[Question #11090] Oral sex std

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17 months ago
Hi, first of all sorry for my english im mexican and isnt very good. I found this site and im learning about how STD works with the answered questions but i want to tell you my specific case.
- June 2023 had unprotected oral sex and protected vaginal sex with a female who is bisexual and is mostly active with womens. It was only one time
-Next weeks and days had unprotected vaginal sex and oral sex with my girlfriend. 
- In february 2024 i started to have a little testicle ache two weeks after my girlfriend gave me oral sex. The ache comes and go its bilateral and i dont have redness or inflamación and i dont have any other symptom like discharge or urine pain.
I did an urine test AND i dont have leukocitary esterasa or wbc 
My questions are:
1. Can i have some STD from my past adventure like gonorrhea or chlamydia from the oral and just this is the first Time that i present Symptoms (or have ping pong transmission?)
2. I should be worried of transmit some STD to my gf or just by the Time Is imposible that we had some STD
3. Hows the testicle pain in epidydimitis caused by STD? (chlamydia or gonnhorea or ngu)
4. In the oral sex interaction i could contract high risk vph and transmitted to my gf? 

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H. Hunter Handsfield, MD
17 months ago
Bienvenido al foro. Gracias por tu confianza in nuestros servicios. Tu ingles me parece bien; entiendo todo.

It is very unlikely you have any STD from the exposure last June or that you have transmitted any significant infection to your girlfriend. Testicular aching is not a likely symptom of any STD, especially when not accompanied by other symptoms like swelling, tenderness, etc -- and when there is no urethral discharge. And the standard STD tests -- which presumably included gonorrhea and chlamydia -- are very accurate. And as you seem to know, the negative leukocyte esterase test also is strong evidence against urethral infection, including NGU. (You use fairly sophisticated terminology. Are you a health professional?)

Those comments start to answer your numbered questions, but to be explicit:

1. You can be sure you have neither of these nor any other lower genital tract infection from the events of last June. In addition to the negative test results etc, you had a low risk exposure:  condoms work, and unprotected oral sex is much lower risk for STDs than vaginal intercourse.

2. It's very unlikely you were infected previously and then infected your partner. As discussed above, your symptoms don't fit with an STD and your recent negative test results are very reliable.

3. The additional symptoms of infectious epididymitis are noted above. The symptoms result from infection ascending up the vas defrens (sperm tube) to reach the epididymis and testicle, where the inflammation typically is considerable. It usually involves one testicle; pain in both typically has other causes. (There's an old saying in STD clinics that epididymitis can often be diagnosed when the affected patient enters the clinic, by the way he walks, i.e. trying to prevent the affected testicle from moving and causing pain. That's an exaggeration, but you get the idea.

4. All sex carries risk for HPV (VPH en espanol) and all sexually active people are infected. Assuming an average sex life over the years, you can safely assume both you and your girlfriend have had genital HPV. Your June exposure did not significantly elevate the chance you have it, however. (Depending on your and your partner's ages, you might consider HPV vaccination.)

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

HHH, MD
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17 months ago
Hi thank you for your answers, im a med student :).
I want to clarify some questions, i DONT have a negative std because the drs told me that was unnecesary because the simple urine test was enough but i dont know if chlamydia or gonorrhea make visible changes on the wbc, bacterias or leuko ( we dont have pcr test in my región and Is very expensive )
1. So the risk of ping pong infection isnt posible?
2. Just by the Time Is imposible that i started to have some infection?
2. In the case of VPH im just want to know if the high risk vph need direct contact between the penis and the uterus or only the low risk vph can be transmitted with the condom?
Thank you for your Time you are a really good doctor AND a nice steategy to the public health :)
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H. Hunter Handsfield, MD
17 months ago
It's always nice to help medical students and other health professionals. I agree with your doctors:  With these symptoms and the single exposure several months ago, plus negative urinalysis, you really do not need STD testing. You are over-analyzing and over-thinking the situation and your risks.

1. Risk of ping pong? No that is not a risk.

2. It isn't quite "impossible" that you have no infection on account of the time involved, but it is exceedingly unlikely. You're fine.

3. There is no difference in HPV transmission risk between the low- and high-risk virus types. As discussed above, assuming you have had a few sex partners in your life, you already have HPV. No single exposure like the one you describe significantly raised the chance you have it. Getting and having genital HPV is a normal, expected, unavoidable aspect of human sexuality. All persons should be immunized against HPV, which is 100% protective agains the 9 virus types that cause 90% of disease (warts, cancer). Please look into it for yourself and your girlfriend.
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17 months ago
Hi I think that this Is my final question because theyre only 3 replys. My concern is that me and my girlfriend we only had sex between us, (I never had vaginal sex with other girl) we dont have any more sexual partners except for the girl of the event of june that i talked in the past answer. 

Thats why I dont know if she Is in danger of having high risk VPH because i use condom in the vaginal sex but i didnt use in oral but I dont know what are the probabilitys of getting VPH in that way and just in one ocasion.

Also what should i expect for my testicular pain because i have It for like 3 weeks and my doctor told me that dont worry but Is uncomfortable, what aré the posible differential dx???

I want to finish my message thanking you because its a very good forum and im very relaxed AND grateful for found it.
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H. Hunter Handsfield, MD
17 months ago
I don't understand "I never had vaginal sex with other girl"; your entire question is on account of the exposure you had last June with another partner. Maybe a language/translation problem?

With you (and presumably your girlfriend) having had no other partners, it is less likely that either of you now has HPV. Conceivably you could have been infected last June, but probably not. But if you were infected and transmitted HPV to your girlfriend, you and she probably will never know. Fortunately, the large majority of HPV infections are harmless and remain silent. In any case, this is an excellent opportunity to be vaccinated -- then you'll both be protected in case either or both of you have other sex partners in the future.

It seems clear your testicular pain is not due to any infection. Keep working with your doctor if it continues. You might look up information about chronic pelvic pain syndrome (CPPS); google it for more information. The Wikipedia article is quite good; also see information provided by the Stanford University Department of Urology.

That indeed concludes this thread. Thanks for the thanks; I'm glad to have helped.
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