Your nether bits aren’t the only place a sexually transmitted infection (STI) can land and set up shop.
“There are many STIs that can occur in areas other than the genitals,” says Michael Ingber, MD, a board certified urologist and female pelvic medicine specialist at The Center for Specialized Women’s Health in New Jersey.
News to you? Scroll down for our nongenital STI guide.
Um, since forever.
Anywhere there’s a mucous membrane, an STI can develop, says Ingber. The most common of those areas include:
“These infectious agents will infect whatever area they can get a hold of,” says Felice Gersh, MD, author of “PCOS SOS: A Gynecologist’s Lifeline to Naturally Restore Your Rhythms, Hormones, and Happiness.”
This means they aren’t technically considered genital STIs, but full-body infectious agents.
So, you got tested for genital STIs, and the tests came back negative. Cool, you don’t have a genital STI!
Unfortunately, that doesn’t mean anything for nongenital STIs. Anal, oral, and other nongenital STIs are still a possibility.
As Queen says, “A person can have a nongenital STI alongside a genital STI, or they can have a nongenital STI [even] if they don’t have any kind of genital infection.”
Depending on the acts in your sexual repertoire, yes.
Let’s say you have a partner who has a penis, and they’ve been diagnosed with genital herpes.
You probably already know that if you and your partner have vaginal sex without a condom — or put the condom on too late, the condom broke, or you otherwise used the condom incorrectly — you’re at risk for developing vaginal herpes.
Well, if you had anal intercourse with, or gave oral sex to, that same partner without adequate barrier protection, you’re at risk for developing the herpes virus (HSV) in or around your mouth and anus, too.
“If you’re given an oral antibiotic, that should clear up the infection everywhere,” says Gersh.
Theoretically, this should completely cure the infection wherever it’s located in or on the body.
Your doctor will likely recommend that you return about 8 weeks after diagnosis to make sure that the treatment worked and you don’t still have the STI.
Here’s where it gets sticky: If you and your doctor don’t know that you have a bacterial STI at another part of the body, they won’t be able to confirm that the infection has truly gone away.
Ingber offers another example:
“If you’re taking oral acyclovir for genital herpes, it will clear up any oral symptoms of the virus, too.”
But the treatment for genital warts is more localized.
“Someone may be prescribed podofilox, a topical cream for genital warts, but that wouldn’t cure warts that are present in other parts of the body that aren’t having the cream applied,” Ingber says.
“The sooner an STI can be found and treated, the more likely there will be only minimal damage or effect on the body,” says David B. Samadi, MD, urologist and men’s health expert at Robotic Oncology in New York.
The exact side effects of leaving an STI untreated depend on the particular infection:
- Chlamydia. It can lead to pelvic inflammatory disease in vulva owners, which can cause painful scarring of the fallopian tubes and infertility. It can also cause infertility in people with penises.
- Gonorrhea. In rare cases, gonorrhea can spread throughout the body, causing damage and severe pain. It can also lead to pelvic inflammatory disease and even infertility in vulva owners. It can cause infertility in people with penises, too.
- Herpes. If you don’t take an antiviral drug to help reduce the risk of an outbreak, the risk of having an outbreak and transmitting the infection to a partner is higher.
- Hepatitis B. Untreated, this virus can invade and damage liver cells, increasing a person’s lifetime risk of liver cancer.
- HIV. HIV attacks your body’s immune system, which can make you more susceptible to illnesses. While people with HIV can live long, healthy, pleasure-filled lives with antiretroviral therapy (ART), untreated HIV can progress to AIDS.
- HPV. There are several types of HPV that infect the mouth and throat. Left untreated, it can lead to throat, neck, head, mouth, cervical, vulvar, and penile cancer.
- Molluscum contagiosum. While this virus typically causes benign lesions, in rare cases, scratching at them can lead to secondary infection or scarring.
- Syphilis. If untreated, syphilis can damage your other internal organs like the brain, nerves, eyes, and joints. In severe cases, it can lead to blindness, paralysis, and death.
- Trichomoniasis. Untreated trichomoniasis can increase your risk for contracting HIV if you’re exposed to the infection.
“Beyond the health risks, if you leave an infection untreated, the risk of transmitting that infection to someone else is incredibly high,” says Gersh.
Basically, all of them can be transmitted from mouth-to-genitals or from genitals-to-mouth.
However, some are more easily transmitted than others. These include:
According to the
There have been no confirmed reports of hepatitis B or C from oral play.
