4 Things You Didn't Know About Oral Sex (cont.)

"One person will not want to receive it because he or she worries about the partner's reaction," Weston says.

Some people may also be anxious about their performance -- doing it well enough to please a partner -- or about responding appropriately to receiving it. "Some people can't just let go and receive," Weston says.

Sexual power dynamics may be part of it, too.

"Some people resist doing it because they feel a bit subjugated," Weston says. Her advice for those people: "They have a very important body part between their teeth; and after all, who is in charge in a position like that?"

Other people, Weston says, experience oral sex as a "relationship strengthener" and "a very intimate connection" shared with a partner. "It's being able to look at the partner and see them going into really very personal space," Weston says.

3. Unprotected oral sex is common, but has risks.

Several sexually transmitted diseases (STDs), including HIV, herpes, syphilis, gonorrhea, HPV, and viral hepatitis can be passed on through oral sex.

"Oral sex is not safe sex," says Terri Warren, RN, owner of Westover Heights Clinic in Portland, Ore., a private clinic specializing in STDs. "It's safer sex, but it's definitely not safe sex."

The risks depend on a lot of different things, including how many sexual partners you have, your gender, and what particular oral sex acts you engage in.

Using barrier protection can reduce the risk of getting an STD. A barrier can be a condom covering the penis, or a plastic or latex "dental dam" placed over the vulva or anus. Instead of a prepackaged dental dam, a condom cut open to make a sheet is also an acceptable barrier.

But most people don't use protection for oral sex. That's common wisdom, and it's also shown by large-scale surveys of sexually active teens and adults.

That's probably because many people don't know that STDs can be spread orally. Or if they do, they don't see the health risks as being very serious, Warren says.

The risks of getting an STD from unprotected oral sex are typically much lower than the risks posed by having unprotected vaginal or anal sex, Warren says.

Warren's advice about using barrier protection for oral sex depends on whom she's talking to. Typically, performing oral sex on a male partner without a condom is riskier than other forms of oral sex, she says.

For example, Warren says she might stress the importance of condom use for a man having oral sex with multiple male partners.

"If a male is giving oral sex to a woman, I consider that to be a low-risk exposure," Warren says. But if a woman's regular partner has oral herpes, "that's a whole different discussion," she says.

4. Oral sex is common among teens.

Many U.S. teens have oral sex before they have vaginal sex. And they don't view it as very risky, says Bonnie Halpern-Felsher, PhD, a pediatrics professor at the University of California, San Francisco.

Compared with vaginal sex, "They really don't consider it as big of a deal," Halpern-Felsher tells WebMD. Past surveys Halpern-Felsher conducted showed that most teens thought that engaging in oral sex would not put them at risk for social, emotional, or health problems. Other surveys she has performed showed teens who said they only had oral sex were less likely than those who had vaginal sex or vaginal and oral sex to report STDs.

Still, there were STDs among all three groups of sexually active teens. Just under 2% of teens who said they'd only had oral sex said they caught an STI, compared with about 5% of those who had vaginal sex only, and 13% of those who had vaginal and oral sex.

The oral sex-only teens were also less likely than other sexually active teens to report getting into trouble with parents, experiencing negative feelings, or having a worsening relationship with a partner because of their sexual activity.

But there was a gender gap in how teens felt about oral sex.

Males were more likely than females to claim social and emotional benefits. Females were more likely to report feeling used or guilty, or that oral sex had hurt a relationship.

In another survey, 425 ninth-graders from the same group were asked open-ended questions about why they thought that people their age would have oral sex.

The idea that it's less risky than vaginal sex was their No. 5 reason. Here are their top four reasons : 1) seeking pleasure, 2) improving relationships, 3) gaining popularity, and 4) curiosity.

That list differed between males and females. Pleasure was the No. 1 reason cited by males; females said their main motivation was to improve a relationship.

Otis Brawley, MD, chief medical officer, American Cancer Society.
Terri Warren, RN, ANP, Westover Heights Clinic, Portland, Ore.
Bonnie Halpern-Felsher, PhD, professor of pediatrics, University of California, San Francisco.
Louanne Cole Weston, PhD, licensed marriage and family therapist , board-certified sex therapist, Fair Oaks, Calif.
National Center for Health Statistics, National Survey of Family Growth, 2002.
D'Souza, G. New England Journal of Medicine, May 2007; vol 356: pp 1944-1956.
American Social Health Association.
Halpern-Felsher, B. Pediatrics, April 2005; vol 115: pp 845-851.
Brady, S. Pediatrics, February 2007; vol 119: pp 229-236.
Cornell, J. Journal of Adolescent Health, March 2006; vol 38: pp 299-301.
Reviewed on September 05, 2011
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