Oral sex is a major risk factor for sexually transmitted infections such as HIV, chlamydia, gonorrhoea, and syphilis, as well as HPV-induced oropharyngeal cancers. However, it is common across races and cultures. Several hypotheses have been proposed for this risk-taking behaviour, such as inducing orgasm in a partner to contribute to ovulation or ejaculation and the detection of partner infidelity. However, among primates, oral sex is routinely performed only by humans. Among other mammals except for bats, this behaviour is not common. Interestingly, humans have a unique vaginal flora mainly composed of lactic acid bacteria, especially Lactobacillus crispatus. This bacterium protects the vaginal mucosa, suppresses sexually transmitted infections, promotes placenta formation, and prevents premature birth. A healthy vaginal flora, mainly composed of lactic acid bacteria, rarely emits an offensive odour. In contrast, in patients with bacterial vaginosis, the population of lactic acid bacteria decreases while the number of anaerobic bacteria increases, and the vagina emits an unpleasant odour. Under these conditions, females have higher risks of sexually transmitted infections, infertility, and premature birth. From the above findings, it can be hypothesized that oral sex performed by a male with a female partner must be a method to evaluate the partner's ease of pregnancy.
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