[Question #10349] Dr hansfield or Dr hook please help!
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23 months ago
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My encounter was that I got a Thai massage with oil in thailand. Then the csw gave me a handjob with plenty of lube. After this I had protected sex with her. I wore boxers and stuck penis through it and didn't let boxers touch her vagina to avoid friction and skin to skin contact. After that however, i received protected oral sex. My concerns: 1) After the handjob with oil, she got a tissue (a used tissue for sure) and started wiping my penis head with it. She is a csw and she may have used the tissue for previous clients too. Is this a risk for stds? I am only worried about incurable stds like herpes mainly. 2) Another one of my concern is that since she dabbed a used tissue on my penis head. Sure enough the virus couldn't have been rubbed in with light touching. However, when I received protected oral, she did it really fast and aggressive and I'm worried that the pressure she put on the condom was pushed against my penis head making the virus from the tissue rubbed into the penis. Is this a legit concern for incurable std like herpes?3) After the session, I had a look at my penis. It seemed to have a bit of trauma, almost tiny bit marks (naturally as blowjob can involve teeth) into the foreskin area. I went to the bathroom and filled up the condom with water and stared at it for 30 seconds. There was no leak at all (no rip). Is it possible to have slight trauma on inner foreskin from blowjob even though a condom was worn ? 4) Usually I am not concerned about herpes from handjob. However, in this case, it was a csw who must have gave a lot of hands jobs throughout the day. And I don't even think she washed her hands. Hence, I am terrified of contracting herpes. Does the number of handjobs she gave on same day correlate with increased risk for me?5) she also had long finger nails and I am worried hsv could be stored under her nails or even maybe hpv. Is her long finger nails a concern?
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H. Hunter Handsfield, MD
23 months ago
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Welcome back to the forum.
I reviewed your recent discussion with Dr. Hook. This seems to be a different exposure, right? However it's quite similar to the other, and these questions either were answered there, or the answers should be obvious from that discussion. The main thing to remember is that without intercourse -- your penis penetrating a partner's vagina, rectum or mouth, without a condom -- in general there is no risk for STD. STDs are not simply genital area infections that can be transferred from person to person; the bacteria and viruses that cause them evolved to require much more intense exposure than superficial contact. Shared towels or wipes, hand-genital contact (even if genital fluids are used for lubrication), fingering, etc alway are risk free. For these reasons, you are going about your non-monogamous sexual contacts with great safety, with little or no risk for HIV or other STDs.
To your numbered questions:
1) No risk at all.
2) This reflects serious over thinking. No risk of any infection.
3) Minor skin marks or vigorous contact do not elevate risk of HIV or other STD, especially through a condom. We always recommend against condom water testing: there is no such thing as small pores or defects that allow transmission of infectious fluids, viruses, bacteria, etc. If a condom does not obviously break wide open, protection is complete.
4) I suspect you are wrong about your sex worker not washing her hands between clients. But even if she does not, there is no risk of herpes or any other STD in this circumstance.
5) More over thinking. There is no reason to suppose that long fingernails raises the chance of transmitting any infection by hand-genital contact.
I hope these comments are helpful. In the future, please understand the general principles in my opening comments. It should not be necessary to ask us about risks after each contact you have. The answers always will be similar.
Let me know if anything isn't clear.
HHH, MD
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23 months ago
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Hello Doctor,
I have a question that I have to ask. Although it may seem silly, I am very serious.
In the past 6 months I had 2 sexual encounters with different people
1) Received oral sex from someone potentially trustworthy (4 months ago)
2) Mutual masturbation
As mentioned previously, 3 days after the mutual masturbation encounter, I started to feel very strong sensations in my scrotum skin (accompanied by muscle twitching in legs lasting for 1 week). I thought it was herpes due to the incubation period of 3 days, however Dr Hook has helped me rule out herpes since my symptoms were ongoing for 90 days and are also bilateral in nature.
Looking deeper into the problem, I now realise the possible cause of tingling sensation – my scrotum dartos muscle seems to be very overactive. It is constantly moving (contracting and relaxing) and occasionally it contracts a little too strongly which brings about the sensation of tingling. These symptoms have appeared 3 days after the second encounter.
My questions are:
1) Is there any std at all that can cause an overactive scrotum (whether it is through affecting nerves or muscle tissue or via another way)?
2) Just to clarify, since my symptoms are bilateral, it is definitely not herpes, right?
Moving forward, I have taken your advice. I have stopped casual encounters altogether and will only pursue a one-person relationship. I already feel much happier about this decision but just need to overcome this current issue. I will move on if you say no std can cause this.
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H. Hunter Handsfield, MD
23 months ago
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I see nothing here that is not addressed above or in your discussion with Dr. Hook last month, or at least the answers should be obvious from that discussion. And this seems to be about the same exposure as that one. But I am happy to confirm what has already been addressed. To your new questions:
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1) No. There is no STD, including herpes, that causes the symptoms you describe. Assuming no visible redness, rash or other abnormality, probably this is anxiety magnifying minor symptoms or even normal body sensations that otherwise would not be bothersome and you might not even notice. But if it continues, consider seeing a dermatologist.
2) Definitely this isn't herpes -- although the reason has nothing to do with the symptoms being bilateral.
It's great to hear you plan on limiting future sex to a single partner -- but of course it is crucial that that partner is also monogamous, having sex with nobody but you. Also, I would urge you to be cautious about such plans, until you in fact have a committed, monogamous partner. Sex is a powerful drive and intentions like this can be very difficult to maintain. In the event you do have future non-monogamous sex, just do it safely -- as you have until now. You can be assured that repeating the kinds of exposure described above and in your previous thread carry little or no risk for STD.
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22 months ago
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1) I forgot to say to Dr Hook that I received oral sex a couple of times (and received analingus once) about 3 months ago by someone who had a cold sore in childhood. I don’t mean this to be a repeat question, its just when you said that you haven’t seen anything not addressed by Dr Hook, I was worried you didn’t read the part where I said I received oral sex. Is your answer in the previous reply (i.e. definitely not herpes) the exact same considering that I received unprotected oral sex a couple of times and one episode of analingus too?
3)
I don’t have any history of cold sores. Does this
mean I definitely don't have oral herpes?
4What is the risk of
getting genital hsv1 from receiving oral sex from someone who had a cold sore just once in childhood?
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H. Hunter Handsfield, MD
22 months ago
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1) I knew you had received oral sex and considered that in my replies. A single episode of analingus is very unlikely to have resulted in HSV1 infection.
2) [No question]
3) Half of all people in the US and up to 90% in some countries have HSV1, usually the result of an oral infection acquired in childhood. Only some of these have history of cold sores. So the answer is no: absence of recognized cold sores definitely does not rule out the possibility of an oral HSV1 infection.
4) If the oral sex giver is not having an visible oral sex outbreak at the time of the event, the chance of transmission during any one episode of oral sex is under one chance in many thousand.
That completes this thread. Your questions indicate an abnormal obsession with a generally inconsequential health issue. Please note the forum policy against repeated questions on the same topic, especially when they originate primarily from anxiety. This should be your last forum question on these topics. If you remain concerned, consider communicating or visiting one of UK's excellent NHS GUM clinics. Thank you for your understanding. Best wishes and stay safe.
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