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Clinically Significant

Summary:

“It is known that the A-O hormonal cycles and olfactory-induced surges are the main responsible mechanism for the A-O reproductive system and dynamics.”

Or: Tedesco fucks around and finds out Bellini is not just a normal Alpha.

Notes:

If you want to go in to this mess like Bellini, read the whole first world building part. If you want to go in as Tedesco, skip it until the line.

It is a mess, idk where exactly am I taking it, there was no reason to do worldbuilding to this extent and I should have been writing my thesis. I hope it is enjoyable anyway. Tell me what you think in the comments.

—Dialogue—
“Thoughts and memories”

Translations in text

Chapter 1: The Scent

Chapter Text

From an informative WHO article about the endocrinology of the A-O population.

 

The A-O population, also known as Alphas and Omegas, have elements to their reproductive physiology distinct to the rest of the population, commonly known as Betas. Beyond the anatomical differences in reproductive organs, described in other articles, it is important to mention one of the key differences is the production of sex hormones that are not present in the Beta population, hormones known as Alphagenos and Omegenos. 

 

These hormones appear to be produced by a series of purpose-specific glandular apparatuses present under the mastoid processes, under the thyroid gland, and over the adrenal glands. This glands seem to be present in those same places regardless of the anatomical arrangement of the individual, and so far, they seem to be physiologically and histologically undifferentiated regardless if the studied individual is a Male Alpha (Configuration TA), Female Alpha (Configuration EPA), Male Omega (Configuration TO), Female Omega (Configuration EPO) or any other configuration outside of the most common four.

 

It is known that the A-O hormonal cycles and olfactory-induced surges are the main responsible mechanism for the A-O reproductive system and dynamics. They are specially relevant in the development of tertiary sexual characteristics, the rut/heat cycles and olfactory-triggering, and the production of A-O Copulins, this is, pheromones to be detected by the CORs (Copulin Olfactory Receptors), sensory receptors unique to the A-O population.

 

The core effects and characteristics of this hormones are as follow:

 

Alphagenos

  • Effects in non A-O sex hormones: the production of Alphagenos seems to accentuate the usual effects of Beta-sex hormones Testosterone, Estrogen and Progesterone. This gives Alphas their tertiary sexual characteristics, which are in summary their secondary characteristics amplified according to their main Beta-sex hormones (body hair, muscle mass, breast and hip development, fat distribution, etcetera). Beyond this, the common trait Alphas seem to have as a Tertiary characteristic is an increase in muscular capacity, resilience, endurance and strength.

 

  • Rut cycling and induction
    • Normal cycle: the usual rut cycle lasts between one and two weeks, with ruts usually lasting between 12 and 24 hours if left unsuppressed and unsatisfied. The rut can be satisfied and stopped by knotting an omega in heat. Sexual relief through masturbation or sexual encounters of other kinds prove ineffective to do so. Knotting an Omega will make the Alpha individual to “latch” onto the Omega, behaving more protective and territorial around them, and showing a clear preference for their attention, which will last until the next rut. Each time knotting the same Omega will make this “latching” either feel more intense or last for longer. 
    • Rut symptomatology: 
      • Sustained state of sexual arousal, akin to a Plateau stage, accompanied with increased energy levels and emotions of euphoria and expectation (also described as “hunt”, a sensation explained as “wanting to stalk and pounce on prey”).
      • Heightened perception of smells, especially Omega Pheromones, as well as production of Alpha Pheromones.
      • Unconscious vocal cord usage (growling in aggression against other Alphas, growling in presence of a desired Omega, purring while having surges of pleasant sensations and emotions, sexual or not). Normal talking voice might sound deeper.
      • “Sensory Seeking” behaviours for touch, described as feeling “touch starved”.
      • Behavioural changes including Posturing (modification of postures, walking pace, etcetera, intending to appear bigger and more imposing to others) and Territoriality (especially present if there is an Omega they favour, might include aggression against other Alphas). 
    • Reaction to Copulins: once the CORs are stimulated by O-Copulins (Omega Pheromones), the body experiences a surge in Alphagenos production, starting the biological process of a rut. There seems to be a cool-down period in between satisfied ruts of at least 24 hours. Exposure to A-Copulins might trigger a Territorial Behaviour reaction without triggering a rut, Alphas with a favoured Omega (partner or not) are more likely to have this reaction. 
  • Rut suppression: Suppressants are to be taken as soon as the first symptoms are identified, working as intended if taken during the first 3 to 4 hours of the rut, and less effectively if taken within the first 6 hours. The medicine will regulate the Alphagenos surge to keep it at a minimum level over the usual, which will allow the Alpha to minimise the symptoms. Suppressed ruts will only present as a vague “hunt” sensation and heightened emotional excitability around the emotions of anger and joy, without arousal, pheromone production or detection. 
    • Extreme cases in which suppressants do not help with Alphagenos regulation require the regular intake of synthetic Omegenos, which will counter the effects of extreme rut surges.

