[Question #10965] Protected oral
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18 months ago
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Hi Doctors,
Quick breakdown-
21/09/23 – Condom protected BJ finished with handjob (maybe some saliva exposure left over from condom) from SW in Spanish Brothel. No symptoms in following days other than some bladder pain that came and went within a day put this down to anxiety. Didn't test stupidly as I didnt think there was a significant risk. No discharge nor burning on urination though.
14/10/23 – Unprotected gentital rubbing with GF. Few more times throughout month. No penetration.
20/11/23 – GF complains of some vaginal and anal discomfort goes within 2 days.
30/11/23 – GF period starts. Some spotting and cramps in days leading up to this. Not usual extreme anxiety my side.
16/12/23 – Penis tip pain starts , grows to be rather intense with intermittent burning on the head. No discharge and no painful urination. Symptoms die down within a week to minor tip pain that still comes and goes. I take it this may mean i had NGU ? Gonorrhea unlikely due to over 2 month timeframe to start of symptoms ?
02/jan/24 – Neg Gon / Ch PCR test. Dr gives 1g azithromycin and both GF and I take 1 gram.
03/Jan/24 – GF same period events again.
What are your thoughts, have I given GF gonorrhea / NGU? I have really bad anxiety and cant put this behind me, should I get us both tested? I had Hypospadia as a child would this impact my chances of acquiring anything?
Thanks
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Edward W. Hook M.D.
18 months ago
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Welcome to our Forum. Thanks for your questions and for your confidence in our service. I'll be glad to comment. You are correct that the exposure you describe was low risk. Few STIs are transmitted from receipt of oral sex and there is virtually no risk from receipt of masturbation (the hand job). Of STIs acquired from receipt of oral sex, gonorrhea and NGU due to introduction of oral non-STI bacteria into the penile urethra are far and away most common; each of these is characterized by discomfort with urination and/or a penile discharge. The risk for other STIs is very small and there is no risk for HIV. The symptoms experienced by your GF and the discomfort occurring at the tip of your penis are not suggest of an STI and are certainly not suggestive of NGI. Discomfort at he tip of the penis lasting several days might be caused by problems with the prostate or low back problems rather than STIs.
Your tests prove that you do not have gonorrhea and chlamydia and while it is unlikely that you have NGU, if you did the azithromycin would have cured it. I see nothing to suggest an STI in you and your GF's symptoms are non-specific and unrelated to your causal encounter. I doubt that this is related to hypospadias. I would suggest that your GF discuss her discomfort with her GYN. Unless your symptoms recur, I would not worry about them and should they recur, I would suggest seeing a urologist unless there is an obvious rash or lesions. If you have a rash or lesions, then a dermatologist or sexual health practitioner would be best to see.
I hope this perspective is helpful and will diminish your anxiety. EWH
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18 months ago
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Thank you for your reply Dr. I am really struggling.
Some follow up questions -
1. Can STDs like gonorrhea be passed on through gentital rubbing? Do you see female patients with this exposure ?
2. How common is it for gonorrhea symptoms to show up 2 months after exposure ?
3. Do you often see patients with gonorrhea who have used condoms ?
4. I read online journal that said 1g azithromycin could clear up to 95% of gonorrhea, whats your thoughts on this.
5. If my GF did have PID would she be experiencing pain right now not just the period symptoms ?
Thanks
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Edward W. Hook M.D.
18 months ago
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How unfortunate that you are having so much trouble accepting that you did not acquire an STI or harm your partner as a result of your virtually no risk casual encounter. Straight to your follow-up questions:
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1. Can STDs like gonorrhea be passed on through gentital rubbing? Do you see female patients with this exposure ?
No! No penetration, no risk.
2. How common is it for gonorrhea symptoms to show up 2 months after exposure ?
Very, very rare
3. Do you often see patients with gonorrhea who have used condoms ?
Almost never if the condom does not break and is used throughout the encounter
4. I read online journal that said 1g azithromycin could clear up to 95% of gonorrhea, whats your thoughts on this.
That figure is a bit high. The research suggests that 1g of azithromycin would cure 60-70% of gonorrhea in most locations
5. If my GF did have PID would she be experiencing pain right now not just the period symptoms ?
Your GF's pain is episodic. The pain of PID does not come and go
Youneed to accept that you were not infected. More testing is not needed, no therapy is needed. You do need to address your guilt however. EWH
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18 months ago
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Thank you Dr. This just stems from severe guilt and regret. Im just petrified my GF will develop PID and become infertile. There has been so many coincidences with the symptoms since the event that it has just spiraled me into researching every single thing. I had almost moved on prior to the penile symptoms.
The final follow up I guess is if you would agree with me saying the fact I had protected oral only , minimal contact with saliva, no discharge or dysuria in the months following and only non penetrative sex with my GF that there is zero chance she has Gonorrhea.
Thank you for your time. I will decide what to do finally but regardless i will seek councilling.
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Edward W. Hook M.D.
18 months ago
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As you know, this will be my final response. I’m pleased to hear that you have opted for counseling. I believe that will help you more than any testing or more antibiotics.
I will just reiterate, one last time, your exposure was virtually no risk. STI‘s are not transmitted in saliva or without penetrative sex. You have tested in the test negative. You really need to believe this. I wish you the best. This ends this thread. EWH
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