[Question #10233] Let’s me frank

24 months ago

I would like to be frank here… I made a terrible choice and performed oral sex on a male ( i am female) I have a significant other, whom I have remained sexually active with. ( please do not judge, I know it was wrong) I did not realize gonorrhea or chlamydia is commonly acquired this way. That being said I have had a panic attack- I tested genitally about eight weeks after the oral sex event and was negative. I thought testing genitally would be a smart idea because I have given my significant other BJ’s and regular sex. Does that mean I did not catch something from the oral sex and in turn passed it on to my partner genitally since I have tested negative?

H. Hunter Handsfield, MD

24 months ago

Welcome. Thank you for your confidence in our services.

Do not be concerned about our judgment of your sexual choices. We pride ourselves in being completely nonjudgmental. You will never see a hint of criticism from the three moderators of this forum about sexual choices and practices, as long as the questioner doesn't reveal evidence of sexual abuse, harm or coercion.

While I understand your concerns, STDs should not be high among them. You have found misinformation or at least misunderstood what you have found. Oral gonorrhea is much less common than you might assume from media attention, and oral chlamydia in fact extremely rare; and when it occurs, usually is gone (without antibiotic treatment) within a week. It is true that genital testing cannot detect oral gonorrhea or chlamydia; for that a throat swab must be tested. The chance you have (or had) either infection is infinitesimal, and absence of urethral/penile symptoms in your regular partner is strong evidence he has not acquired genital infection from your giving him BJs.

Honestly, all this sound very trivial in terms of STD risk. I really don't think you need be at all worried. But if you would like some additional reassurance, you could have a throat swab test for gonorrhea. (Chlamydia testing really isn't necessary -- but probably will be done anyway, because it's almost always done automatically by labs when they test for gonorrhea.) If you do it, you definitely can expect negative results.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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24 months ago

Thank you so much for your words of wisdom. I know that gonorrhea is quite symptomatic in men, however I am not so sure about chlamydia? How worried should I be about transferring a GE it’s chlamydia infection via oral sex? We have sex about once a week which includes oral and genital. If it has been 8 weeks can I safely assume I did not acquire an infection and pass it genitally to my signifant other since I have test negative genitally in the past week?

24 months ago

*genital not GE it’s… apologies

H. Hunter Handsfield, MD

24 months ago

Here comes a summary of some of the current scientific data pertinent to your worries. You obviously have a pretty good understanding of some of the issues already; I'm confident you'll get it, but of course let me know if anything isn't clear.

You correctly understand the differences between gonorrhea and chlamydia symptoms. Nearly 100% of urethral gonorrhea in males is overt and obvious. Probably only 60-80% of chlamydia causes obvious symptoms, leaving a substantial minority with minimal or no symptoms. Still, despite what you might assume from online buzz, there has never been a single case of biologically confirmed transmission of chlamydia from mouth to penis -- not one! At least no published reports. I can't say it never happens, but it is very rare. Chlamydia does not readily infect the mouth or throat -- there's a very low rate of infection even in people who have performed oral sex on known infected partners; and as I implied above, most of those 1) have very low numbers of organisms; 2) have negative cultures despite detection of chlamydial RNA, probably meaning the test is just detecting a past partner's inoculum and not active, transmissible infection; and 3) usually have negative results (without treatment) when retested 1-2 weeks later.

Even among the most sexually active males, under 5% have chlamydia, so if your one-time partner is average, there was a 1 in 20 chance of exposure. If exposed, your throat probably was not infected. If it was, it probably was in too low numbers to be transmitted to your regular partner. If he was infected, there's a 60-80% chance he would have developed symptoms. If we summarize these odds, the odds you currently have oral chlamydia become exceedingly low, well under one chance in a thousand.

Your negative genital test result is reassuring that you didn't infect your partner and then re-catch it from him. But it's not proof you do not have a current oral infection. For the other reasons just summarized, I think you can safely forget it; if somehow I were in your situation (or if I were advising say my daughter), I would say just forget the whole thing and not be tested. But as noted above, you are free to have a throat swab for chlamydia testing if the negative result would increase your reassurance. But truly I do not think it necessary at all.

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24 months ago

Dr. Hunter,

Thank you for your knowledge and advising me as if I was your daughter, I greatly appreciate it. I have no further follow ups

H. Hunter Handsfield, MD

24 months ago

Thanks for the thanks. I'm glad to have been of help. If happy with our services, you might consider a tax deductible donation to the sponsor, the American Sexual Health Association is the nation's premier private nonprofit organization in support of sexual health in general and STI prevention in particular. There's a donate link at www.ashasexualhealth.org.

Best wishes and stay safe.

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