My mental health is suffering.

Me: white, mid 40's, married, children. Her: Same. I've known her yrs, she is not a stranger. Business trip, we drank to much, unprotected oral/vag. I have no memory, so I'm guessing duration was short. She said this is not normal for her, has had 2 partners the past few yrs.

Next day I had nervous break. I had z-paks, & took 1 g at the same time. Took 500mg more 2 days later. I know this was very stupid.

Week 1, no obvious discharge. 6 days after meds I squeezed my penis, saw small white drop of discharge, I was aroused prior to this.(In the past I've been able to sometimes squeeze white discharge & tests were always negative). Still, this caused panic & I took full 2g zpak at once. I'm embarrassed for being so stupid.

I've felt weird sensations wholetime. I'm guessing stress? I'm terrified of losing my family.

Questions:

1. 1g zpak day after should prevent chlam/ngu? Effective for SOME gono? Was it too early? Could it stop Gono from infecting?

2. Any discharge would be constant, noticeable & prob get worse right?

3. 2g dose zpak would likely take care of most other issues right? Is 4 days enough time for meds to work?

I think you realize you are seriously overreacting. There is virtually zero chance a woman like your partner has a transmissible STD. It indeed is unfortunate you took the azithromycin, but probably it makes no difference because you clearly were not exposed to anything it would treat. As for symptoms, "weird sensations" means nothing -- espeically considering that whenever someone suspects his or her own symptoms have a psychological origin ("I'm guessing stress"), almost always s/he is exactly right.

To your questions:

1. Yes, 1 g azithromycin would cure or prevent chlamydia and NGU, and most gonorrhea as well. In addition, there is virtually zero chance of gonorrhea in this situation; forget it.

2. Yes. Abnormal urethral discharge is obvious and continuous -- altthough often most noticible on arising in the morning.

3. Do not take any more antibiotic. Any unlikely benefit already is maximum with what you have taken so far.

I recommend against any testing for any STI and further than you confidently resume unprotected sex with your wife without worry. If you continue to obsess about all this, your next best option is to discuss all this with your one-time partner, and perhaps both get tested for common STDs. Perhaps you will find she is just as worried about this event as you are:  statistically, there is no reason for her to assume you are uninfected either.

All is well. Nothing harmful has happened or will. I hope these comments are helpful. Let me know if anything isnt' clear.

HHH, MD

Just to clarify. You say zero chance of Gono in this situation, but that is due to her likely not having anything? I realize I am overreacting, I have read somr6 stats that for single sex act if one partner is positive the chance of infection is still low (4.5 - 20%) if you are male.

Sorry, I should have been more clear about "sensations". Over the past few days I've noticed kind of a burning/itchyness but not when urinating. Then a feeling like I still have urine or something at the tip of my penis. It is a constant feeling. I did have split stream urine 2 times yesterday, but I've been dehydrated and had to hold my urine for long periods due to work, so maybe that is related. I have had this before, but maybe not two times in a row. I looked for discharge overnight since I found a small drop yesterday but there was nothing noticeable this morning. 

Sti's usually have burning/itch during urination not so much inbetween? Or do I misunderstand that. Is something like yeast possible after the meds?

I have talked to the woman a bit. She told about a brief relationship she had during a separation earlier in the year, but doesn't seem worried.

Thanks Doctor I appreciate your response style.

The odds a female of her age and life situation would have gonorrhea or any other bacterial STI (syphilis, chlamydia, etc) is vanishingly small. That isn't worried further confirms her near zero risk of having an active STI.

Thanks for the expanded description of your symptoms. They are typical of nothing at all -- probably anxiety magnifying your awareness of meaningless symptoms or even normal body sensations that otherwise would not be bothersome and perhaps not even noticed.

Trust me on this:  if somehow I were in your situation I would not have taken the antibiotic, would not be tested for anything at all, and would continue unprotected sex with my wife without the slightest worry.

I guess this is my last chance to ask you anything, so I will try to move on after.

1. Is there any need to be concerned for MGen? I realize my meds may not have covered this. 

2. Is it likely to contract from 1 episode?

3. I try to not excessively check myself but I still feel a tickle in my urethra so it is hard to ignore, I'm 5 days from my 2g dose. I seem to be able to squeeze a small white-ish drop of substance every few times I check (not everytime) but I've also read it's not really discharge if you have to squeeze.

4. MGen info is hard to find (discharge colour, amount etc etc), but looks like it is as common as other sti's.

Thanks again Doctor I appreciate you taking the time to answer my questions.

2) There are as yet no data on the risk for M gen from any particular exposure.

3) Ignore your remaining symptoms. For sure stop squeezing yourself looking for discharge:  that's a great way to CAUSE increased discharge! If you're not

4) Reliable tests are available; M gen is no longer any more difficult to diagnose than other STIs like gonorrhea and chlamydia. But for the reasons already discussed, I advise against testing.

As you understand, that compeltes this thread. I hope the discussion has been helpful.