Many people have questions about anal and oral sex. Are they safe? What are the risks? Can you get pregnant or get a sexually transmitted disease (STD) from either? Are either safe during pregnancy?
Even though the pregnancy risk is not really significant with anal or oral sex, sexually transmitted diseases (STDs) can still be spread from one person to another. There are other serious risks associated especially with anal sex, particularly during pregnancy.
Here you will find information on both anal and oral sex as well as answers to many frequently asked questions. Then you can weigh the risks and decide on your sexual boundaries.
What is anal sex/intercourse?
The most common perception of anal sex is when a male inserts his penis into another person’s anus, which is mostly what this article covers. However, it can also include penetration of the anus with sex toys or fingers or stimulating the anus with the mouth or tongue. It is still considered anal sex if insertion happens, but ejaculation does not occur.
There are two ways that we talk about anal intercourse: receptive anal intercourse and insertive anal intercourse. “Receptive” refers to the person that is receiving penetration, and “insertive” refers to the person (male) who is providing penetration to the anus. There is also heterosexual versus homosexual anal intercourse; here, we will mainly focus on heterosexual anal intercourse (man with a woman).
What is oral sex/intercourse?
Oral sex is when one partner uses his or her mouth on his or her partner’s genitalia (vagina or penis) to stimulate a pleasurable response. It is still considered oral sex even if ejaculation or orgasm does not occur.
Can you pick up or pass on an STD through anal or oral sex?
Yes, you can still contract or transmit STDs through anal and oral sex. Anal sex can more easily damage tissue (tears in the lining of the anus or rectum) than during vaginal sex because the anus is not designed for insertion. Therefore, the skin barrier that often protects against infection is broken and STDs can more easily enter the body. This means that transmitting or contracting an STD is more likely from anal sex than with vaginal or oral sex.
The Centers for Disease Control and Prevention have released the following statistics in terms of the likelihood of contracting HIV from anal sex. Receptive anal intercourse makes a person:
- 13 times more likely to contract HIV than for insertive anal intercourse;
- 17 times more likely to contract HIV than with vaginal intercourse;
- 2 times more likely to contract HIV than a person who practices needle sharing during drug use.
Similarly with oral sex, if the person performing the act has any cuts or sores in his or her mouth it makes it easier to transmit or contract an STD since the protective barrier is broken. However, even without cuts or sores, it is still possible to pick up or transmit an STD. Certain infections can specifically affect the mouth, lips, or throat when it is contracted through oral sex, like herpes (HSV-1), chlamydia, and gonorrhea.
Do my partner and I need to use condoms and/or lubricant during anal or oral sex?
Since STDs can still be spread through both anal and oral sex, it is a good idea to use physical protection such as a condom to protect both yourself and your partner. Since the skin of the anus and rectum is thin, prone to tears, and not well lubricated, it may also be a good idea to use a water-based lubricant to protect these delicate regions from tissue damage. A lubricant cannot, however, completely prevent tearing or injury. With oral sex, no lubricant is suggested because most brands are not safe to ingest.
Can a woman get pregnant from anal or oral sex?
Though neither act itself can get a woman pregnant, if any fluids containing sperm accidentally come into contact with the vaginal opening or tract, there is a possibility of pregnancy. This is more likely with anal sex because the vaginal opening is so close to the anus.
What are the risks involved from having anal or oral sex?
With anal sex, the lining of the anus and rectum is thin and may be easily damaged which allows bacteria and other infectious agents to enter the bloodstream directly. This can increase the risk of certain rectum-related health issues. Anal sex is known to:
- Increase the chance of contracting an STD (for a woman, it is 17 times higher than with vaginal intercourse, specifically with HIV);
- Heighten the risk of exposure to hepatitis A, B, and C,
- Increase the chance of developing anal cancer or anal warts (both usually associated with HPV, a viral STD);
- Irritate, inflame, or rupture existing hemorrhoids, causing discomfort and/or anal bleeding;
- Heighten the risk of contracting digestive infections from bacteria, parasites, and amoebas that normally only exist in the digestive tract and do not cause problems otherwise. (Especially for couples that participate in vaginal after anal intercourse or oral-anal play.) Examples include:
- E. coli
- Intestinal amoebas
- Be a factor contributing to fecal incontinence (not being able to control bowel movements);
- Cause urinary tract infections in the male or female, especially for those who participate in vaginal after anal intercourse.
Most of the risk with oral sex is associated with the possibility of contracting or spreading STDs. Almost all STDs can be spread through oral sex, like HIV, the virus that causes AIDS. Herpes (mostly HSV-1), gonorrhea, and chlamydia can all infect the mouth, lips, or throat. If you have herpes type 1 (cold sores) and perform oral sex, you may transmit it to your partner which could cause genital herpes to develop.
For women who are receiving oral sex, it is important that your partner does not blow any air into your vaginal tract. A bubble can cause a pressure differential which may burst blood vessels near the surface. This may cause vaginal bleeding or more serious effects.
To learn about risks specifically in pregnant women, read the next section.
Are anal and oral sex safe during pregnancy?
Oral sex is generally only deemed “likely safe” during pregnancy if you are in a mutually monogamous relationship in which both of you have tested negative for STDs. For those who choose a new sexual partner or have multiple sexual partners during pregnancy, there is the risk of contracting STDs, of which many can negatively affect a pregnancy and the developing fetus.
During pregnancy especially, it is important that if you are receiving oral sex that your partner does not blow into the vaginal opening and cause any air to be trapped inside the vagina. This is because this bubble of air can travel and enter the placenta, which can cause problems with fetal development. Additionally, the pressure differential caused by air being trapped in the vagina can cause blood vessels to rupture, causing spotting or bleeding.
If you do decide to engage in oral sex during your pregnancy with a new sexual partner or outside of a mutually monogamous and disease-free relationship, using a condom can help reduce your chances of contracting STDs through oral sex.
Anal sex during pregnancy is not typically considered safe. This is due to a few things:
- Pregnancy may cause hemorrhoids to form, which can make anal sex painful or uncomfortable and may inflame the hemorrhoids or cause them to rupture. Anal bleeding can be serious, especially during pregnancy.
- Some infections can cause problems during pregnancy, such as Giardia (giardiasis) and Group B Streptococcus (GBS), among others. Giardia can cause chronic diarrhea which may lead to dehydration and malnutrition, both of which can be dangerous during pregnancy both for the mother and fetus. GBS may be transmitted to the baby during delivery and can lead to an infection in the infant. Both Giardia and GBS often colonize the rectum and can be spread to the vaginal tract if vaginal or oral sex follows anal sex, or if there is any touching (hands or genitals) after anal sex.
- Anal sex increases the risk of contracting STDs, many of which can cause serious complications for a developing fetus.
Last updated: August 25, 2017 at 10:05 am
Compiled using information from the following sources:
1. Mayo Clinic. Anal Sex Risks
2. Mayo Clinic. Diseases and Conditions Associated with Anal Sex
3. NCBI, National Library of Medicine
4. National Health Service (NHS) of the UK
5. Nature / The American Journal of Gastroenterology
6. WebMD, Anal Sex Health Concerns
7. Medical Institute for Sexual Health