After reading your column on hand washing after urination [January 12], I’m certain I’m going to die–that is, if coliform bacteria are as bad as you say. My girlfriend and I often share the pleasures of fellatio and cunnilingus. Heck, one night I even got up the nerve to perform (ahem) analingus. But what about the dread coliform bacteria? I’m certain some of these bacteria came in contact with our mouths at some time. Yet I have never been sick due to these forms of sexual gratification. Do we just swallow it and put it back where it came from (our intestines) or what? Please don’t tell me I have to refrain from yet another fun thing to do. –Matt Hostetler, via the Internet; similarly from Peter Montgomery, Don Martin, Bubba the Salty Dog, Dr. Dormammu, J. Moore, Parker Trudeau, Joe Mantango, David Reid

There’s nothing like causing a national panic. Now I know why Pat Buchanan likes to run for president. Mrs. Adams had the same thought you guys did, probably at about the same point during the evening. “Babe,” I said with what may well have been a shit-eating grin, “you think sex is safe? Let me tell you about sexually transmitted diseases.” Not the most romantic line I ever used. But the truth is you can catch lots of bugs via oral sex; many of them are transmitted by, or have their transmission facilitated by, coliform or other fecal bacteria or, for that matter, fecal viruses. There’s no point in stopping now though. You can catch most of the same germs from intercourse, kissing, or simply holding hands.

For example, a common complaint among women is urinary-tract infection, which is often caused by sexually transmitted fecal bacteria. Research suggests these bacteria travel to the entrance of the vagina, get shoved in by the penis during intercourse, and then migrate to the bladder. In other words, the guy helps infect the woman with her own germs. (Doctors–male ones usually–blame this on the “woefully short” female urethra.) It seems likely oral sex could accomplish the same thing, but for a given infection there’s no way to tell.

It’s rare that a specific sexual practice is associated with spreading germs, but there are exceptions. About 20 years ago clinicians began noticing what has come to be called “gay bowel syndrome,” a collection of intestinal and rectal complaints that frequently plague gay men. Many of these illnesses stem from infection by fecal bacteria following anal sex–specifically, anal intercourse, analingus, and fellatio following anal intercourse. Some heterosexual couples (estimates range from 5 to 27 percent) also engage in anal sex, and they’re at risk too.

The question is how much risk. The answer is probably not much, unless they’re unusually out there sexually. A key factor in gay bowel syndrome and in the spread of STDs generally is multiple sex partners, which exponentially increases your exposure to infection. In contrast, monogamous couples, whether gay or straight, soon achieve “homeostasis”–they’ve swapped germs, didn’t come down with anything, and thereafter coexist in a state of microbial equilibrium. That’s not to say they’re germfree; they may simply be “asymptomatic carriers” of some bug that doesn’t make them sick but that might lay low an outsider. Granted, the danger isn’t very great, but it exists. I was just reading in the Harvard Medical School Health Letter about a 51-year-old guy who learned that hepatitis C had destroyed his liver. He’d had no previous symptoms, but the kicker is that he’d contracted hepatitis C 46 years before. Hepatitis C isn’t transmitted by fecal bacteria; my point is that just because you don’t think you have anything doesn’t mean you don’t. Thus the apparent paradox: you can frolic with your honey all you want, but you still have to wash your hands after using the pot.


Is there something you need to get straight? Cecil Adams can deliver the Straight Dope on any topic. Write Cecil Adams at the Chicago Reader, 11 E. Illinois, Chicago 60611, or E-mail him at

Art accompanying story in printed newspaper (not available in this archive): illustration / Slug Signorino.