[Question #12400] General questions

8 months ago

hello. I know I’ve been to the forum a few times. This one is sort of just general questions. If I gave oral sex to a man the other day, and he ejaculated in my mouth, what are the chances of developing oral chlamydia or gonorreah? I understand these are not as common but I want to know if it’s something I should be worried about. After this interaction I took 200mg of doxycycline because I read that doxycycline as a PEP can reduce the chances of developing this. Do you think this helped lower my chances of developing oral clam/gon? I also read here in your forum that chlamydia can pass through your gastrointestinal tract and then infect genitals if you give oral sex. Have you come across a lot of this situation? I have heard that once you get chlamydia once, it can live in your gut and reinfect you out of the blue. I’m just concerned with this as I had chlamydia once in 2021 and wanted to hear an expert’s knowledge. Would you suggest another 200mg of doxycycline after my activity Tuesday night or do you think that would do more harm than good? And lastly, is it okay to resume sex with my usual partner, or should I get a throat swab?

8 months ago

Also, this is a random one but is cefpodoxime recommended for gonnorea at all anymore?

8 months ago

This sounds silly but the only other time I have taken doxycycline was for a previous chlamydia infection in 2021. It has been gone ever since but I’m worried that by taking doxy again, it may trigger a response and bring back the chlamydia. Is this even possible or does that sound ridiculous?

H. Hunter Handsfield, MD

8 months ago

I'm sorry, but your questions are becoming excessive. Repeated anxiety driven (or OCD driven) questions are not permitted, even if the specific topic differs.

Whether you were at risk for an STD from this event of course depends largely on the likelihood your partner was infected, and of course I have no way of knowing that. But on average, probably under one episode of receptive fellatio in thousands results in oral gonorrhea. Chlamydia is not a problem; it rarely infects the throat. Doxycycline was nearly 100% protective against chlamydia and syphilis, and reduced your risk of gonorrhea by about 50%. Still meaning under one chance in a several thousand that you were infected.

The business about chlamydia colonizing the GI tract and later resulting in genital infection is highly theoretical. Its frequency isn't known, but undoubtedly is very low.

I would not advise another dose of doxycycline. Cefpodoxime is not generally recommended to treat gonorrhea, but often would be effective.

The odds of any infection are sufficiently low that I would say it's safe for you to have sex with your regular partner.

Having had doxycycline in the past cannot possibly "bring back" chlamydia. Where in heaven's name does THAT idea come from?

I'm sorry, but there will be no opportunity for further discussion. And repeated anxiety driven questions are not permitted. This being your sixth such question in two months, it will have to be your last one; future questions reflecting your inflated fears will receive no reply and the posting fee will not be refunded. This policy is based on compassion, not criticism, and is intended to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thanks for your understanding.

I do hope the several discussions have helped you. Best wishes and stay safe.

HHH, MD

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