[Question #11278] Received unprotected oral from SW
15 months ago
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38 y.o. man from SoCal. Received oral sex from female SW at massage. Last encounter 4-18 (12 days ago). STD test in March was clean, had a few encounters after.
On 4-25 (5 days ago), stretched my penis at night by grabbing under the glans and pulling the penis from behind. Some sting on the penis that night but thought nothing of it.
Next morning, as I am masturbating, noticed red spots just under glans.
There are 3 red spots, one on the top/front just under the glans, and two in the bottom/back where skins connect near glans. They aren’t blisters or bumps or warts, they are just red – upon close look, they are red because the tiny blood veins are visible in those areas. Area is generally red also. The front/top red spot looks indented, triangle shape, like a scrape. They have improved since then in appearance, but still there.
I also noticed a patch of what look like Fordyce in a small, 0.5” circular area on my shaft (mid area, bottom side. About 50 or so tiny grain looking bumps, not cauliflower). It’s only visible when I pull and stretch out my skin. I think it was always here, but I’m not sure. No symptoms really, other than what is visible.
I am so paranoid Doc, I can’t eat or sleep. Please help.
15 months ago
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Adding due to letter/word limit:
1.Some, almost unnoticeable, itch on the top red spot. Hoping because it was scraped and new skin is generating.
2. This was weeks ago, but I noticed I had to pee more often. This hasn't been the case for a couple of weeks at least.
3. Again, no symptoms other than described, just scared to death and don't even have the courage to take the 10 panel test because I'm so worried to death.
Should I test? Should I stop having sex w/ my long-term partner? When should I worry?
1.Some, almost unnoticeable, itch on the top red spot. Hoping because it was scraped and new skin is generating.
2. This was weeks ago, but I noticed I had to pee more often. This hasn't been the case for a couple of weeks at least.
3. Again, no symptoms other than described, just scared to death and don't even have the courage to take the 10 panel test because I'm so worried to death.
Should I test? Should I stop having sex w/ my long-term partner? When should I worry?
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Edward W. Hook M.D.
15 months ago
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Welcome to the Forum. Thanks for your questions. I'll be glad to comment. Thanks for your detailed descriptions. The lesions you describe do not particularly suggest any STI. Rather it sounds as though you have been worried about your exposures and this has led to overly vigorous self examination, "discovery" of benign dermatologic processes which have amplified your anxiety. The fact that the lesions you noted are improving is consistent with this. Further, increased frequency of urination is NOT a sign of STIs.
While testing is a personal decision, I think you should consider testing. Testing will not change whether or not you have an infection (I am confident you do not) but will provide you with reassurance that you do not. Should you test, I am confident that the tests would be negative, showing that you do not have an STI. I see no reason to worry and no reason to abstain from unprotected sex with your regular partner. EWH
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15 months ago
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Thank you so much for your response doc. Some relevant info:
1. When I did a sperm test for fertility etc, they found I had higher than normal level of white blood cells.
2. This morning I noticed a tiny bit, maybe a drop of two, of clear liquid at the hold of my penis. Never noticed this before despite my obsessive inspection every hour. Could be normal but I'm too scared.
3. I have warts on one of my foot, read it is caused by HPV... Could this be related to my SW encounters?
4. The test was actually in Feb, not sure how reliable this place was. About 6 encounters w/ SW since then.
5. Can I be sure that my red spot, which is scraped looking as in I can see a bit of flesh (no puss, but slightly yellow ish compared to surrounding area), is not a sign of STI?
6. Internet can be misleading, but read some claims of men receiving STD from unprotected oral from masseuse. What are your thoughts?
7. I also had covered vaginal sex with the SW... and in my whole life only had unprotected sex with 2 people, including my current long term partner.
15 months ago
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Edit: just checked and the red spot isn't yellow exactly, more red. Might be my skin color since it's the lighter part of my penis..
15 months ago
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2nd edit for your 2nd response: just want to add, I can't tell if this red spot is a scrape from pulling the glans, or early chancre of syphilis... The red spot looks more prominent when it's wet (when I shower). I'm sure I am being a hypocondriac and am freaking out over nothing, but just want to let you know. Thank you so much, Doc, I am very happy to receive your knowledge and wisdom.
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Edward W. Hook M.D.
15 months ago
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Let me start with a general answer, then get to the specifics of your follow-up questions. My sense is that your guilt/anxiety over your casual encounter is fueling man-eating anxiety. Take a deep breath, relax. As I've already told you, the encounter you described was very low risk and not something to worry about. I also sense that you have gone to the internet looking for guidance- this is a terrible idea. There are no filters/editors on the internet- much of what is there, despite being said authoritatively is incorrect. Sometimes it is out of date, sometimes it is taken out of context or reflects misinterpretation of information and sometimes it is just plain wrong.
1. When I did a sperm test for fertility etc, they found I had higher than normal level of white blood cells.
You don't mention when this was done. Irrespective, it is a non-specific finding. Further, testing of ejaculate as part of an infertility workup is non-specific and has many benign causes.
2. This morning I noticed a tiny bit, maybe a drop of two, of clear liquid at the hold of my penis. Never noticed this before despite my obsessive inspection every hour. Could be normal but I'm too scared.
