For clarification, I am late 30s female. End of sept I performed unprotected oral sex on a male co- worker. The oral sex was short, not deep and no ejaculation occurred. About 5 weeks later, I started dating a new man. Terrified of chlamydia from the oral event 5 weeks earlier- I took 500mg of azithromycin x 3 days. I waited 3 weeks and then we had unprotected oral sex.  

My questions are as follows- 

1. What is the realistic chance of acquiring chlamydia from giving oral sex?

2. If I had acquired it- would the 3 days of azithromycin taken care of it?

3. By 8 weeks since possible exposure could I have transmitted chlamydia to my new partner via oral sex? 

I have read through the forums and am just confused. I have seen where Dr. hhh says chlamydia is no risk, but I have also seen replies where it is small risk. 

I would just like to know my risk post 500mg azithromycin x3 days if no ejaculation occurred 

There has been a lot of attention online in the last year or two to oral sex and chlamydia. Much of it is overblown and seriously inaccurate. In fact, chlamydia doesn't take well to the oral cavity:  the large majority of those exposed by performing oral sex do not get infected. And when a throat test is positive, roughly half the time it's only chlamydial genetic material (RNA) detected; live chlamydia is absent. And most of these become negative in only a few weeks. Oral chlamydia therefore is rarely transmitted to new oral sex partners -- that is, there is very low (maybe nearly zero) chance of transmitting oral chlamydia to someone's genital tract. Finally, oral chlamydia has never been known to cause symptoms. (Your summary statement -- that you have seen me say it's no risk and other statements of "small risk" -- is exactly right. Perhaps "little or no risk" captures it.)

1. "What is the realistic chance...?" Probably under one chance in hundreds or thousands, even if your co-worker had urethral chlamydia. And since at any point in time urethral chlamydia probably is present maybe one person in a thousand, the chance you acquired oral chlamydia is zero for all practical purposes.

2. If you had it, there's around an 80-90% likelihood the azithromycin would have cleared it up.

All things considered, you can put this event in the rear view mirror. You were at little if any risk of oral chlamydia (the risk was a lot higher for other STDs, like gonorrhea -- but even this would have been under one chance in thousands). I really wouldn't worry about it at all.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

So you are confident that by 8 weeks even if I had oral chlamydia it would have been gone by then? That is very reassuring. 

That completes the two follow-up exchanges included with each question, but it will stay open for a day for one final comment or concern if you have one.

When I said oral partner I meant… oral exposure- meaning if he had genital gonorrhea he would have had symptoms. He reported no symptoms at time of encounter. 

I appreciate you explaining all of the symptoms and asymptomatic natures. I’m going to go with I was most likely not exposed or it would have been gone by the time I was with my new boyfriend.