 

Omegenos

  • Effects in non A-O sex hormones: the production of Omegenos seems to diminish the usual effects of Beta-sex hormones Testosterone, Estrogen and Progesterone. This gives Omegas their tertiary sexual characteristics, making them appear more androgynous regardless of their main Beta-sex hormones. Beyond this, Omegas seem to have a common Tertiary characteristic of heightened sensory sensitivity in all areas, including better colour and pattern differentiation, better sight in low light environments, extended peripheral vision, heightened proprioception and spatial-perception, wider hearing range, and not-heat-induced touch and smell sensitivity. 

  • Heat cycling and induction
    • Normal cycle: the usual heat cycle lasts around a month, with heats usually lasting around 3 days if left unsuppressed and unsatisfied. The heat can be satisfied and stopped by the individual being knotted by an Alpha. Sexual relief through masturbation or sexual encounters of other kinds prove ineffective to do so.
      • Most of the cycles, Omegas will experience a Base heat that will only transform into a Full heat if exposed to Alpha Pheromones. After being knotted by an Alpha, it is common that the next 2 to 3 heats will be Full heats, after which the body will readjust to the usual Base as long as the Omega is not knotted again. Each knotting by the same Alpha will heighten the Omega’s pheromone sensitivity and preference for that specific Alpha, searching for their presence as a source of comfort and both sexual and non-sexual pleasure.
    • Heat symptomatology:
      • Base heat
        • Sustained state of low physical and emotional sexual excitement, accompanied by a low fatigue, increased body temperature, low appetite and drowsiness.
        • Heightened perception of smells, especially Alpha Pheromones, as well as production of Omega Pheromones.
        • Heightened sensitivity to touch accompanied by unintentional vocal reactivity to it. Normal speaking voice might sound higher.
        • Behavioural changes including Presenting (modification of postures to show themselves more open, soft, and tender) and Nesting (especially present if there is an Alpha they favour, might include searching and cuddling the Alpha or their belongings). 
      • Full heat:
        • Sustained state of sexual arousal, akin to what is described as an “incomplete orgasm”, accompanied by a sensation of “sinking”, described as feeling their whole body as heavier, more difficult to move and in a state of bliss. 
        • Increased production of Omega Pheromones in a feedback loop with Alpha Pheromones.
        • Increased sensitivity to touch, dilated pupils and elevated body temperature. Voice will sound notably higher if speech is attempted.
        • “Sensory Seeking” behaviours for touch and sexual relief, which includes involuntary movement of hips, pleasure vocalisations, and surges of energy directed towards seeking or guiding the Alpha.
    • Reaction to Copulins: most of the time, Omegas will only perceive Alpha Pheromones as a specific scent tied to the Alpha they are perceiving, without an actual reaction to it. The only way Alpha Pheromones might trigger an out-of-cycle heat is if the Omega has already been knotted several times by the same Alpha, which will tune the CORs to those specific pheromones. 
  • Heat suppression: Suppressants need to be taken in regular intervals according to the length of the individual’s cycle. The most common pattern is 6-day intervals for cycles of 30 days, totalling 5 takes per cycle. The medicine will regulate the Omegenos fluctuations throughout the month, halting the production of pheromones and reducing the sensitivity of CORs to Alpha Pheromones.
    • Emergency suppressants, just as Alpha suppressants, are to be taken during the first 6 hours of the heat for maximum efficiency, designed to be taken to stop a Base heat to turn into a Full heat, possible even with the use of suppressants if the exposure lasts for too long. Emergency suppressants are often synthetic Alphagenos directly injected, that collide with the surge of Omegenos during Full heats and return the body to a Base heat. 

