[Question #10562] Ruptured condom

21 months ago

Last night I had protected sex with a girl I met at the bar. She is 35 years old gainfully employed single mother. During our time together I immediately realize the condom ruptured. Probably 15 seconds of unprotected sex with no ejaculation. I am married with active sex life.

1. Do i just monitor for symptoms and if so what is the time frame for each?

2. Should I do any preventative treatment just to be sure (antibiotics etc)?

I need to ensure the safety of my wife and while this episode has convinced me that I'm done with this lifestyle, I really don't want to confess the episode, unless it puts her at harm.

Edward W. Hook M.D.

21 months ago

Welcome to the Forum. Thanks for your confidence in our service as well as your commitment to condom protected sex. Condoms do break about 1% of the time. This was a low risk exposure (see below) but not no risk. Depending on your situation, you may want to seek preventative treatment of may wish to wait and test. Taking 200 mg of doxycycline at this time (this is so called "post-exposure prophylaxis) will nearly eliminate your risk for acquiring syphilis and chlamydia and will reduce your risk for gonorrhea somewhat. The medication however needs to be taken within 24 hours of an exposure.

In terms of waiting and testing- tests for gonorrhea and chlamydia will be reliable at any time more than 3-5 days following your exposure and can be done with a simple urine test. Other STIs such as syphilis and HIV are much less common than gonorrhea or chlamydia and require a blood test taken later (at least4-6) weeks to provide reliable results and more than 6 weeks to be conclusive.

I say this was a low risk exposure because most people do not have STIs and most single exposures to infected partners do not result in transmission of STIs.

I hope that his information is helpful. If any part of this answer is unclear, please use your up to two follow-ups for clarification. EWH

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21 months ago

Thank you. I would agree low risk but for obvious reasons need to reduce that as much as possible.

You mentioned doxycycline and that it would reduce my risk for gonorrhea somewhat. Is there something else that would better suited for gonorrhea. I received a prescription I will be picking up today for Azithromicine (z pak) Doxycycline and Metronidazole. Does that seem appropriate?

Edward W. Hook M.D.

21 months ago

We base out replies on scientific studies. The scientific data are there for doxycycline but not azithromycin. I really see no need to take the azithromycin if you take just the one dose of doxycycline, 200 mg. There is no need to take more. The metronidazole is optional. EWH---

21 months ago

Thank you. Last question. If I follow the suggested regimen and am asymptomatic after a week, would I need to test before resuming sex with my wife.

Edward W. Hook M.D.

21 months ago

If you take preventative antibiotics as described above and do not develop symptoms after a week there is a more than 99% chance that you do do not have an STI that could be transmitted to your wife. If I were you, I probably would not bother to tests.

I hope this helps. As you know, this completes tis thread which will be closed shortly. EWH

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