[Question #10714] Gonorrhea Reassurance

20 months ago

Dear Dr Handsfield, Dr Hook and Mrs/Ms Warren.

I hope you are all well, you are providing a great service and I thank you in advance.

I have read through much of the information you have provided around this subject but am just after some final reassurance.

My concern comes after an encounter with a stripper. I received PROTECTED fellatio for 5 minutes but stopped it and left after mental clarity. Following this I went back, washed the condom lube away from base of my penis with water only as there was no soap available. I masturbated following this and am concerned i could have spread potential gonorrhea bacteria into my urethra. What are your thoughts on this?

I have had no discharge, i tested negative for syphilis and GO/CT although unfortunately this was an immunoassay not NAAT. However, frequent LET urine dipsticks have also never been positive.

This was over 10 months ago, I know I am over thinking this but my long term partner recently had some spotting with cramps 36 hours before her period.

Just would like some reassurance I am in the clear as the anxiety is getting to me.

Many thanks again.

H. Hunter Handsfield, MD

20 months ago

Welcome to the forum. Thanks for your kind words about the forum and your confidence in our services.

There are several reasons you can be confidence you do not have gonorrhea. First, even among the most sexually active women--including sex workers, strippers, etc--at any point in time probably under 1% have oral gonorrhea, and certainly under 5%. Second, when oral gonorrhea is present, the transmission risk for a single episode of unprotected fellatio (oral-penile contact), the large majority of exposures do not transmit the virus--probably under 10% risk. Third, condoms are 100% protective, and the amount of exposure to your partner's oral fluids from the way you removed the condom and rinsed with water almost certainly would not be enough to transmit the bacteria. Fourth, urethral gonorrhea causes overt and obvious symptoms 99% of the time -- i.e. painful urination and pus dripping from the penis. Fifth, your normal dipstick urine tests are additional strong evidence against any urethral infection. Finally, urethral gonorrhea in males is cleared by the immune system long before 10 months -- it's usually gone in a few weeks.

I think you'll agree that all this amounts to 100% certainty you don't have it. Finally, your partner's symptoms are not particularly concerning in regard to gonorrhea or other STDs. She's the one to judge whether her symptoms are normal for her (e.g. occurring occasionally with other menstrual periods) or if they are sufficiently unusual or severe to seek medical care. If so, of course she should be in touch with her doctor -- but you can be sure there is no possibility she has gonorrhea (at least not from you, and not on account of your strip club adventure 10 months ago).

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

HHH, MD

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20 months ago

Thank you for your reply Dr Handsfield.

Rest assured, I will continue to ensure my partners saftey if any PID symptoms do arise.

Just as a follow up question, for interest and further reassurance. Due to reasons I wont go into here, my partner and I only engage in "outercourse" and oral. I understand this decreases the risk even further that I could have passed the bacteria onto her ? I never ejaculate onto her Vulva, only fluid would be small amount of precum. Are the mucus membranes of the external female genitalia capable of being infected with gonorrhea?

This will be last question. Many thanks.

H. Hunter Handsfield, MD

20 months ago

No, external genital infection does not occur with gonorrhea. Really, gonorrhea shouldn't be a concern. Do your best to disregard any further thoughts about any of these issues.---
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20 months ago

Hi Dr Handsfield.

I thought I would use my final reply as im still having anxieties over this.

Few questions

1. Would Chalmydia be completely zero risk in this situation? I know gonorrhea may still be theoretical risk based on the recent saliva data.

2. I know there is unlikely to be any data on this but I noticed the moisturiser I use to masturbate contains multiple alcohols including alcohol denate. I imagine this would decrease ability of GN to colonise from saliva in urethra?

3. Would GN / CH impact period schedules in Women and does PID cause intermittent cramps or is pain constant?

Thanks Dr , trying to put these thoughts behind me.

H. Hunter Handsfield, MD

20 months ago

Any continuing anxiety about this situation is frankly unwarranted.

1) Yes, chlamydia is no risk at all.

2) Probably not. Cleaning or disinfectants either before or after exposure have no significant on risk of gonorrhea, chlamydia, or any other STD.

3) Irregular periods are not a common consequence of either gonorrhea or chlamydia. PID pain generally is continuous. And as noted above, with "outercourse" your main (or only) sexual practice with your partner, you could not infect her with gonorrhea or chlamydia. If she is have such symptoms, and if she (not you!) considers them unusual, she should see her gynecologist. But you can be 100% confident she has no STD on account of the exposure you described above.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe (as you have bite).

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