Good Afternoon,

Thank you so much for everything, first. Between this and other sites, I have learned SO much about STI risks and info from Dr. Hook and Handsfield! 38 y/o female with admitted anxiety over STDs any time I've been with a new partner. I've been STD free, only been with heterosexual men, and have only had around 5 partners in my life time. I've entered a new relationship within the last few months and we had a frank talk about STDs and made the plunge from condom protected to unprotected sex. He's a 47 yr old male with no reported history of STDs/symptoms, heterosexual. I have zero worry about HIV given the stats in my favor with all of the above. I do however tend to have a quick vaginal reaction with almost every new partner that has resulted in overall discomfort/agitation for a few days that clears up within a week (literally, EVERY partner, and EVERY time I fear it's an STD... so wild!). This time around, after unprotected vaginal sex episode number 2, within four days I experienced abdominal pain so I of course feared the worst thinking STD-PID. It was up toward the left side of my abdomen and for a few days, but has since pretty nearly completely gone away, or I've only noticed it once in a great while. I also noticed an increase in white, milky discharge mixed with typical clear discharge that was leaving a film in my underwear. I'm still somewhat getting it. It has no odor and I have no painful urination. I really, really don't want to continue to put myself through testing based on anxiety (other than routine, annual testing I always do) unless it really seems necessary. Do these symptoms reflect a possible Chlamydial/PID infection? Would they start and then go away, like the pelvic pain? I would imagine they'd get worse! Thank you SO much.

You describe a very low risk sexual lifestyle in regard to STIs, as well as current minimal risk. Your age and that of your partner are a significant factor:  while sexual behavior and exposures of course are the main determinants of STI risk, statistically active/transmissible STIs all are dramatically less frequent beyond age 30-35, and the older the better! Even disregarding age, what you say about your new partner suggests he's at as low risk as you are.

We're not experts in the physiology of sex, but certainly changes in vaginal moisture, discharge, and so on are common in women in new sexual relationships. As you can imagine, it creates a common dilemma in management and advice for persons at higher STI risk than you are. Because such symptoms can be caused by STIs, testing is advised if the STI risk is significant. However, as for your particular vaginal symptoms, absence of odor -- and also apparent absence of colored discharge and/or staining of underclothes, since you don't mention them -- also suggest no STI is responsible. I have no good explanation for the pelvic pain you have experienced, but I would assume it's either psychological or some sort of internal muscular tension etc related to changes in sexual frequency. It's an obvious fact that sex often is more vigorous and frequent in the early, passionate stages of a relationship -- maybe contributing to such symptoms.

Of course you're free to be tested (only for gonorrhea, chlamydia, syphilis and HIV), and perhaps discuss your concerns with your partner, if the expected negative results would be reassuring. New couples often openly discus their past sexual experiences including STIs, and some get tested simultaneously -- which sometimes can be a positive sign of commitment and respect. That said, from a medical/risk perspective, I see this as entirely voluntary. It seems very unlikely you are at significant risk.

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

HHH, MD

The title of your question mentions vaginal pH, but the question at all said nothing -- but now you raise it aain. It is conceivable that a transient "pH balance" issue might imply your pH was on the high side at times? Sexual frequency and new partnerships can be associated with bacterial vaginosis, which elevates vaginal pH. However, by far the main symptom of BV is strong vaginal odor, which apparently you don't have. I really wouldn't worry about your pH balance.

I do hope your partner understands you were "mostly" joking! Anyway, of all STDs for which you conceivably were at risk and could cause vaginal discharge, gonorrhea is the least likely.

That completes the two follow-up exchanges included with each question and so ends this thread. I have enjoyed the discussion. Take care and stay safe.