[Question #11719] Unprotected Encounter
12 months ago
|
On July 11, I engaged in sex with a female CSW. The condom broke while penetrating. It was seconds before I pulled out and put on a new condom. I also received unprotected oral from her. I experienced no symptoms. 15 days later (7/26), I resumed unprotected intercourse with a regular female partner. As luck would have it, the same day or day after, the head of my penis was a bit irritated and a bit red. It was uncomfortable when I urinated (little burning/blockage feeling). A clear non-ejaculate fluid was also present (very scant but on urethra) without milking (but more so if I apply pressure). Two days ago, on Monday (7/29), I went to urgent care. I was negative on everything (uti, trich, ureaplasma, gonorrhea, chlamydia, syphilis, hiv, hep, etc..). I feel my symptoms are improving; however, the clear fluid is still present and the urination does not seem to flow as easy (although I think this may be from anxiety). The negative tests were reassuring; however, this whole episode has stressed me out beyond belief as I always use care with my sexual health. Did I pose any risk to my current partner (or future partners)? Should I follow up with urgent care? What course of action should I take? I'm not sure what's going on with me. Any advice or help is appreciated. Thanks for all you do. Also, Dr. Handsfield and Dr. Hook, please try to update your profile photos showing how distinguished you both are looking these days :)
![]() |
H. Hunter Handsfield, MD
12 months ago
|
Welcome to the forum. I'm happy to help.
The unprotected exposure (unintended) could have risked nongonococcal urethritis (NGU). Your symptoms aren't typical; I don't know what to make of the penile head "irritation", and NGU discharge usually isn't clear. (Are you circumcised?) I agree your negative lab test results are reassuring, but they do not exclude possible NGU which half the time is not associated with any particular cause that can be identified with standard testing. Do you know if your evaluation included evaluation for white blood cells in your urethra or in the clear discharge? Did your test results include Mycoplasma genitalium? If the discharge is continuing, you should be re-evaluated, this time by an STD experienced clinician, e.g. at an STD clinic. If urethritis is confirmed by WBC testing, you and your regular partner both will need treatment with doxycycline.
I hope these comments are at least somewhat helpful. Let me know if anything isn't clear -- and the outcome if you are reevaluated. Good luck in the meantime.
HHH, MD
---
12 months ago
|
Shortly, after I typed my initial email, the clear fluid went away (or to the point where I don't notice). I treated the redness/irritation on the head of my penis with lotrimin and that too has subsided. Now, the redness only appears after I masturbate and it has lessened with the lotrimin. I took azo as well. I am unsure as to what this was. Maybe a yeast infection or skin irritation? The urgent care physician hinted it might be something superficial that happened. I'm still worried but I feel better overall. Subsequently, I returned to urgent care, but they did not prescribe me anything as results were negative. Although, I wish they had just to make me feel better. This might be a stupid question, but is there ever just an antibiotic or an otc that can just flush out the system?
To answer your questions, I am circumcised. With regard to the wbc question, it was leukocytes neg - leu/dl ref.neg in the urinalysis. I was tested for mycoplasma but it was hominis (not isolated). I had never even heard of these until the physician ordered them. My final test results came back today. Negative on uti, trich, gonorrhea, chlamydia, syphilis, hiv, hep, ureaplasma urealyticum (not isolated), mycoplasma hominis (not isolated) Is it necessary to restest or perhaps test for mycoplasma genitalium (does this one pose risk)? Is it necessary to return to urgent care or do you feel I'm in the clear?Finally, as a result of all of this, I'm starting to get that genital anxiety hangup (erections not as good, examining, feeling sensations that are normal).....is there any advice for getting over that? Prior to this, I always had sexual health checkups every six months with no worries in the interim....now just feeling a bit all over the place. Thanks for your help, Dr. Handsfield. Any advice or further information is greatly appreciated.
![]() |
H. Hunter Handsfield, MD
12 months ago
|
I'm glad to hear things have cleared up, and that the urgent care doc also had a reassuring evaluation and advice.
I don't know that you mean by a treatment that might "flush out the system".
Mycoplasma hominis is a normal bacteria in the genital tract; it would not have mattered if that test had been positive. With your symptoms clearing up, M. genitalium isn't an issue; you don't need to be tested for it.
There's no need to return to urgent care. And I really don't have any further advice about your symptoms. I agree that anxiety is the best bet. If you can't shake your worries or the symptoms continue, I would advise professional counseling. But I see no need for further evaluation for any STD.
---
12 months ago
|
Thank you for your help, Dr. Handsfield. Between your latest reply, the urgent care physician consult and test results, I feel much better and I'm ready to move on. I feel 100% better physically (symptoms have cleared). I realize that you have to close this thread, but before you do, can you please just take a guess as to what initially happened to me physically to bring me to the forum in the first place. Maybe I could have taken more preventative measures, but as I've mentioned, I always try my best to be careful when it comes to my sexual health. Any additional insight would be helpful. Regardless, thank you. I've been reading your advice for years and it's truly helped me be more aware of being safe and responsible. Enjoy the rest of your summer.
![]() |
H. Hunter Handsfield, MD
12 months ago
|
My best guess is that the penile irritation had nothing to do with your CSW contact, but was some sort of physical irritation or perhaps a superficial yeast infection -- which could be from your regular partner. (Yeasts are normal in the vagina, and can irritate a male partner's penis.) This fits not only with the timing, but with improvement on Lotrimin -- an anti-yeast medication. If it happens again, your partner might consider seeing her gyn for evaluation for possible yeast infection.
As you anticipated, that concludes this thread. Best wishes and stay safe.
---