[Question #1137] Looking for resolution

96 months ago

Hi Doctors, I have browsed medhelp and this site for situations similar to mine and have found many answers but thought posting would be the best way to get some resolution to the anxiety I have been having. Encounter: Nearly blackout drunk condom protected oral and protected vaginal (separate condom) then masturbation to completion after quickly sliding condom off. This was with a csw at an establishment in puerto rico. I am uncircumcised. Despite anxiety resumed normal unprotected relations with SO a few days later. 4 weeks - HIV duo neg. 6 weeks - Chlam/HIV - negative. 8 weeks - Again chlam/HIV but this time included ghon and trich (Quest RNA, TMA test)- all negative. 15 weeks - itching of distal urethra and irritation/redness near meatus (last sex w/ SO was 2 weeks prior) - urgent care dx w/ fungal infection and prescribed fluc 1 tab. Symptoms abate over the next 2 days. Repeat tests for chlam/ghon/HIV/syphilis which were all negative and a UA and CBC which were both completely normal. 19 weeks - first sex w/ SO in 2 weeks, develop redness around rim of foreskin and some redness of glans (looks like balanoposthitis) 2 days later. Though this has occurred fairly commonly in the past, given everything else I was still anxious. Went to derm for yearly skin check a few days later and showed him, didn't think it was concerning. This has since improved. Main concerns: My SO seems to have been having abnormally bad cramps during menstruation (and similar pain at other times in her cycle) over the past few months and I am terrified I gave her something that led to PID. She has not reported discharge or fevers. Specifically, I wonder if I had something immediately after the encounter, passed it along, and then had spontaneous resolution before I underwent all of my testing. Trich/chlam/ghon are the major players on my mind. Huge mistake I think I can overcome if my mind is put at ease about this. Thank you.

H. Hunter Handsfield, MD

96 months ago

Welcome to the forum. Thanks for your question.

First, you had a safe sexual exposure. Congratulations for using condoms, even for oral sex, despite your apparently inebriated state. Second, you describe no symptoms that suggest STD. Third, you had negative results with very comprehensive STD testing. Finally, symptoms like your partner's are very common and almost never are due to STDs.

So I am confident you have no STD. Could you have been infected but then had spontaneous resolution before testing? Perhaps, but unlikely. The far more likely probability is that you were never infected, especially given the condoms. Your partner probably doesn't have PID, although she could see her doctor to be sure. It is unlikely her symptoms have anything to do with your sexual encounter in Puerto Rico. I really don't think you should be worried about it.

Please let me know if anything isn't clear. Best wishes--

HHH, MD

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96 months ago

Thanks for your reply. Some new developments. While doing the wash just a couple of days ago I noticed some of my SO's underwear was stained with some kind of dried whitish discharge, I looked for other clothes with signs of discharge and found many other pairs with both white and yellow dried discharge and found one with some that was not yet dried. It was gray-white and mucus-like. I tested it with one of those vaginal pH testing kits and the color changed to indicate "abnormal pH". The discharge had a very strong smell which I am not sure how to describe. Not "fishy" as is classic for BV, but more "musty" maybe? I am not sure how long this has been going on so I am not sure if it is abnormal (my gut says it is), and am again worried that I may have had something that cleared in between testing and then passed it on to her. She hasn't said anything about the discharge at all, and also hasn't said anything about itching, pain, soreness, etc. I haven't noticed any post-coital bleeding or anything like that and she hasn't said anything about pain during intercourse. Again I have had no symptoms to speak of.

Does this sound like run of the mill BV to you or could it be something more sinister (like trich/chlam/gon)? What do you make of the abnormal pH test, if anything? Do you still think I can be reassured that this is most likely unrelated to my indiscretion? How much of a risk was involved with sliding the condom off after vaginal and then masturbating? There must have been some fluids somewhere around there. Also, my memory is rubbish from that night and I do not know if the condom broke (though I do not think it did), but I can't be sure as I slid it off in a right hurry and didn't check it afterwards. I do remember cleaning myself off with some kind of cleaning wipe that was provided to me immediately afterwards.

Any reassurance or statistics you could give me would be greatly appreciated. Cheers.

H. Hunter Handsfield, MD

96 months ago

Hmmm... you're surreptitiously inspecting your partner's underwear for dishcarge? And even testing it for pH and odor? In any case, I don't know how much credence to put in your concerns. For example, after several hours or a couple of days, bacterial growth could cause odor in entirely normal vaginal fluid and perhaps rising pH as well. If she has anything, "musty" could mean BV -- odor is very subjective, and one person's fishy might be another's musty. But BV isn't an STD, at least not in the usual sense. it seems to me that if she is concerned about discharge, she should see her doctor. But it also seems to me it's her busines, not yours. If indeed she has abnormal discharge, I remain confident it has nothing to do with your other sexual encounter. BV, yeast, and numerous other non-STD causes are more common causes of vaginal discharge than STDs are.

As for the risk of your exposure, you're seriously overthinking it. While I can't say there is no chance of infection from contact with "some fluids somewhere around there", the chances are low and your tests all were negative.

My advice remains to move on from this. It's up to you whether to 'fess up to your checking up on your partner's genital health by examining her underwear.

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