Because noncoital sex, including mutual  masturbation, oral sex, and anal sex can increase the high risk of sexually  transmitted diseases, it is important that clinicians ask direct questions  about their patients' noncoital sexual activity and provide risk reduction  counseling, according to an American   College of Obstetricians  and Gynecologists Committee Opinion published in the September issue of 

  The committee members reviewed recent research showing  that up to 88% of women and 90% of men aged 25 to 44 have engaged in noncoital  sex. They also presented evidence showing that noncoital sex can spread HIV,  herpes simplex virus, HPV, hepatitis B and C, syphilis, gonorrhea, chlamydia,  chancroid, shigellosis, salmonellosis, and other enteric infections.

  The committee urged clinicians to ask their patients if  they engage in noncoital sex, whether they have it with men, women, or both, or  if they have multiple partners. They recommended counseling on correct and  consistent condom use during anal and vaginal sex, and on risk-reduction  strategies such as abstinence, mutual monogamy, limiting the number of partners,  and STD testing before engaging in sex with a new partner.

  “Great efforts are needed to educate health-care  practitioners and the public regarding the potential health risks of noncoital  sexual activities and the importance of risk reduction and barrier methods of  protection,” the authors conclude. “Ultimately, additional research is needed  to determine the full impact of noncoital sexual activity on the health of  patients.”
  ACOG Committee Opinion No. 417: addressing health risks  of noncoital sexual activity. 

Because noncoital sex, including mutual masturbation, oral sex, and anal sex can increase the high risk of sexually transmitted diseases, it is important that clinicians ask direct questions about their patients' noncoital sexual activity and provide risk reduction counseling, according to an American College of Obstetricians and Gynecologists Committee Opinion published in the September issue of Obstetrics and Gynecology.