[Question #11729] Unprotected Oral Sex
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12 months ago
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On 7/8 I had unprotected oral sex with a guy online both giving and receiving.I asked if he was clean he said yes. I sucked his penis for a few minutes and tasted a bit of Precum but no cum. He then sucked my penis until I cummed in his mouth.When I got home I washed my penis with soap.The next day I had a burning sensation in the tip of my penis no sores or discharge. That continued with frequent urination. On 7/12 I went to the ER. They took urine sample and treated me with Rocephin and doxycycline for 7 days for gonorrhea, chlamydia, and Trichomonas. All tests are negative. I started having diarrhea. Throughout the next week the burning somewhat got better it would come and go. On 7/23 I started having testicular pain aching pain in my calves.I feel like my muscles are disintegrating. My right calf feels smaller than before.Now 8/2 and I’m trying to wait till 8/19 to get a full panel std test. My anxiety is through the roof. I went down the google rabbit hole and now I think it could be HIV or HSV. My only symptoms are a burn in the urethra here and there cloudy urine diarrhea testicular pain here and there and pain in my calves/legs.
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12 months ago
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1)Are these symptoms of an STD
2) Could I have passed whatever it is I’m having to my partner through oral sex after a week.
3)Do you recommend waiting the 6 weeks to get tested?
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H. Hunter Handsfield, MD
12 months ago
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Welcome to the forum. I'm happy to help.
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This was a low risk encounter. Oral sex isn't entirely risk free, of course, but it's far lower risk for all STDs (and HIV) than vaginal or anal sex. I see no need for any further testing, especially in view of the treatments you received. The ceftriaxone (Rocephin) and doxycycline eliminated any possibility of gonorrhea, chlamydia or syphilis. (It was ineffective for trichomonas, but trich doesn't infect the mouth or throat and is not acquired or transmitted by oral sex.) Presumably the urine sample in the ER was to test for gonorrhea and chlamydia. I assume that was negative.
I agree your online searching took you down a rabbit hole. Like many anxious persons, your online searching is leading you to "see" those things that enhance your fears and miss the reassuring information that also is available. (The now famous statistician Nate Silver (of fivethirtyeight.com) wrote a book about statistics, "The Signal and the Noise". In it is this approximate quote: "Give an anxious person a computer with an internet connection in a dark room, and soon he'll believe his cold is the bubonic plague." Sounds familiar, right?)To your specific questions:
1) No, your symptoms are not typical for any STD. The initial burning and penile pain was too soon -- no infection can cause symptoms in less than 24 hr. My guess is you worked some soap into your urethra, which is quite irritating and a good bet for the burning sensation. The on and off discomfort later, testicular pain, etc do not fit with any STD but are typical for genitally focused anxiety. Neither HIV nor HSV causes any of the symptoms you describe. Cloudy urine is the effect of diet and fluid intake, and testcular discomfort and frequent urination are two of the most common symptoms of genitally focused anxiety.
2) I am confident you have nothing you could have transmitted to anyone. I would advise you to continue sex with your regular partner.
3) From a medical/risk standpoint, there is no need for any further testing at all. That said, reassurance itself is often a good reason for testing. If you will sleep better having the evidence of negative test results in addition to my professional assessment, feel free. However, there is no point in further testing for gonorrhea, chlamydia or syphilis, which are impossible after the antibiotics you had. So the only other test to consider is an HIV blood test, and 6 weeks would be the right time for a standard antigen-antibody (AgAb, "4th generation") test. For sure do not have a "comprehensive" test panel, which would include a number of things for which you definitely were not at risk, and some such tests are simply too unreliable with higher chance of false or misleading results than of detecting any infection that matters.
Do your best to move on without further worry. If your symptoms continue, see a physician -- but I guarantee no STD is the problem. Perhaps professional counseling would be advised given your anxiety level.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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12 months ago
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Thank you for the response. As for the aching muscles and diarrhea could that be because of anxiety as well. I also lost some weight because of the diarrhea and loss of appetite. This was my first time ever doing anything with another person besides my girlfriend and the guilt I feel is so immense that I was worried I contracted something and would pass it on and end what I’ve worked so hard to build.
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12 months ago
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Sorry I also forgot to mention I had yellow sperm after the week of antibiotics is that normal? Or could that be an infection of some sort?
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H. Hunter Handsfield, MD
12 months ago
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Muscle aching fits well with anxiety. So many things influence bowel frequency that it's harder to judge, but no STD is a possible explanation. Slightly off color semen also isn't caused by any STD -- certainly none that could result from oral sex. If your semen returns to normal color after the next couple of ejaculations, I wouldn't be worried.
Do your best to separate your feelings of guilt or shame over a regretted sexual decision from infection risk from the event. They aren't the same!
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12 months ago
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Hello Dr.
I ended up taking the STD panel test which was 30 days/4 weeks after the initial exposure. I was super worried and I just wanted to know if I had an std. I got the results today and everything came back negative. But I am still having testicular pain leading up to my pelvic area and diarrhea. As well as cloudy/ strong smelling urine. My questions are
1) Should I be good and not worry about testing again since everything came back negative even though it was only 4 week test.
2)Is it possible that this could be a uti?
3) Should I move on and start looking for another cause to these symptoms and not worry about passing them on to my girlfriend?
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H. Hunter Handsfield, MD
12 months ago
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We advise against such "comprehensive" panels because some of the tests are often misleading or for infections so unlikely that it's a waste of money and time. So I'm especially glad your panel was entirely negative.
Testicular and pelvic area pain suggest genitally focused anxiety -- which is similar to the chronic pelvic pain syndrome (CPPS). Google it for more information; the wikipedia article is good and also see information available from the Stanford University Dept of Urology. I'll bet you'll see parallels with your discomfort. Diarrhea also could be anxiety related. Strong smelling urine isn't a health indicator of any kind; it's entirely due to diet and fluid intake.
1) There is no need for any further STD testing.
2) UTIs are rare in healthy males and your symptoms don't fit with UTI.
3) See my comments above about CPPS. You have nothing you can transmit to a sex partner.
That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful.
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