As small amount of urethral secretions is entirely normal and not something to worry about. Repetitive self-examination is irritating and increases the urethra's tendency to make normal secretion to protect itself from the trauma of repeated examination.
3. I have warts on one of my foot, read it is caused by HPV... Could this be related to my SW encounters?
Foot warts are caused by HPV but entirely different HPV strains than found in genital location. Your foot warts were likely acquired on a shower stall or gym floor. They ahve nothing to do with genital warts.
4. The test was actually in Feb, not sure how reliable this place was. About 6 encounters w/ SW since then.
STOP- get over it. Believe your test results.
5. Can I be sure that my red spot, which is scraped looking as in I can see a bit of flesh (no puss, but slightly yellow ish compared to surrounding area), is not a sign of STI?
Acknowledging your subsequent posts- this in no way suggests ANY STI
6. Internet can be misleading, but read some claims of men receiving STD from unprotected oral from masseuse. What are your thoughts?
Receipt of oral sex is low risk but may lead to STI acquistion, most commonly gonorrhea. Nothing you have described suggests gonorrhea. M infected partners do not ost people do not have gonorrhea and most expsoures to infected partners do not lead to infection
7. I also had covered vaginal sex with the SW... and in my whole life only had unprotected sex with 2 people, including my current long term partner.
Relax. your encounter was protected, virtually eliminating any risk
You need to move on. If you cannot, after a single follow-up test (the tests are highly reliable. further testing is a waste of time. When you get negative test results, accept them and move on, figuring out how to address your guilt.
FYI, you have one follow-up remaining. After that the thread will be closed and there should be NO reason for further questions. EWH/
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15 months ago
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Thank you for your response Doc.
The psychological impact never existed until last week, only because of the red spots. But you are right, I have anxiety from this whole episode. I will say though that I haven't been this anxious before with other encounters.
For the semen test, it was done on the same day as my last std test in Feb. This was all in Asia this year when I went on a business trip for 1 week, and they took both urine and blood yet only gave me urine results via email after my return to US, hence the curiosity of its validity.
With your advice for a peace of mind, I completed a panel test this morning. Still waiting for results.
Question: As for the main red spot on top side, just below the glans, it is slightly like a crater (dips in) but no pain to touch. No liquid or blood came out of it, as far as I know. I would think a scrape or burn from penis manipulation/stretch would be tender to touch? Just don't know if this is actually injury that triggered unnecessary anxiety or coincidental and unrelated to the penis stretch pull.
Question2: I didn't quite understand your response to question 6 above. Could you please clarify?
Question3: what potential circumstances in the future (i.e. change in appearance of the red spots, new spots, etc.) would be alarming per your expertise? If things don't get worse, as we both expect, do you find that the probability of me having caught an STI/STD is small enough to not rely on negative panel results? For the peace of mind, that is.
The work that your team do is very valuable and appreciated. Also want to say Go Big Red! (That's me trying to relax and find some humor). Thanks Doc!
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Edward W. Hook M.D.
15 months ago
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I must say that I'm perplexed by the intensity of your concerns since you have not experienced similar concerns in the past. I anticipate that your anxiety relates to the red spots that you describe and which you previously said appeared to healing/improving. I also think that getting tested was a good idea and when the results return as negative, I hope you will be able to move forward. Nearly all tests for STIs (with the exception of blood tests for herpes) are very, very reliable, particularly in persons with symptoms In response to the 3 final follow-ups which will conclude this thread:
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Question: As for the main red spot on top side, just below the glans, it is slightly like a crater (dips in) but no pain to touch. No liquid or blood came out of it, as far as I know. I would think a scrape or burn from penis manipulation/stretch would be tender to touch? Just don't know if this is actually injury that triggered unnecessary anxiety or coincidental and unrelated to the penis stretch pull.
A healing scrape need not be tender. You describe repeated self-examination. All too commonly this slows the healing process and on occasion, squeezing and pulling can actually worsen such areas.
Question2: I didn't quite understand your response to question 6 above. Could you please clarify?
Apologies for the typos. The reply should have read- "Receipt of oral sex is low risk but may lead to STI acquistion, most commonly gonorrhea. Nothing you have described suggests gonorrhea. Most people do not have gonorrhea and most exposures to infected partners do not lead to infection." In other words, in the unlikely circumstance that your prior partner had oral gonorrhea, a single exposure still has a less than 10% chance or resulting in infection. Further, oral gonorrhea would not lead to the sort of red spot which appears to be the focus of your concerns.
Question3: what potential circumstances in the future (i.e. change in appearance of the red spots, new spots, etc.) would be alarming per your expertise? If things don't get worse, as we both expect, do you find that the probability of me having caught an STI/STD is small enough to not rely on negative panel results? For the peace of mind, that is.
I anticipate that your tests will be negative. When they are that will be very strong evidence that you did not acquire an STI and that the red spot you are concerned about is not due to an STI. If that relieves your anxiety, great. If it does not, my advice is to believe your test results and seek evaluation by a dermatologist.
This completes this thread. Despite my advice not to return, I see that you have. This thread will be closed and I will now address your next questions. EWH