Introducing Jake Deutsch, M.D., a veteran ER doctor and contributor to The Daily Details. Send your health questions to Ask@Details.com. We'll publish the answers here every Friday.
I walk into the consultation room and the first words out of my patient's mouth are "Doc, my dick looks like Frankenweenie." Reflexively, I withdraw my handshake. As it turned out, he had genital herpes, which he picked up getting a blowjob. My patient, like millions of other horny guys, assumed that oral sex is safe sex, but that's not always true. There are more than 30 types of infections that can be transmitted orally. Nowadays, doctors use the term "sexually transmitted Infection" rather than disease, since most are treatable (STD is so 2001). Curable or not, an STI's natural tendency to spread doesn't discriminate when it comes to orifices; some are spread via body fluids and others simply by skin-to-skin contact.
Here's the lowdown on what you need to know before going down.
It's a two-way street. It doesn't matter whether there's fish or beef on your menu; notorious infections like syphilis and chlamydia are being swapped at alarming rates. Giving head to an infected person can result in a throat besieged by sores, white discharge, and red spots, and gonorrhea of the throat may last for months and can be resistant to antibiotics, making it difficult to treat.
The reverse scenario isn't any better. If you're on the receiving end of a blow job from a partner with a throat infection, you can look forward to a drippy dick and a shot of penicillin in the ass. Unfortunately, infections are not always visible or symptomatic, so you or your partner might have gonorrhea or chlamydia and never know it, but this doesn't mean you can turn a blind eye. If it's left untreated in women, it can permanently scar the fallopian tubes, while men can expect inflamed prostates and infertility.
It's gone viral. Herpes and genital warts are the most easily transmitted STIs, and your partner doesn't have to have an outbreak for you to catch them. When you break down the math, 80 percent of people carry the herpes simplex virus (like cold sores), the most commonly transmitted STI from oral sex; 50 percent of sexually active people have genital warts caused by the human papillomavirus (HPV), which, when orally transmitted, is thought to be a cause of head and neck cancers.
Don't be a sore loser. HIV and hepatitis transmission via oral sex is low, but if there are open sores in the mouth and they come in contact with ejaculate, the risk magnifies significantly. If you're the one receiving oral sex, the risk of contracting HIV or hepatitis is extremely low, but put on the breaks if the cunning linguist has fresh piercings, bleeding gums, or canker sores.
Don't order the crab. Pubic lice (a.k.a. crabs) are nasty little parasites that require only brief contact to catch—carpet munching included. Oral sex has been shown to transmit crabs to eyelashes and eyebrows—not a pretty look.
Practice sexual defense. You have to set your own limits on the risks you're willing to take with a romp in the hay. Talk to your partners. If you can give head, I'm sure you can have a conversation about safe sex.
—Dr. Jake Deutsch is an New York City-based ER doctor. Follow him @DrJakeDeutsch.