[Question #11846] Risk of STDs from oral
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12 months ago
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Many thanks Doctors for providing your expertise!
I am a male and 6 days ago I had unprotected oral sex from a
CSW. No vaginal sex. This lasted 15
minutes.
2 days ago, I went to a massage parlor, had unprotected oral
sex which I ejaculated, followed by more unprotected
oral sex which I ejaculated again. There was french kissing, rimming, and the
outside of her vagina grinded vigorously against the shaft of my penis. I also
licked her vagina and put my finger inside her. No vaginal sex. This lasted 1.5
hours.
There are no symptoms so far. Here are my
questions:
- Could
you please list all possible STDs from oral sex, and provide an estimate whether I have contracted any STDs?
- I
have a very mild sore throat for the last 3 days. Is this a symptom of
STD?
- Would
you recommend testing?
- Would you advise me to carry on having sex as normal?
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Edward W. Hook M.D.
12 months ago
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Welcome to our Forum. Thank you for your questions. I'll be glad to provide some comments. Among penetrative sexual activities oral sex is lower risk for acquistion of STIs with cunnilingus being somewhat lower risk than receipt of fellatio (a blow job). It is important to remember that most people, even most commercial sex workers do not have STIs and that most exposures to infected partners do not result in infection. Since you mention French kissing, I'll point out as well that there are a very few reports of persons acquiring oral gonorrhea from French kissing but this is also very rare. In response to your questions:
- Could you please list all possible STDs from oral sex, and provide an estimate whether I have contracted any STDs?
In theory any STI could be transmitted through oral sex although it is rare. Gonorrhea is the STI most often acquired from oral sex. If you do not already have HES_1 (the virus that causes cold sores) there is a slight risk of acquiring genital HSV-1 from receipt of oral sex. HSV-2 is almost never acquired or transmitted through oral sex. The risk of HIV from oral sex is estimated to be less than 1 infection in 10,000 exposures to an untreated, infected person making it extraordinarily rare. Syphilis is rarely transmitted by oral sex, most often among men with other men. The risk of trichomonas and chlamydia is much lower than the already low risk of gonorrhea.
2. I have a very mild sore throat for the last 3 days. Is this a symptom of STD?
Most oral STIs are asymtomatic.
3.Would you recommend testing?
Testing is a personal choice . your risk of getting an STI from the exposures you describe is very low. Many of our clients find that having a negative test is comforting if they are anxious.
4. Would you advise me to carry on having sex as normal?
I would not be particularly worried if the only exposures you have had are the ones you have mentioned.
I hope that this information is helpful. EWH
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12 months ago
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Many thanks Dr. Hook for your response. I just have some follow up questions.
- I never have herpes (HSV-1 and HSV-2). I did not notice any blisters / bumps / pimples, whether during their mouths or genital areas, from both girls during these two encounters. I did not notice any rash from them, and no vaginal discharge. Does this mean the risk that they have anything is lower?
- The girl at the massage parlor said that all of the working girls there get tested every 3 months, and they also would refuse to serve anyone who appear to have contracted an STDs. Assuming what she said is true, would this further reduce the risk that she would have anything and also the risk that I would have anything?
- What is the STD risks from rubbing the outside of the vagina against the shaft of my penis?
- If I continue to show no symptoms, does this mean that I am very unlikely to have contracted anything - would you say less than 0.1% (or any other %)? And how long should I keep looking out for symptoms, i.e. incubation period?
- I can get tested for Chlamydia and Gonorrhea (urine sample), and Syphilis and HIV (blood sample). I read somewhere that NGU can be contracted from oral sex. Does the urine sample for Gonorrhea include testing for NGU?
- You are probably going to advise me against taking doxycycline. Would doxycycline alone treat Chlamydia, Gonorrhea and Syphilis? If I would take doxycycline 100mg from next week, what is the doses that I should take (1x 100mg per day for 3 / 5 / 7 days)?
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Edward W. Hook M.D.
12 months ago
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Your questions are extensive and difficult to answer in a general way. I will provide general answers. For more information you might wish to look at the web site of the US CDC. I cannot provide a textbook for you through this site. Brief responses:
1. 60% of adults have HSV-1, whether or not they know it. If is often acquired in childhood.
HSV is transmitted through direct contact. The absence of lesions certainly lowers your risk.
2. Yes
3. Very low- mainly lesion infections such as syphilis or herpes but again, the risk is low
4. A urine test for gonorrhea and chlamydia would provide conclusive results any time more than 3-5 days after an encounter. Conclusive results for syphilis and HIV take 6 weeks. Urine testing for gonorrhea would not diagnose NGU. IF SYMPTOMS ARE PRESENT a urinalysis can help diagnose NGU.
5. NGU from oral sex can occur. It is diagnosed based on symptoms supplemented by a test for white blood cells in the urine or at the penis. If you do not have symptoms I would not worry about NGU
6. I advise you against doxycycline- you do not need it
You have 1 follow-up remaining, then the thread will be closed. Please make any followup questions brief. EWH
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12 months ago
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Thanks Dr. Hook.
I just wanted some clarifications with regards to symptoms and testing.
1. Symptoms
I heard some STDs may not have any symptoms (perhaps 30% of Chlamydia cases) and some others will always show symptoms (maybe Syphilis, Gonorrhea). I could be wrong here so could you please educate me which STDs may not show any symptoms? And how common for STDs to cause no symptoms at all, statistically?
Without the need for testing, if I continue to have no symptoms over the next few weeks, would you say that the chance I have caught any STDs become even more extremely unlikely (as the activities are low risk and symptoms are absence)?
Overall how long does it take for symptoms to show up to be conclusive?
2. Testing
I understand you agree that testing can help to ease my nervousness. From a medical point of view, would you recommend testing for these low risk activities?
Based on what I described, which tests should I go for?
I read somewhere on this forum that only Chlamydia and Gonorrhea maybe useful here, as Syphilis is extremely rare from the activities that I did, and there is no documented HIV case from unprotected oral sex makes the risk virtually zero? Again I could be wrong here so please correct me as I just want to understand this scientifically.
Many thanks for your help!
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Edward W. Hook M.D.
12 months ago
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This is another overly broad question. I will provide brief responses, then the thread will be closed. Please do not return with these broad, non-specific questions. They are not the purpose of this forum
1. Any STI can be asymptomatic of have symptoms so mild that they are missed. If you are concerned about STIs, testing is the surest way to be sure that you are not infected. If symptoms are evaluated with a test and the test in negative, then the STI tested for is almost certainly not the cause of the symptoms. Unless you have had a particularly risky encounter, the absence of symptoms is always a good sign.
2. I have already pointed out that in nervous persons, testing can help to resolve anxieties. If you test and are negative you do not need to test further.
When we recommend testing we typically recommend testing for gonorrhea and chlamydia because they are the most common STIs. These tests are conclusive any time more than 3-5 days after an exposure. Testing for syphilis is often included as screening for STIs and is conclusive 6 weeks after an encounter. There is no need for testing for HIV if your only penetrative sexual encounter is receipt of oral sex.
This concludes this thread which will now be closed. If you have further question, they should provide more specific details about any exposure or activities of concern in order to provide you with a better, more focused response. EWH
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