[Question #11617] Mutual masturbation, brief unprotected oral

13 months ago

Drs. Thank you for all your work in educating the public about STI's and risks. My questions focuses on gonorrhea and NGU. I am 30 yo white male, I engaged in mutual masturbation with a 45 yo male 3 days ago. At the end he tried to put me in his mouth, and I pushed him away. I think he briefly had his mouth on my member. I know from previous post and reading the thread that mutual masturbation is considered a no-risk event. However the brief (under 1 minute) mouth contact has me worried, as I do not want to pass anything to my LT partner. I did have unprotected sex with my partner the following day (which I regret).

I am currently 3 days past "exposure" and have had no symptoms. No burning upon urination. I am having anxiety of this mistake so I have been acutely aware of genital sensations and a mild sensation at the tip on my urethra, but would not describe as a burning pain. My questions: 1) is this considered a low risk event, even with him putting his mouth on me, again briefly. 2) I have read in other threads that gonorrhea symptoms typically present in 2-3 days, when do you think I would be "in the clear" as far as symptoms? 3) Do you recommend testing at this time? 4) Should I proactively take azythomycin to rule out any risk of NGU?

13 months ago

Follow up questions. Follow up 1) If I were to be tested, would urine test NAAT be considered reliable at 4 days, or should I wait until 7-10? 2) If I were infected with gonorrhea - would it be obvious ie. would the pain be extreme and noticeable?

H. Hunter Handsfield, MD

13 months ago

Welcome back.

I see your previous question a few months ago pretty well covered the risks (mostly lack of risk) from receiving oral sex; and the very short exposure makes that risk even lower. I would put the risk as zero for all practical purposes. Gonorrhea risk from oral sex is greatest with deep contact, i.e. the partner's throat; and I've never heard of NGU resulting from such a brief oral exposure. And you say you already understand that mutual masturbation is risk free, which is correct. I'm confident you did not put your regular partner at risk for anything. The vague genital symptoms you describe are typical for genitally focused anxiety.

Those comments pretty well cover your specific questions, but to be explicit:

1. Yes, very low risk.

2. You're probably in the clear now, but certainly will be in the clear after 7-10 days have passed.

3. I do not advise testing.

4. Azithromycin is no longer advised as the main NGU treatment, and I strongly advise against it. The main effect would to screw up later diagnosis if more concerning symptoms appear.

Follow-up questions:

1. Urine testing now will be conclusive for gonorrhea (and chlamydia, but that's zero risk). There is no advantage to waiting til 7 days.

2. Gonorrhea symptoms typically are very obvious: pus from the penis, painful urination. (A line from the book Band of Brothers, about US soldiers in WWII, a guy with gonorrhea complains of "pissing razor blades.")

HHH, MD

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