[Question #1991] Sorry to Bother You

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90 months ago
Drs

I was on your forum in 2015 and asked a question. Now, as my mother always said there is no fool like an old fool, and at 67 I'm old and a fool. Maybe silly but I'm a worrier at heart and I'm married...42 years...I try and not be tempted although on a rare occasion I am. I had a massage at a hotel in Shanghai tonight, and the girl wanted to give me a happy ending of course for money. I mainly had her masturbate me through my shorts but my penis slipped out the last 30 seconds maybe. There was no other contact other than the massage itself. Any chance at all that I contacted anything other than the guilties?? Should I refrain from sex with my wife when I return for some period? I feel stupid and embarrassed and wish I weren't tempted by the devil. Thank you again for your advice. Best Regards.
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90 months ago
I had one other question before you responded....I am not certain but I believe you once told me Herpes like the kind might be possible albeit unlikely, how about HPV...I'm not certain whether its an STD or not but could you catch it from the way I described? Would this also be a reason to abstain from sex with my wife? Sorry to ask...thank you again.
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Edward W. Hook M.D.
90 months ago
Welcome back to the Forum.  Receipt of masturbation from your masseuse did not put you at meaningful risk for any STI.  All official sources, CDC, WHO, others agree that masturbation is safe sex with virtually no risk for traditional STIs such as gonorrhea, chlamydia, syphilis, HIV, etc.  In our earlier interactions a year and a half ago we also began to address the concept of risk.  Let me expand it that a bit- scientific assessment of risk is really an exercise in estimation, based on scientific studies, the cumulative observations of others and understanding of the theoretical bass behind such estimates.  They are still estimates however and strange things happen.  There are no absolutes.  For instance. your risk for STI from the events you describe is lower than your risk of being hit by a meteorite falling from the sky but there actually is a person, mentioned in the Guinness Book of Records I believe, who has a meteorite fall through the roof of their house and into their living room.  Just as I hope that you are not going to worry about being struck by a meteorite, I hope you will not worry about getting an STI from the receipt of masturbation that you describe.  There is just no reason for concern and no reason for testing or any sort.  Nor is there any reason for you to abstain from sexual activity with your wife.

HPV is a bit more complex than most other STIs but I would extend my assessment of your recent encounter of no risk to HPV as well.  HPV is a virtually omnipresent infection which is transmitted by direct contact.  There are over 100 different types of HPV and not all types infect all types of skin.  For instance, the types of HPV that cause warts on the hands or feet do not cause genital infections and vis versa.  A week or two ago, the newspapers summarized a recent study that showed that about half of ever sexually active adults in the U.S. have HPV infection and the number who have had the infection in the past is higher, probably exceeding 80%.  Thus anyone who has ever had sex has an over 80% chance of having had HPV.  That said, these infections for 99+% of persons are of no consequence and should not be a concern. Further, there are no recommended tests for HPV in men.  Transmission of HPV from person to person through hand to genital contact may occur but is very, very rare - your case your risk is probably far less than 1 in 1000 and is not something I would worry about.

I hope these comments are helpful and that my response about HPV has not caused you concern.  My sincere advice is that there is NO reason for you to feel guilty about receipt of masturbation as part of your recent massage, that this did not put you at risk for any STI including HPV, ad is not a reason for you to abstain from sex with your wife.  If there are further questions or you need clarification on my comments, please do so with follow-up questions.  EWH
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90 months ago
Dr Hook,

You are a nice man and provide thoughtful compassionate responses. I'm much calmer now, and hope to only have this brief follow up:

1. .10 % chance of HIV is very small but dying in a plane crash is 1 in 11 million and many still worry. I worry more for my wife than me so how would I ever know if I had HPV and would it potentially effect my wife. I think you said no testing? Are there any other very low chance diseases I should be aware of in my circumstances? And, lastly, if the conditions were identical as I described assuming your happily married would you continue on and do nothing...no testing, sex with your wife...same as normal in other words. Thanks Dr. Hook.
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90 months ago
2. Forgot to add 2. getting old. In your 30+ years as a sexual disease dr. have you ever seen or heard of a case of some sexually transmitted disease from the activity I described? I'm confident you have seen thousands of patients and discussed this issue with many professional colleagues. Again, a heartfelt thanks. Happy Easter.
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Edward W. Hook M.D.
90 months ago
You are overstating the risk by far.  Your risk of having acquired HPV is far less than 1/10th of 1% although there are no data to provide a precise estimate.  Were it measurably common, there would have been scientific reports.   I have never seen any case of STI transmitted by receipt of masturbation, including HIV.  Nor have I heard of transmission of any STI through receipt of masturbation.  There are no estimates of HPV transmission rates for genital transmission, much less through masturbation.   Even in the remarkable low chance that HPV was acquired through receipt of masturbation, the infections typically resolve without therapy of their own accord.  Only a tiny fraction of HPV infections go on to develop cancer   Were I in your situation, I would have no hesitation to have unprotected sex with my wife, your should you with yours.  EWH
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90 months ago
Dr. Hook, Please forgive my ignorance, but we discussed in the below posts that I virtually have nothing to worry about as it pertains to HPV, HIV, or other STI's...I believe I'm stating this correctly but I do not think we discussed any STD's unless they are the same as the aforementioned. Thats my final question and we can close the discussion. Thanks for your help. I wish you continued success and a healthy year.
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Edward W. Hook M.D.
90 months ago
No my answer was more comprehensive than that. The only STIs even theoretically potentially associated with would be lesion type diseases- syphilis, perhaps HPV as you suggested. The chance of this actually happening is infinitesimally low and really should not concern you - really.  Please consider your experience a no risk event. I urge you to move forward without concern as there is absolutely NO reason to worry that this could be an STI of any sort.  EWH
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