[Question #2809] Massage and STI

40 months ago
Hi Doctors,

June 27 of this year I recieved a massage in Hong Kong while on business.  At the end of the massage the masseuse masturbated me for about 30 seconds until I stopped her.  After that I started to worry about STI's so I turned to the internet.  After reading many post on here and medhelp I put the incident out of my mind. 

But this week my wife became sick which really didn't concern me until she told me she had a bump about the size of a half grape on her vagina.  The bump is painful and is making it difficult to put in tampons as she is menstruating.  Her symptoms other then the bump include low grade fever, sore throat and a canker sore at the back of throat.   

The only complaint I've had since the incident is that the back of my throat,  sides of tongue and the roof of my mouth has been sore on and off.  Also the tip of my penis has at times itched and burned on and off.  I chalked that up to anxiety. 

In your opinion should I get tested for an sti from this encounter?  I'm particularly worried about syphilis. 

Thanks in advance
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
40 months ago
Welcome. Thanks for your question and your confidence in our services. Also thanks for scanning the forum for other questions similar to your own.

I can confirm what you apparently learned on the forum before asking this question. No STDs are transmitted by massage, body rubbing, or hand-genital contact. Your first instinct to "put the incident out of my mind" was the right one.

That said, of course I understand your concern for your wife's symptoms. The most common cause of a fairly large (grape size, or nearly so) lump near the vaginal opening -- which I am guessing is on the side of the vaginal opening -- is a Bartholin gland infection. Although STDs like gonorrhea and chlamydia can do this, most such infections are not due to STD. And these would not e likely to cause fever, sore throat, or a throat ulcer. Syphilis is not a likely cause of symptoms like your wife's, and is not realistically possible from the kind of contact you had.

A small STD related possibility is that your wife has a new herpes infection. However, although a new herpes infection could cause fever, sore throat, and the throat ulcer ("canker sore"), it is an unlikely cause of a single vaginal lump of this sort. Still, I would not discount herpes as the cause. HOWEVER, if your wife in fact has new herpes, almost certainly it is not from your massage contact. When new herpes occurs in a committed couple, usually it means his or her partner has been infected chronically and the infection only recently was transmitted the first time. In other words, if it's herpes, probably you have had it from a past sexual exposure, which is far more likely than catching it from a massage including masturbation. In this case, it could be either oral, almost certainly due to HSV type 1; or genital, most likely HSV2. Neither your oral nor penile symptoms is typical for herpes of either site. But many people are infected with no symptoms at all.

The next step should be your wife seeing her doctor. She should do it ASAP for accurate diagnosis (the sooner the better for accurate testing, and for examination when her symptoms are not prolonged) and for prompt treatment in the off chance an antibiotic is needed, and especially if herpes seems likely. You also could go ahead with STD testing yourself, which might be a good idea for reassurance (not because you really were at risk or likely to be infected, but strictly for reassurance). If so, have blood tests for HIV and syphilis and a urine test for gonorrhea and chlamydia. If you go ahead with this, you can definitely expect all these to be negative. However, I suggest you hold off on HSV testing. The blood tests are far from perfect, often with misleading results. HSV testing can always be considered later if herpes still is in the picture after she has been examined by her doctor. But even in that case, I would still exonerate the massage incident:  if you have asymptomatic oral or genital herpes, it isn't from the massage events.

I hope this information is helpful. Let me know if anything isn't clear. I would also be happy to comment further if you would like to report the outcome of your wife's medical evaluation and/or your test results if done.

Best wishes--  HHH, MD

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40 months ago
Thank you so much for the quick reply Dr.Handsfield.

I do have a question regarding your response. 

My wife and I have been monogamous for 20 years and I can assure you that this is the only incident involving myself that would give me any concern.   And am fairly  positive almost 100%  she has been faithful.  Would you still recommend testing knowing the above? 

Also just to keep you up to date on her symptoms.  She says the lump is getting larger and is turning black.  She does plan on seeing her doctor tomorrow. 

Thanks again
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
40 months ago
"Turning black" doesn't sound good and might require sooner medical attention without waiting until tomorrow, especially if it seems to be a black eschar (a hard, scab-like covering of an ulcer or wound). If it's black and blue like a bruise, it may be less serious. All this is atypical for herpes, but I still cannot say for sure your wife's problem is not herpes. Your clarified sexual history also makes herpes less likely, but still not impossible:  if you have undiagnosed oral herpes, for example (e.g. from childhood), delayed transmission remains possibles, even after 20 years.

I look forward to hearing more after your wife has seen her doctor. If she develops fever or if the genital lesion is expanding rapidly in size, those also would be indications she should get care today. Although it is unlikely this is something dangerous, it could be -- and her health should be the dominant concern at this time (as I think you understand), not where and how it originated. Anyway, it remains unlikely it has anything to do with the massage events several weeks ago.

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H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
40 months ago
FYI, I asked Dr. Hook to take a look at this discussion. He replied "I agree that this warrrants evaluation by [her] doctor. Clearly this is unrelated to his receipt of mastubation but any time a lesion hurts and turns black it should be evaluated sooner than later."

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40 months ago
Thanks again Doctor's, 

She will be seeing a doctor tomorrow.  I will keep updating this thread as long as you allow me. 

I do feel much better after reading your 
responses regarding sti's.  But I'm am very concerned about what is actually wrong.

Thanks again


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
40 months ago
Normally threads are closed after two follow-up comments and replies, but I'll leave this open for now. I look forward to hearing the outcome of your wife's doctor visit tomorrow.---
40 months ago
She was able to see a nurse practitioner today, our family doctor was not in. 

She did not show or tell the Np about her vaganil issues which disappointed me (she was embarrassed).  She did however have her throat looked at and was told it looks like an ulcer.  It was swabed for strep and it was negative. 

There is one new symptom which I will relay to you.  She has developed another sore just inside the vagina witch also resembles a canker.   

I do have one last question, but completely understand if you would like me to resubmit. 

Could this be NSAGU? 

To recap she has a throat ulceration and two ulcerations on her genitals at different locations.  The one previously discussed  and one one the inside, which she told me about today.  Accompanied by a fever and a general feeling of unwell. 

Thanks again for all your information it's greatly appreciated. 




H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
40 months ago
Very disappointing your wife didn't get the vaginal problem evaluated. This might be a VERY big mistake:  one of the conditions I am concerned about is a necrotizing ("flesh eating") strep infection. Also, a second genital ulcer is once again suggestive of herpes. I recommend she return to the doctor's office with the full story. Embarrassment is a poor excuse for risking a dangerous health problem, or even a not-so-dangerous one like herpes (but which could be treated effectively). Don't get me wrong:  most likely it's nothing dangerous. But from what you have saiid, I am worried about it. If her fever is high or she gets spreading redness or blackness from the vaginal area, she should go to the ER tonight -- don't even wait until tomorrow.

I don't know the abbreviation NSAGU, cannot comment further. I remain confident that none of this has anything to do with your trivial sexual indiscretion several weeks ago. Do not post a new question to ask about it:  there is no information you can provide that would make any STD more likely or that would change the advice you have had.

Beyond that, I'm glad the information has helped and I hope things go well for your wife.

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40 months ago
Thank you Dr. Handsfield.