In addition to skin-to-skin STIs, rimming can transmit:
- hepatitis A and B
- intestinal parasites, such as Giardia
- bacteria, such as E. coli and Shigella
What increases the risk of transmission?
The main risk factor? Not using a barrier method with a partner with a known STI or whose STI status you don’t know.
“Almost all of the STIs can be transmitted through anal penetration,” says Ingber.
“Chlamydia, gonorrhea, syphilis, HIV, HSV, HPV, hepatitis A, B, and C can all be transmitted to the rectum if you have unprotected sex with a partner with a penis with one of these infections,” he says.
What increases the risk of transmission?
This is gonna sound familiar, but not using barrier protection with a partner with a known STI or whose STI status you don’t know increases transmission risk.
“Because the tissues of the anal canal are so delicate, there’s a heightened risk of developing small nicks or tears in the tissues,” says Samadi.
“[This] allows bacteria and infection to more easily get into a person’s system.”
In the case of anal penetration with a penis, showering ahead of time can help reduce the risk of bacteria transmission into the anus.
When it comes to using a toy, washing it ahead of time can help. It’s also important to use a toy made of a nonporous material, such as:
- stainless steel
“Most STIs are asymptomatic, which means you can have an STI and spread it to your partner whether you have symptoms or not,” says Ingber.
That’s why he recommends you get tested for anal and oral STIs as often as you should be getting tested for genital STIs. This frequency can be:
- once a year
- after every new partner
- after having sex without a barrier method with a partner who has an STI
You should also get tested if there was a barrier mishap with a partner who has a known STI or whose STI status you don’t know.
Common mishaps include:
- the condom breaking
- the condom sliding off
- the dental dam slipping out of place
Most people who have an STI don’t experience any symptoms at all. But in the case that you do, here’s what to expect.
Oral STI symptoms include:
- mild sore throat
- sores, bumps, or warts around your lips, on your tongue, or in your throat
- swollen glands
- difficulty swallowing
- vocal changes
- dental pain
Anal STI symptoms include:
- painful bowel movements
- pain during penetration
“Testing for oral and anal STIs can be quick and easy,” says Samadi.
“Depending on which STI, you’ll need to give blood sample, have the area swabbed, or provide a urine sample.”
|STI||Blood sample||Swab area||Urine sample|
|HSV (no sores)||X|
|HSV (visible sores)||X|
|HPV (oral)||sample of lesion taken for biopsy to determine if it’s cancerous|
|Syphilis (no sores)||X|
|Syphilis (visible sores)||X|
Can you get them both at the same time? At the same time as genital testing?
Yes and yes!
When you’re getting one area tested, you should get your other areas tested, too.
All STIs are either treatable (meaning the symptoms can be managed) or curable (meaning that they go away completely after treatment).
But (!): “The longer someone waits to get treatment, the more dangerous these STIs can be,” says Ingber.
The first step? Learn your own STI status, and ask any potential partners what their STI status is and when they were last tested.
Use barrier protection
If you’re getting hot and heavy with someone who has an STI or who doesn’t know their current STI status, use barrier protection — for all sex acts!
Putting lube on the inside of the condom or on the vulva-side of a dam can make barrier protection more comfortable for the wearer.
And putting lube on the outside can make penetration and performing oral more enjoyable for the giver. Yeehaw!
Consider preventive medicine
You might also ask your doctor or other healthcare provider if there’s any medication you or your partner can take to reduce the risk of transmission.
For example, they may recommend you take pre-exposure prophylaxis (PrEP) if your partner has HIV (or might have HIV) — or vice versa.
If your partner has herpes, your provider may recommend that they take an antiviral drug to decrease the risk of the virus getting transmitted to you — or vice versa.
No matter what kind of sex you’re having, it’s important to know your STI status!
That way, you can treat any genital or nongenital STI you do have and share your status with your partner or partners.
This will allow you each to make an informed decision about what safer sex practices you want to use.
If you don’t feel comfortable asking your current provider to test you for genital, oral, or anal STIs, Queen says:
“Find a new doctor! There are sex-positive providers who have these conversations every single day in a way that will make you comfortable, seen, heard, and informed.”
According to Queen, Planned Parenthood and other clinics that specialize in sexual health and STI testing are generally your best bet for this kind of care.
Gabrielle Kassel is a New York–based sex and wellness writer and CrossFit Level 1 Trainer. She’s become a morning person, tested over 200 vibrators, and eaten, drunk, and brushed with charcoal — all in the name of journalism. In her free time, she can be found reading self-help books and romance novels, bench-pressing, or pole dancing. Follow her on Instagram.