[Question #10341] Question re oral sex risk.

23 months ago

Dear Drs,

In Mid July I had a brief unprotected oral encounter with a massage worker whilst traveling in SE Asia, 12 days after I had a STI Screening (Hep B, HIV, Chlamydia, Ghonarea, Syphilis) due to some slight irritation in the head of my penis and frequent urination. All results were clear at which time I had unprotected intercourse with my wife.

The irritation remained and Local Dr in Australia proceeded to do urinalysis for UTI, plus provided some Keflex for one week. All results clear. Whilst traveling in Maylasia, testicle pain started and local Dr there following some examination suggested potential Urethritis so prescribed (DOXY) for 1 week.

Returned to Australia discomfort still present although eased a little, Local DR wanted to retest for STI’s around 4 days after i finished the Doxy, this time including Trich and M.GEN and full culture etc. (No bloods, HIV or Syphilis but urine and swab tests) nearly 6 weeks after my original encounter. ALL clear, no WBC etc. Has suggested pain may be due to non-infection reasons and that I should get an ultrasound.

My concern is for my partner as this week (4 weeks after our only unprotected sex, and 6 weeks past my incident) has notes she is feeling some vaginal irritation like previous fungal infections she has had. Could I have passed something to her due to my original encounter. Would you agree with the Drs comments about looking into non-infectious reasons.

H. Hunter Handsfield, MD

23 months ago

I'm sorry to see you back. You ask nothing here that wasn't discussed in your two recent threads, or at least the answers should be obvious from those discussions. I agree with your doctor's assessment that no infection explains your symptoms. They are typical for genitally focused anxiety, magnifying your perception of minor symptoms or even normal body sensations that otherwise you would ignore or perhaps not even notice. As for your partner's vaginal irritation, that is rarely a symptom of STI and never of HIV; but indeed is typical of vaginal yeast (fungal) infections. Undoubtedly it has nothing to do with your oral sex exposure. That your symptoms eased "only a little" with doxycycline also indicates no infection is the cause.

If your username implies where you reside, Australia's federally funded sexual health centres comprise probably the world's very best network of STI/HIV clinics; and if you happen to be in Sydney or Melbourne, you have access to the best of the best. If concerns remain, you could rely on their evaluation and advice. But I am confident they would affirm the minimal risk of your exposure and your doctor's and my opinions and advice.

Further question on these topics will indeed be managed as noted in closing your previous thread -- without even this much reply. Please do your best to move on without further worry.

HHH, MD

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23 months ago

Dear Dr's

Thankyou for your very candid and direct response, sometimes having access online creates more need to search and although I have some doubts about my recent testing after finishing Doxy i will try to move forward.

If I may I just would like to ask for clarification on a point i am confused about reading your forums. Mycoplasma Gen and unprotected Oral sex, is it a concern?

I understand if you decide not to respond and thankyou for this service.

H. Hunter Handsfield, MD

23 months ago

Mycoplasma genitalium rarely if ever infects the mouth or throat, and therefore genital infection cannot be acquired by oral sex.---

23 months ago

Hi Dr. Handsfield

Thankyou for your reply, with the various discussions and knowing that regardless of the various antibiotics etc. my initial tests @ 12days would be reliable for Gonnareah and Chlamydia at least and that things like M.Gen and Trich are not a concern for an Oral unprotected exposure and without any sores appearing for syphilis I have some confidence that the symptoms now are not related to an STI regardless for the other tests and potential interactions with Antibiotics.

I will now try to get past the anxiety side and hopefully this will help manage the frequent urination and ongoing mild pain and sensations in my penis and testicles.

thankyou Again

Regards

H. Hunter Handsfield, MD

23 months ago

I'm glad you understand and glad to have helped. Thanks for the thanks -- but for sure this is your last discussion on this exposure. Best wishes and stay safe.---