 

It is hypothesised that the lack of sex-differentiation in A-O glands mean that all A-O individuals are able to produce both Alphagenos and Omegenos, both at the same time and separately, under the right conditions, regardless of anatomy. The functionality of this dual production possibility and the physiological signing needed to indicate which hormone to produce is still unknown and being studied. The main piece of evidence in the last few years* to support this hypothesis is the increase in reported cases of “false Beta” subjects, mentioned in recent literature as Deltas. Most of these subjects produce too little of their A-O hormones to make a significant impact in their daily life, being identified as Betas until testing specifically. However, it is the rising identification of Mixed-Genos Deltas, meaning Deltas that produce both A-O hormones in such a way they act as suppressants for each other, what is currently the main interest for the supporters of this model. 

However, so far the sparse cases of study and evidence are insufficient to support this hypothesis, and they seem to point towards it being a population-specific mechanism, with the possibility of naming a new Configuration, and not a generalised mechanism to most of the A-O population.

*Actualisation needed for recent Favero et al. research on Hyperalphagenosis effects on Alphas. 

 

Written by Dr. Elena Favero

Head of the A-O Endocrinology Department of the University of Rome La Sapienza

 


 

Eminenza Bellini! Piacere vederti!

<<Eminence Bellini! A pleasure to see you!>>

The hums, the strides, that annoying mocking tone in his deeper-than-usual voice, the way he was smiling and went immediately to grab his shoulders, being too rough. The feeling inside his own chest. 

No doubt about it. Tedesco was having a rut. And, as usual, he didn't take any suppressants for it. 

 

Dimmi, Be-lli-ni, are you sure you are an Alpha? You are just so small.

<<Tell me, Be-lli-ni>>

He was trying to reel him up for a fight, and Bellini wasn't going to give that to him. However, the intense scent of his cherry pheromones, plus the extra synthetic cherry scent of his vape, were so offensive to his nose he just wanted to get up and punch him in the face. 

No matter. He was better than that. He wasn't going to give in. At least he was focusing on him and not flaunting around the whole Vatican. He deliberately ignored Tedesco and tried to keep focusing on his food at the dining hall of Casa Santa Marta, which the italian didn't like at all.

A low growl came from the Patriarch's body and Bellini felt himself being pulled up by the arm to be standing, face to face, with Tedesco. He pushed him away, which seemed to amuse Goffredo.

 

— What on Heaven and Earth is wrong with you!?

Mah! I want a distraction. Having a rut can get annoying. You would know if you were a true Alpha. 

— I am, I just happen to be considerate to my Brothers and Sisters and actually take my suppressants! 

— Suppressants, bah! If God wanted us to suppress this natural…

— What if one of our Brothers or Sisters is an Omega, eh? You would have just forced them to go run and fetch their emergency suppressants because you refuse to be even mildly responsible…

— Ah! So now you see why I think this little… reform of yours and the Holy Father is a wrong move? Allowing the ordainment of Omegas! Not defrocking hidden Omegas! Tsk tsk, Bellini, you are exposing them to a sea of Alphas!

— IT IS MORE THAN VIABLE IF WE ALL TAKE THE SUPPRESSANTS LIKE WE SHOULD— this was annoying to say the least, and was making Bellini furic at worst. Everyone in the dining hall, not many but still enough, was now staring at them. —You are impossible to deal with without the rut rotting away your already scarce brain cells, but this… this isn’t even worth it. 

— Are you a secret Omega, Segretario di Stato? Are you getting all hot and bothered by me? 

— You… you are not thinking right.— Bellini tried to breathe deeply in spite of the horrendous pheromones —You are in a rut and Seeking someone to touch you to relieve that part of the sensations. I am not your entertainment. 

