I read that discussion with Dr. Hook and agree with all he said. There are several common causes of vaginal discharge in women, and most of the time no STD is involved. Your description of your wife's discharge, and the irritation/itching she has experienced from time to time, are most consistent with a vaginal yeast infection. Vaginal yeast symptoms often are a bit worse following sex -- friction etc can be irritating. Yeast is just about the most common overall cause of vaginal complaints, and probably 80-90% of all women experience vagina yeast infections from time to time. There are other possibilities as well, and often there is no infection of any kind. Depending on her age (maybe approaching menopause), falling estrogen levels might be responsible.

The single most important part of Dr. Hook's advice was that your wife see a gynecologist for evaluation of her symptoms. Presumably you haven't done that or you would have said something about it. So that is my current advice as well. Until and unless she is professionally evaluated, there's really nothing more this forum can offer to sort things out.

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

HHH, MD

2) I don't recall your non marital sexual risks recently. If you've had no sex with anyone else since you last had negative testing for gonorrhea, chlamydia and trichomonas, I see no need for you to be tested; that can wait until your wife has been evaluated. But if you are potentially at risk since last tested, it would be reasonable for you to be tested now.

The proportion of STIs that are asymptomatic can indeed be confusing. You have triggered another of my occasional blog-like replies for potential use in event of similar questions in the future.

What proportion of new urethral gonorrhea in men causes no symptoms? Around 1% or lower. However, for any treatable medical condition, those with symptoms tend to be treated promptly, leaving behind those without symptoms. Therefore at any point in time, maybe 10% or even 20% of urethral gonorrhea in males can be asymptomatic. It's further complicated by when men are tested, i.e. how long after they were infected:  some infections start out without symptoms but have symptoms later. Others are the opposite: early symptoms that clear up over time. Then consider anatomic site:  half of rectal infections are asymptomatic, oral gonorrhea almost always. Women are much more likely than men to have asymptomatic genital gonorrhea. Similar considerations apply to chlamydia, but the proportion without symptoms is a lot higher than for gonorrhea. For new urethral infection in men, probably 20-30% have no symptoms or such minor ones they pay no attention; and in the population, around half of all infections at any time are asymptomatic. On top of all this, consider who is being studied. If a research project seeks to determine the prevalence of infection in persons who say they have no symptoms, almost all infections are asymptomatic (duh). But how many of those actually had symptoms but denied it? (There are many reasons why this is quite common. For example, women often have increased vaginal discharge but don't consider it abnormal, because the amount of discharge can vary naturally over time.) And so it goes, to varying extent for all STIs.

The bottom line for men in your situation is that if you have a potentially risky penile exposure and within 5 days have not developed urethral discharge and painful urination, there is very little chance you caught gonorrhea (see the initial 1% figure above). There's a higher chance for chlamydia, but absence of symptoms within about 10 days still is quite reassuring. Given your wife's symptoms, I applaud your intention to be tested. But as already discussed, most likely her symptoms are not due to any STI.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful.