[Question #11441] Oral sex - white discharge
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14 months ago
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it finally caught up with me. I went to an Asian massage parlor in north east and received unprotected oral. I was expecting a condom to be used but they gave me oral for a couple min without , this was 7 days ago , Day 6 I had some slight burning when peeing but not extreme, I caulk it up to anxiety from the event. That night I checked and I had some wet spot in my underwear and I slightly squeezed my penis and white discharge was coming out. It happened when I woke up too, discharge was there and coming out of my penis. I scheduled an appointment immediately and going today .
I'm married and haven't slept
With my wife in 4 months.
Can the doctor treat me without test knowing I have gonorrhea or chlamydia? My fear is if they test me with insurance it will show and be on my record forever and I'm worried about the cdc contacting me at home by mail. I'm trying to put this behind me and move on with my
Life. My plan was to get tested with quest direct without insurance if I need a follow up. If I didn't have sex with my wife in a long time and get treated, how long will treatment take to resolve before I can have sexual intercourse again?
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14 months ago
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Doc, to add more, just got to dr and they gave me a shot of ceftriaxone and prescribed me doxy 2x a day for 7 days but didnt give me the azithromycin pill I see you say is also needed. Will the shot and doxy treat my situation ?
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H. Hunter Handsfield, MD
14 months ago
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Welcome back to the forum, almost 5 years after your other questions.
There are two likely causes of your urethral discharge -- nongonococcal urethritis and gonorrhea. NGU is much more likely: gonorrrhea symptoms usually start within 2-3 days, and the discharge is creamy or yellow (pus); NGU onset is usually 5-10 days, so your symptoms and timing are typical. When NGU follows oral sex, almost always the standard STD tests are negative. For example, chlamydia causes 30% of NGU following vaginal sex, but never after oral sex.
Normally people in your situation should be tested for gonorrhea and chlamydia. However, almost certainly both of these would have been negative. It is normal to start treatment without waiting of test results. You have misunderstood something we have said before. You had the ideal treatment, i.e. ceftriaxone plus doxycycline for 7 days. Azithromycin is recommended only when doxycycline is not prescribed. The doxycycline alone is just fine. Your symptom should clear up over the next several days.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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14 months ago
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Thanks for the quick reply, yes, I was hoping I wouldn't be back here and I'm hoping I never return. With the likelihood of NGU and not gonorrhea, but knowing I was treated based on what I mentioned above, how long should I wait before I return to sexual activity with my wife? As I mentioned, I haven't slept with her in months, and this was the only encounter I had with an external female , I just got the shot and I'm picking up the prescription shortly. Just don't want to risk my wife who has a compromised immune system if we have sex and I want to know the timeframe to wait where it's safe.. thanks
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H. Hunter Handsfield, MD
14 months ago
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Standard advice is to wait at least a week, or until all symptoms have cleared -- whichever is latest. On the other hand, NGU from oral sex probably is caused mostly by entirely normal oral bacteria and not likely to infect or seriously endanger a sex partner. Contrary to popular belief, compromised immunity rarely increases susceptibility to any infection. The main risk of immune deficiency is in worse outcomes if infection occurs, but not in risk of infection itself.---
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14 months ago
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Hi doc,
After the shot and the first day of the taking the antibiotics, the discharge stopped. I still have a tingle down there throughout the day but not visible discharge. Is that normal. If no discharge, does that Mean no concern and all good after 7 day cycle?
1. Is it safe to say this should be resolved after the 7 days doxy?
2. If it happened to be gonorrhea and not ngu, the med should have killed those plus chlamydia and syphilis too?
3. Since the timing and white discharge, being ngu and no viable discharge, after 7 days having unprotected with wife would be Ok?
4. I was thinking about testing, is it worth it to try and pinpoint exact cause or would that no matter since I'm in the middle of treatment and not accurate? I just wanted to confirm I'm clean after 7 days to be confident in no issue for wife?
Just want to put this behind me and be sure the meds cleared anything concern since no more discharge . |
H. Hunter Handsfield, MD
14 months ago
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We offer general information and advice but are not a substitute for direct medical care. You should discuss all this with the doctor or clinic treating you.
1. Probably yes.
2. Yes -- except if gonorrhea, the doxycycline was superfluous, only the ceftriaxone injection was important.
3. Probably yes, that's the usual advice. And as I said above, NGU following oral sex is believed to often be caused by normal oral bacteria and not likely to harm infected men's sex partners. But there is no proof or professional agreement on this, and no helpful research.
4. It's too late to attempt to define the exact cause. And the only available tests before treatment would have been for gonorrhea and chlamydia, which you can safely assume are cured if they were present.
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.
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