 

He stood up and started to walk away. To his annoyance, Tedesco purred and started to follow him. Tedesco became so annoyingly impulsive during his ruts that made Bellini sincerely miss his usual academic and theological “debates”, and that was already something he wished he never had to deal with. It was even worse because he knew exactly why Tedesco seemed to fixate on him every time, and he hated how it was impossible to do anything about it. One tiny mishap on the worst moment possible, and now he had to deal with this. 

 

— Now that I think of it, Bellini… I’ve never seen you have a rut. 

— Well, I take my suppressants diligently. As we all should.

— Can you even have them anymore? 

— You are older than me, and still have them.

Beh, sì, ma… People say taking those things for so long can damage your body in perpetuum.

<<Well, yes, but… / in perpetuity>>

— And science says that’s bullshit. Suppressants are safe. You would know if you took the time to read anything about our biology.

 

Tedesco’s purrs seemed almost a hum while he was walking behind him. So fucking annoying.

 

— I have smelled you, you know? You smell like rain hitting the ground. Come lo chiamano? Petricore? It is an interesting smell. It calmed me.

<<How do you call it? Petrichor?>>

 

“It sure fucking did”

 

He was sounding way calmer and nicer, even genuinely curious, but Bellini had been through this song and dance enough times to know that was bait. 

 

— It’s just… even then, you were not rutting, Bellini. Or are you such a good little disciplined actor that you act exactly the same, rutting or not? 

— As I said, I take my suppressants. And that’s it. 

— So that’s how ruts are for you, suppressed? Just… nothing?

 

Bellini kept silent. He wasn’t in the mood to explain his specific condition to Tedesco, of all people. Not worth it. 

He finally arrived at the elevator and turned to firmly stop Goffredo from following him in. Aldo internally cringed at the purr that followed him pushing the other away. 

 

— I am not going to do anything to you, for God’s sake! And my room is on the same floor as yours. 

— You will annoy me. Stop there, and leave me alone for once. Take the next lift. 

— You are not fun. 

 

He finally, finally, got rid of Tedesco and his cherry pheromones. He rushed to his room before the Patriarch could get there as well. He collapsed in his bed, annoyed out of his mind. He sighed and checked the hour. He was late for his daily suppressant dose.

 

“Perhaps that’s why Tedesco was especially annoying back there”

 

He needed to be better at keeping the times consistent. At least this time it wasn’t during a rut. 

 

He took out one of the packets, some rubbing alcohol and cotton balls, and undressed. Already used to it, he rubbed the alcohol over the skin-coloured patches placed over his adrenal glands to remove them. It was the option that happened to be less of a hassle, better than the daily injections he had to take before. He took them off, cleaned the area, opened the new patches, and placed them without looking, already used to their positions after two decades of use. 

Encounters like this made him extremely aware of the importance of this little daily ritual. His was no normal case, and it could get dangerous for himself and others to be irresponsible about it. Tedesco had only gotten a whiff of his pheromones once, and it had been enough for him to Seek him every time he had a rut and they were in the same building. And he was an Alpha, a very compatible one, and more vulnerable for his refusal of suppressants, but an Alpha nevertheless. What could his full rut do to an Omega? 

 

He counted the packets left in the box. 

 

“Less than I thought. Shit.”

 

He would have to text Dr. Favero about it. It had been harder to get the type he needed lately, since the American company that usually made them had to halt production after new anti-queer policies from their government. Dr. Favero had been tirelessly searching for a new provider, but the scarcity would take a while to be solved while new companies took their place.

He carefully wrapped the discarded patches with the empty packet and placed them in a separate box, to be tossed away later, discreetly, and out of the Vatican. As much as he needed them, the Curia and the press would have a Feast of Rumours if they found Omegenos hormone replacement patches in the trash of the Secretary of State. 


 

A couple of months later, Tedesco was returning to the Vatican yet again, ready for a new series of meetings with other Cardinals. Innocent kept pushing for these meetings and discussions to have place, something something “a synodal, community Church”.

