[Question #12059] general STI questions

10 months ago

hello doctor! i just had a few random questions. so first, Im a female and had protected sex with a guy, and i got tested for chlamydia and gonorrhea 10 days after sex just to make sure. How come many websites and doctors say to wait 14 days or longer to test for chlamydia and gonorrhea? It’s convincing me I’ve tested too early even though i have read on here that 4-5 days after exposure is conclusive for those two STIs. Would my test be conclusive 10 days after sex? it was negative and we used a condom, but I’m nervous what if 10 days may have been too soon? Let me know what you think about this. Also, about half the time i get a urinalysis, they always mention that my white blood cell/lymphocyte count is elevated. I get UTIs sometimes but even when my urine culture is negative for UTIs and I test negative for STIs, the lymphocyte count is high. Do you think this indicates any STI that is somehow not detected or is that normal sometimes to have a high white blood cell count? I have gotten tested for all other STDs at my physical recently and I was negative for everything. I just wanted to know if it was common to have high white blood cells in urine with no infection sometimes.

Edward W. Hook M.D.

10 months ago

Welcome to the Forum. Thanks for your questions. I'll do my best to help, working through your questions.

Regarding your encounter- most people do not have STIs, most single exposures with an infected partner do not result in infection and condoms are highly effective for prevention of STIs. This was a very low risk encounter.

On line statements that tests for STI are not accurate until 10-14 days after an exposure as incorrect and reflect internet-based misinformation. Tests for gonorrhea and chlamydia provide accurate results any time more than 3-5 days following an exposure. Have confidence in your test results.

Regarding your lab results, you seem to be talking about 2 different types of tests. Urine tests showing the presence of moderate to large amounts of white blood cells (WBC) may be indicative of a urinary tract infection (UTI) and warrant further investigation. On the other hand, blood tests are typically non-specific at best and unless markedly abnormal are probably not something to worry about.

Bottom line, given your recent negative tests, I would not be worried.

If I've missed something or there is more information, please feel free to use your follow-ups for clarification. EWH

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10 months ago

Thanks for the response! I meant to say leukocytes in urine, not lymphocytes sorry about the misspell. I read that some leukocytes may be normal at times but I feel like half the time I get a urinalysis it shows some trace of leukocytes. My culture comes back showing no UTI most times so would you say the trace of white blood cells is a normal thing in urine from time to time? About the testing results timing, so online info about that is just outdated? I went to urgent care to get my test and the nurse said I should wait 3 weeks after sex to get a conclusive test, but I feel like that isn’t really accurate after hearing your thoughts. I wonder why she would say that. So, to reiterate, Would you say after 10 days after sex, my results were 100% conclusive? I just wanted to make sure that I don’t have to get another test in 4 days, at the 14 day mark or in another week or anything. Since it was negative after 10 days I don’t have to get another test for that time of protected sex? I have anxiety about this so i probably sound redundant and I know the thread prohibits that but I just wanted to be clear.

Edward W. Hook M.D.

10 months ago

Trace WBCs from time to time is certainly a normal finding. If you have ruled out UTIs and STIs (gonorrhea, chlamydia and possibly trich) and the finding is intermittent, I would not feel the need to pursue it further.

The online info is relevant for someone who has not been tested but you are beyond that.

Your results are conclusive. In fact, I would worry that waiting for 3+ weeks to test might set you up for complications or transmission to someone else.

I hope this information is helpful. EWH

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10 months ago

thank you for your response:)

So you mean that the online info is relevant for someone who has never tested ? Do you mean never been tested and had an exposure or something? Im not sure what you mean by that i just wanted to clarify. also, So, waiting 3 weeks like the nurse originally said is too long? As long as you think my test is conclusive, i don’t need to get another test in a week right? and you say 10 days is enough time because it would have definitely detected the bacteria if i had chlamydia or gonorhea after that time? I wish i had the knowledge that you do so that I can stop being so paranoid. Am i good to continue unprotected sex with my usual partner knowing that i am 100% negative?

10 months ago

Sometimes i feel like I actually manifest STD symptoms after sex because I am so paranoid. But this testing 10 days post sex should give me a peace of mind?

Edward W. Hook M.D.

10 months ago

I think you are worrying more than you need to be. This follow-up is a bit repetitive. One final time:

1. Test results are accurate and conclusive any time more than 10 days and actually, most probably any time more than 5 days after an encounter.

2. Waiting for 3 weeks to test is too long.

3. The presence of moderate to large (not trace of small) WBCs in urine MAY be a sign of a UTI or STI and warrants further testing, whether symptomatic or not. In your case, you were tested and found to be negative- accept the results. There is no need for additional testing.

4. You are good to continue to have unprotected sex with your regular partner

FYI, on occasion, when persons become concerned about a possible STI they tend to have heightened awareness which results in them noticing normal sensations which would otherwise be overlooked.

We provide up to 3 responses to each client's questions. Therefore this thread will be closed shortly without further responses. Please don't worry. It's time to move forward without concern. EWH

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