[Question #10189] one last question
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25 months ago
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Hi Dr.
I would like to know if I had unprotected vaginal sex 6 times in the last 2 months would genital gonnorhea or chlamydia most likely be transferred? I know you have stated STDs are not always transmitted
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Edward W. Hook M.D.
25 months ago
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Welcome back to the Forum. On this occasion I happened to be assigned your new questions. In preparing to respond I reviewed your earlier interaction with Dr. Handsfield and agree entirely with his comments. I’ll provide a somewhat more extensive reply than you might expect.
In science, for better or worse, we deal with probabilities rather than absolutes when it comes to issues of acquisition of infection. As a generalization, for Gonorrhea, which has been best studied, estimated risk for a woman acquiring infection after a single unprotected act of vaginal intercourse with an infected man is about 30%. For a male exposed to a woman with Gonorrhea the figure is about 20%. (With oral sex which is a biologically less efficient means of transmission, rates are lower, likely less and perhaps far less than 10% per exposure). In all likelihood other variables such as the duration of intercourse, voiding after sex,, and among women, the type of contraception may modestly affect infection rates. The same probabilities appear to be operative for chlamydia but it is less well studied. Based on these figures if you or your partner had Gonorrhea or chlamydial infection would have been transmitted. HOWEVER most people do not have these infections and for the reasons Dr. Handsfield cited, I will join him in urging you not to worry. Further, as he said, if you remain concerned, testing is easy and reliable. Personally, I would not worry.
Finally, it appears that you have been searching for information on this topic from the Internet. We urging not to do this. Much of the information found on the Internet is incorrect and/or alarmist. Much of what it said there is taken out of context, is out of date, or is just plain wrong.
I hope this information is helpful to you. EWH.
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25 months ago
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Thanks for the reply. When I tested it was a urine test, and I was menstrating. Are those results conclusive? My mind thinks the menstrating urine would be able to detect infection better as it has the blood pass through the cervix.
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Edward W. Hook M.D.
25 months ago
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Are conclusive. Menstruation does not change the validity of test results. EWH ---
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25 months ago
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Thank you, but let me clarify, I wasn’t questioning the validity of the results. I was wondering if menstration would be more likely to catch a positive result as opposed to non menstrating. I have heard urine is not as good as vaginal swab, but since menstration comes from the uterus and passes through the cervix, I was just curious if it be more likely to carry infectious material if there was an infection
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Edward W. Hook M.D.
25 months ago
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I understood your question. Menstruation has no effect on the accuracy of current tests for gonorrhea and chlamydia. Menstrual flow does not either increase or decrease the sensitivity (likelihood of a positive result). EWH---
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25 months ago
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Thank you for the explanation. I appreciate the knowledge you have given me. Could you briefly explain why oral sex is a biologically less efficient way? Is it because the penis has to come into direct contact with the throat? and Lastly, the STD test i took was urine, is that acceptable or do I need a vaginal swab?
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Edward W. Hook M.D.
25 months ago
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Sigh. This thread should have been closed and it will be after this final answer. If you have continued concerns, my sense it is with your partner, not your tests.
When persons have vaginal sex ejaculate pools and is retained in the vagina, bathing the target of the infecting organisms (the uterine cervix). OTOH with oral sex infectious material is cleared quickly.
One last time, your urine test is reliable. There is no significant different in the performance of vaginal swabs and urine tests for detection of gonorrhea and chlamydia.
I hope you can accept the FACT that you were not infected. EWH
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