He hummed, pleased with the sensations he was starting to feel pooling in his stomach. He would have his weekly rut soon, probably in the next couple of hours. Beh, better now, when he was going to just hang around his room to unpack, than during the meetings. He would need his wits with him.

 

And he could always go and annoy Bellini if the rut got too bothersome. 

 

From the moment he stepped in the Vatican he noticed something was off. For starters, he wasn’t given his usual suite on the fifth floor of Casa Santa Marta. 

 

— We are terribly sorry, Patriarch. The fifth floor is currently closed due to health concerns. It will be available again on Thursday, if you wish to go back to your usual room then. 

 

“Health concerns?”

 

The Sister that tended the front desk couldn’t give him much more information, so he decided to not argue for once. As he proceeded to the 3rd floor suite assigned to him, he kept noticing some of the staff had blue circle pins with numbers on their lapels. He stopped one of the assistant priests, who had a pin with the number 17, to ask what was that about.

 

—Oh, A-O staff are not allowed into the fifth floor currently, so Sister Agnes called all Beta staff to her office this morning to be identified. If anything is needed on the fifth floor, only identified Beta staff can request an elevator key. 

 

“Elevator key? Since when do they actually use that?”

 

He thanked the man and, once out of sight, he went back in the elevator. He tried pressing the 5th floor button, and sure enough, the small screen and electronic voice indicated the need for a keycard to be inserted into the slot. 

He went back to his assigned floor and finally went into his new room, confused. As the rut settled in, he couldn’t really stop thinking about the whole situation. Health concerns? Specifically for A-O population? What could have even happened for it to require the whole floor to be closed off? And why for such a long time? 3 full days… was someone having a heat? Was the full floor occupied by Omegas somehow synced in their cycles? 

His mind flew to Bellini, as it usually did in such cases. His room was also on the fifth floor, no? Beh, he could probably ask him in the morning. 

 

Except… he couldn’t. Bellini was nowhere to be found. They had the first day of the meetings without him, and he wasn’t at the dining hall during any of the meals.

 

“—Eminences, our brother Cardinal Bellini is currently out of the Vatican for diplomatic reasons. He will join us on Thursday…”

 

Thursday… it made no sense. Bellini never missed a single one of these synods. Innocentius and Tommaso never let Bellini miss them either, even rescheduling at the last minute if necessary. Especially if Tedesco was going to be there.

 

Then…

 

It couldn’t be, could it? 

 

Back at Casa Santa Marta, he took the elevator to the 4th floor and then walked to the staircase. He went up, just to find the staircase blocked with yellow tape and signs in Italian, English, Spanish, German and French about the lockdown. He decided to ignore them, breaking some of the tape to get through, and finally reached the closed door to the 5th floor. He pressed his nose to one of the door margins and focused on the smell. 

It was faint. Barely there. Definitely not enough to make a reaction happen, but noticeable to someone that, like him, had already been exposed to it. Petrichor.

So Bellini was an Omega, then? It made no sense. His physical traits didn’t match how usually Omegas presented, as much as he loved to make fun of him. Also… the smell calmed him, instead of triggering a rut, even the first time he smelled Bellini’s scent, which made even less sense. 

 

Wasn’t Bellini’s room relatively far from this door? How strong were his pheromones if he could smell them all the way there? Why and how was it necessary to close off the whole floor? Why couldn’t any A-O staff get in? It would make sense if no Alpha staff could, but Omega staff as well?

 

Something in him tugged. It was an odd sensation at the bottom of his stomach, which he dismissed as mere curiosity. He just had a rut, surely at his age he couldn’t develop another so fast, right? 

He tried the door. Being an emergency exit door, it couldn’t really be locked, likely why the staircase itself was taped off. He ventured into the dimly lit hallway, trying to make no sound. The scent was stronger there, although still quite faint.

He felt oddly calm, at first. Relaxed. Surely enough, there was light under Bellini’s door, and an empty tray of food sitting outside, which reminded him he hadn’t yet eaten dinner. He should be starving. But… that seemed so… irrelevant, currently. His stomach wasn’t even protesting, surely he could wait a tad more, no? 

