[Question #11868] Unprotected oral
11 months ago
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Hello
Exactly 1 week ago I received oral sex twice from 2 different CSW a few hours apart. Less than 45 hours later, I was given 7 days of Doxycycline as well as cefixime and metronidazole. I am set to finish the last doxycycline tomorrow night. Last week I started to feel a tingle at the tip of my penis. I do not always feel it. My testicles seem to be a little sensitive too. I have not seen any markings or had any discharge.
Does this seem to warrant testing?
Is it anxiety driven?
What are my actual risks here of having something?
Thank you
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H. Hunter Handsfield, MD
11 months ago
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Welcome to the forum. Thank you for your question and for your confidence in our services.
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I'm afraid you (and the doctor or clinic you saw) over reacted. You were treated excessively -- indeed should not have been treated at all. Post exposure antibiotics are only advised in far higher risk situations than you describe -- primarily for men who have unprotected anal sex with other men at especially high risk. Current internet buzz about oral sex and STD risk is way out of proportion to reality. These were very low risk exposures that did not warrant the antibiotics you received. Doxycycline: primarily to prevent chlamydia, which is little or no risk from oral sex; and metronidazole prevents or treats only trichomonas, which does not infect the mouth or throat and therefore is never transmitted by oral sex. The main STD of any importance from oral sex is gonorrhea, but even this is rare -- but at least it sort of justified the cefixime (which also would have prevented syphilis if you were exposed).
Those comments address your last question: even before the antibiotic treatment, the risk of any STD was near zero. As for your current symptoms, the "tingle" and "sensitive" testicles indeed are likely "anxiety driven" (your words -- and whenever someone suggest their own symptoms have an emotional or psychological origin, usually they are right!). Infection symptoms do not come and go; and no STD cause such symptoms either.
I see no point in testing for anything -- indeed I would have advised no testing even if you hadn't received the antibiotics.
Sorry if this sounds like a lecture -- maybe it is -- but I hope you'll learn from it! Let me know if anything isn't clear.
HHH, MD
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