina.
The bacteria than can commonly be transmitted by oral sex are chlamydia and gonorrhea. The viruses that are associated with oral transmission are hepatitis, herpes and human papilloma virus. The risk of oral sex infection increases when there is a wound in the genitalia or open sores in the mouth. The risk of HIV transmission via oral sex is exceedingly rare but reported in medical literature. Two authoritative reviews demonstrated the probability is between 0% to 0.04% per act of oral sex.
There is no specific study to demonstrate whether the performer or receivers are more at risk. The rate of transmission is equivocal especially if the performer has an infection in the throat or the receiver has an infected penis, vagina or anus. The risk also increases when the performer has poor oral hygiene and bleeding gums. The risk of receiver escalates when visible sores are noted on the genitalia. Being exposed to men with pre-cum of an infected person also poses a higher risk. Therefore, the risk of women contracting infection is equally high.
To reduce the risk of oral sex transmission, the penis can be covered with non- lubricated condoms. A dental dam is also proven to be protective. However, being in a long-term monogamous relationship with a partner who is infection-free, is the key to have risk free oral sex.
One of the twentieth century’s major poet, TS Eliot once said: “Only those who will risk going too far can possibly find out how far one can go.” When young men (and women) start their sexual journey, it is also the beginning of journey risk-taking. The experience that starts with kissing and caressing is inevitable to progress to oral sex, and eventually the full-on “risky” penetrative intercourse. How far should one go, and how much risk to accept is often a conundrum. When Dr G is put on the spot by the young lovers who are wondering how far can one go in this risky business of sex (and oral sex), his response is “Only those who trust and respect each other can possibly find out how far one can go, without risking going too far!”
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Dr George Lee is a consultant Urologist and Clinical Associate Professor whose professional interest is in men’s health. The column “Ask Dr G” is a forum to help men debunk the myths and taboos on men’s issues that may be too “hard” to mention. You can send him questions at email@example.com