The tug pulled in a stronger way. Was the AC off? That was cruel. He had heard Omega heats involved almost feverish body temperatures. He tugged on his collar, a tad uncomfortable, and took off the cape and the Mozzetta, folding them under his arm. 

The scent kept growing in intensity and delight as he walked towards Bellini’s door. It was nice. So unbelievably nice. Goffredo breathed in deeply, letting it fill his lungs. Something in the back of his head begged him to stop, to run away, to stop taking off his collar and undo the first buttons of his cassock. But the scent was so nice it almost made him dizzy and it flooded his nose and lungs to make his blood boil in such a good way…

He could feel his face flushed. The originally dim lights seemed bright now. His body walked on its own, following the tug, following the aching need his skin now had. Almost the same as when he had a rut and felt touch starved, but so much more intense, so much worse than ever before. He couldn’t breathe normally anymore, taking in as much of the delicious, hypnotic scent of Bellini’s petrichor as he could. He felt… desperate. Swaying, like walking in a dream, but walking towards certain relief. This… whatever this was, it was addicting. 

 

He didn’t even realise when his usual scent of cherries joined the petrichor. Or how his scent was sweeter, less overwhelming.

 

As he reached the door, his limbs could no longer hold the clothes he had taken off and dropped them to the floor. He leaned against the wall, panting and sweating. His breathing carried with it some high-pitched sounds he had never heard himself make. He was hard. He was aroused to a point he had only experienced right before an orgasm, and such sensation had never stayed for this long. He felt like a broken record, skipping and returning over and over to the same part.

 

The door opened, and the pheromones brought him to his knees.

 

He couldn’t even rise his head until the Alpha’s hand took him by the chin. Bellini was there, wearing only a white tank top and clearly tented boxers, smiling in a way he had never seen him smile before, growling in anticipation.

The next few moments became the most pleasurable blur in Goffredo’s existence. He felt Bellini pull him up, drag him into the room and push him to his very unmade bed. He felt himself twitching, moaning, for the bed had his scent all over it. He felt Aldo take off his clothes hurriedly, but oddly enough still in a careful way, when he just wanted him to rip them off and feel their skins together. 

Every kiss felt like glory. Every brush felt like ecstasy. Tedesco felt drunk with desire and pleasure and kept begging for more and more from Bellini, who happily gave him more while taking him completely. His bites felt scalding in such a good way they made Goffredo scream in pleasure, they were both so hard and eager they were already dripping precum. But something in Goffredo told him he wouldn’t be able to find any relief.

 

Not until he was properly knotted by his Alpha.

 

He couldn’t stop thinking about how attractive Bellini and his masculine body looked over him. That until Aldo brought him close and started penetrating him slowly, and he lost all ability to think.

It felt nice. It felt too nice. It felt unbearably nice. It felt like that was his place, his only place in the world where he could find any semblance of happiness and fulfilment. Bellini’s cock filled him completely and kept attacking his prostate, bringing out the most delightful moans and begs out of his mouth. He couldn’t help moaning his name, begging for more, telling him how good it felt and to keep going just like that in all of the languages he could think of, all while kissing him and holding himself against him.

Bellini was struggling to keep quiet too. Beyond those delightful groans and grunts that were already pushing Goffredo into insanity, Aldo kept telling him how good he felt, how good he smelled, how he was his and only his, how good he was taking him in and how he was such a good Omega for him. Goffredo felt tears of joy and pleasure run free from his eyes.

The pace picked up and Aldo kissed Goffredo passionately and deeply, groaning more than during the whole ordeal, and filled him up with his cum. Goffredo’s cock also spilled his seed in excruciating ecstasy as he felt it splashing inside of him and finally, finally, felt the knot forming and being pushed inside of him. They kissed as if they needed to breathe each other instead of oxygen to keep alive. 

The bliss knocked both of them down, making them both fall asleep still joined. Goffredo was due a rough, confusing and life-altering awakening.

 

After all… it is hard to recover after an Omega heat as it is. And he had only experienced Alpha ruts up until that point.