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STDs (Expert Forum)
syphilis from oral sex
Answered by
University of Washington
Seattle - WA
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
Doctor's Answer
by H. Hunter Handsfield, M.D., Mar 06, 2009 03:15PM
, Mar 06, 2009 03:15PM
I doubt there has been a single case of syphilis acquired by performing cunnilingus in the past 10 years in the United States. Why? One reason is that there aren't very many infected women, outside rather restricted population groups (two thirds of all cases occur in gay men).
The proportion of people with newly acquired syphilis who remain asymptomatic depends on the site of exposure. It is hard to miss a chancre of the penis or mouth, but easy to miss one inside the rectum or vagina. The chance someone could catch syphilis of the mouth and not notice anything wrong probably is well under 10%. The symptoms of secondary syphilis can be subtle, however. But considering all people with newly acquired infection probably at least 80% would have symptoms of primary or secondary syphilis.
Assuming this all applies to you, it seems you have little reason to worry about syphilis. But if this reassurance doesn't completely resolve your fears, have a syphilis blood test about 6 weeks after the exposure.
I hope this helps. Best wishes--- HHH, MD
The proportion of people with newly acquired syphilis who remain asymptomatic depends on the site of exposure. It is hard to miss a chancre of the penis or mouth, but easy to miss one inside the rectum or vagina. The chance someone could catch syphilis of the mouth and not notice anything wrong probably is well under 10%. The symptoms of secondary syphilis can be subtle, however. But considering all people with newly acquired infection probably at least 80% would have symptoms of primary or secondary syphilis.
Assuming this all applies to you, it seems you have little reason to worry about syphilis. But if this reassurance doesn't completely resolve your fears, have a syphilis blood test about 6 weeks after the exposure.
I hope this helps. Best wishes--- HHH, MD
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Contrary to what you assume, many commercial sex workers are not at particularly high risk for most STDs or HIV. The frequency of syphilis in escorts (i.e., more expensive CSWs) probably is very low, especially in those who routinely use condoms for vaginal and anal sex, as yours apparently does. My estimate above of the likelihood of someone acquiring syphilis by cunnilingus applies to you. You aren't likely to be the first such case in recent years, especially in the absence of a lesion of your lips or tongue that you would notice.