Cunnilingus concerns with CSW's weighing heavily.

[Vincent1234]

Hello Doctor.  I've had a few encounters with escort type CSW's over the past few years here in NE Ohio, including recently, whereby I performed unprotected cunnilingus. With all the intense media scare about HPV and male throat cancers, is there a real concern?  If so, what are the chances that I obtained 'the cancerous strain'?  Is there a test to find out?  In addition, i've had a cough, mucus production, and phlegm for well over a year now, and my physician diagnosed (with a blood test) mycoplasma pneumonia.   Even after 2 rounds of Biaxin recently, my bronchial symptoms have returned a bit.  I took an anonymous full panel STD test a few months ago and was negative for STD's.  Would cunnilingus, in any way, have caused these bronchial symptoms (can you catch anything that would pass into the lungs)?  I am in my late 40's.  Thank you in advance for your response.

[Edward W Hook, MD]

Welcome to our Forum. I'll try to help.  Among types of sexual exposure, cunnilingus is probably the lowest risk for becoming infected with any STD. The reasons for this are part anatomical and partly due to the fact that the throat is rather resistant to infection with most anything.  As for oral HPV, this is an emerging field where there is a lot of research going on and, unfortunately, a lot of media and internet generated hysteria which is sensationalistic an unwarranted.  Last year on our country of over 350 million people there were less than 7000 cases of oral/throat cancer due to HPV 16, the genital HPV now associated with these cancers.  Since the majority of sexually active people have HPV at some time in their life and since most of them have included oral sex in their sexual activities, any one person's risk is quite low.  As for risk facts, while there is an association with HPV and it is logical to consider oral sex as a contributor this contribution is small an currently not something to worry about.  On the other hand, far and away the most common risk factor for oral cancers is smoking or chewing tobacco. Thus, at this time, the best thing a person can o to avoid oral cancer is to not or stop smoking and other tobacco use.  In addition, most dentists now inspect for oral cancers during their regular checkups so see your dentist regularly.  There is no test an even if there were, if HPV were detected in your mouth, the significance would be unknown.  Remember, most HPV infections resolve on their own, without treatment an only a tiny fraction of them go on to cause cancer.

As for your cough, I think you need another opinion.  Mycoplasma should not be diagnosed with a blood test an there may be another contributor.  I am confident however that your cough is not related to your history of oral sex.

I hope these comments are helpful.  EWH

[Edward W Hook, MD]

No, there are no STDs which might cause the sort of long lasting respiratory symptoms you describe.  As i said, I think you need a second opinion by an interist or even a respiratory (pulmonary) specialist.  Take care.  EWH

[Vincent1234]

Thank you Doctor.  Is there *anything* else (like yeast, fungus, molds, or other bacteria or viruses) that can possibly be transmitted by unprotected cunnilingus that could concievably cause any long term bronchial symptoms (cough, mucus, phlegm, etc.) like i've been experiencing?  This will be my last posting, and I thank you in advance for your time and knowledge.