[Question #11760] Syphilis

12 months ago

Hello. My question today is regarding a potential syphilis exposure. I am a 21 year old male living in Indiana , USA. 16 days ago I met up with a female escort from a site. Her description read she does not do condom less sex which was reassuring to me as I am very anxious about std’s. This encounter involved extremely little touching as I made sure to be careful. I did touch her bare breast for 2-3 seconds , and over her panties for 2-3 seconds as well. I placed my own condom that I provided onto myself knowing it had no flaws as she placed lubrication onto her vagina. She then spread her labia apart revealing her whole vagina. In this instance I did not notice anything abnormal whatsoever (lesions, sores, rash). I then had sex with her for about 2 minutes and 30 seconds total. Ensuring I didn’t touch my skin to hers I didn’t go all the way into her vagina. Halfway between the sex I asked to switch positions, she turned around revealing her anus which seemed to be nothing abnormal (we only had vaginal sex, I was just observing). My concern stems from when I pulled out of her vagina I had a build up of lube at the base of my penis. Could me coming in contact with this lube potentially put me at risk for syphilis or any std beings it was in her vagina as well ?

H. Hunter Handsfield, MD

12 months ago

Welcome to the forum. I'm happy to help.

You describe a partner who almost certainly does not have syphilis. In general, escorts -- by which I mean expensive female sex workers who work by appointment -- are at low risk for STDs. They generally use condoms, as does your partner; are aware of the health risks and work hard to protect themselves; and most of their customers are low risk for STD (men like you!). So the chance your partner had syphilis is extremely low, probably under one chance in millions. And from your description, the exposure itself was near zero risk for syphilis and any other STD. The contact with lube (and vaginal fluids) at the base of your penis doesn't make this a risky event.

For those reasons, from the medical and risk perspectives, you don't need testing for syphilis, HIV, or any other STD. That said, of course you are free to be tested anyway, if you remain worried despite absent risk. In that case, have a syphilis blood test about 6 weeks after the event.

I hope this reply is helpful. Let me know if anything isn't clear.

HHH, MD

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11 months ago

You genuinely don’t believe there is anything that could’ve put me at risk here ? I have also been feeling strange ways including numbness in the leg, and a few other things that could potentially be symptomatic. You don’t think hsv 2 could cause this, or syphilis ? I was tested for Hsv 2 a week after my exposure and it came back negative on a igg test.

11 months ago

I have had no lesions or anything. A few days after my encounter I experienced swelling in my groin area. I went to the doctor in which they told me it could possibly be a hernia. I had a ct scan done showing there is no hernia ! Could a std potentially cause swelling in my mons pubis area around my penis ? Is this indicative of any std ? Did I test too early for hsv 2 beings it was only a week after the encounter ? Im still really worried and it’s been a full month since the encounter !

H. Hunter Handsfield, MD

11 months ago

Of course nobody can say the risk of infection was zero -- but it was extremely low. And your symptoms do not even hint at syphilis, herpes, or any other STD. And although I haven't examined you myself, I have to believe your doctor's "possible hernia" was his or her easy way of avoiding discussing your symptoms entirely, or attributing them to anxiety -- which seems by far the best bet to me, especially with the normal CT -- which would have detected not only a hernia but any other important cause of tissue swelling. I have to wonder if the "swelling" is in perception and not reality: the power of an anxious mind to misinterpret trivial symptoms or even normal body sensations and appearance is very large.

Beyond that, I really have no further advice. You can't go through life attributing every little itch or tingle to an essentially risk free sexual exposure. As suggested previously, you probably should be tested for syphilis and HIV, strictly for reassurance; and perhaps also a urine test for gonorrhea and chlamydia. In the meantime, perhaps it will also help you to know that in the 20 years of this and our preceding forum at MedHelp.org, with thousands of questions like yours, not one has turned out to have actually acquired HIV, syphilis or herpes. In other words, our track record in advising users like you is 100%. Given the nature of your sexual event, you're not going to be the one to break our record!

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11 months ago

The swelling is real , and apparent ! I believe I have some kind of injury to my groin area from heavy lifting hence why I had a ct scan. This just coincidentally happened a few days after my encounter with this woman, and I’m just worried. Doc’s said it’s a strain , but that’s exactly why I’m on here to see if this could potentially be a std that would cause swelling in my groin area. As you said this is more than likely not that , but I will proceed with getting tested again next week. I already tested for chlamydia and

Gonorrhea both of which came back negative !

H. Hunter Handsfield, MD

11 months ago

OK, thanks; your alternative explanation for the swelling makes sense. Also, if the cause were an inflamed lymph node (the only STD cause of swelling in the groin), probably it would have been obvious on the CT scan.

What are you going to test for again? The gonorrhea/chlamydia tests are highly reliable, so no need there. And if you had acquired syphilis, you would have had a hard-to-miss chancre (open sore) on your penis. On top of your unusually hyper-careful approach during the sexual exposure. But of course it's up to you.

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful.

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