[Question #13457] More Education Before Therapy
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5 hours ago
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Hello, Drs.
My OCD had gotten so bad that I moved home and lost my job. I since have started therapy a month and a half ago and feeling really good! It’s hard, but rewarding.
We are going forward with a harder part of OCD therapy at the end of O tober called ERP. Basically, my therapist will no longer give me reassurance on OCD thoughts. I am suppose to just tackle it and learn to not respond.
She told me to tackle any fears this month and prep because it will be hard. So I’m here to ask questions for my knowledge so I can hopefully move forward and back into the dating scene and my normal life.
1 After my last exposure, I got tested 12 days after for Gonorrhea and Chlamydia. Negative. 45 days, blood drawn for Syphilis and HIV (4th gen.) are these conclusive?
2. How soon do STI’s show signs? If I go on a date and hook up, see a dot or something on my penis, should I freak out or is that impossible?
3. Syphilis kills me, im scared to shake hands or run food. Can syphilis appear on the hand, and can it transmit from this if I work in the restaurant industry?
Thanks doctors!
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5 hours ago
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4. Besides condoms, do you have any other suggestions or advice for OCD people like me that can educate me?
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Edward W. Hook M.D.
2 hours ago
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Welcome back to the Forum. Thanks for your questions and congratulation on seeking care for your OCD. Working with a professional is the right thing to do. Please tell your therapist that you reached out with these questions which have been answered, at least partly in the past on the Forum. Coming here is a work around of the recommendations your therapist made. I suspect he/she will confirm this. This is response to your questions:
1 After my last exposure, I got tested 12 days after for Gonorrhea and Chlamydia. Negative. 45 days, blood drawn for Syphilis and HIV (4th gen.) are these conclusive?
These results are conclusive and there is no need for further testing.
2. How soon do STI’s show signs? If I go on a date and hook up, see a dot or something on my penis, should I freak out or is that impossible?
This is variable, depending on the STI, and some STIs cause no symptoms at all. When symptoms occur, they never start within 36-48 hours of an encounter. For the most common STIs (gonorrhea and chlamydia) symptoms begin between 3 days and a week or so after contact.
3. Syphilis kills me, im scared to shake hands or run food. Can syphilis appear on the hand, and can it transmit from this if I work in the restaurant industry?
Syphilis is acquired through DIRECT sexual contact, NOT by shaking hands, running food, or the activities which are typical of working in the food industry.
4. Condoms for initial and casual encounters is always a good idea. Asking partners about whether they have STIs or have been tested and when that testing was performed is often reassuring as well. EWH
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2 hours ago
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Thank you doctor!
Yes, my therapist does know I was going to ask these questions this month. This actually part of the ERP. I still read this site every day and she wants me to go six months without coming back after this thread.
I want to challenge my OCD and not use all three replies. So I’m going to ask one more set of questions and try not to return.
1. Unless there is penis inserted vaginally, orally, or anally, you can not transfer STI’s?
2. Does every bump or blemish on the penis mean an STI, or are there normal things that happen?
3. I see often you guys say “most people do not have STI’s.” Is there a decrease in STI’s in the population?
4. Does a woman’s ejaculation cause STI’s? If I’m fingering a girl and she “squirts” on my hand and then I rub my penis head transfer anything?
5. I watched a YouTube video that syphilis is on the rise from a urologist. Is this true even for heterosexuals?
6. Do I need to test after after oral experince?
I want to end this and say thank you Dr.s. I really want to work on myself and I am going to try mt best to get out there to date and regain control of my mind. I know people like me are annoying, but it really does help!
All the thanks and appreciation I could never show - Uneducated Man
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Edward W. Hook M.D.
1 hours ago
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Thanks for your clarification on your return to the Forum. I want to support you and your therapist- seeking help is a great thing to do and I applaud it.
Your follow-up questions are complex and pags and pages could be written about each topic. That is not something I am going to do or that the forum is designed for. Please find brief, general replies to your follow-ups below. I do not plan on providing further detail to "what if" questions.:
---1. Unless there is penis inserted vaginally, orally, or anally, you can not transfer STI’s?
This is true for the most common STIs such as gonorrhea and chlamydia. For the so-called "lesion" STIs such as syphilis and herpes, contact with an active infectious lesion on the external genitalia without penetration can theoretically transmit these infections but it is uncommon.
2. Does every bump or blemish on the penis mean an STI, or are there normal things that happen?
Absolutely not. In fact, Dr, Handsfield has written an entire book on genital dermatology in which only about 10% of the lesions described are STIs. Further, it is clear than when persons are worried about STIs and exhaustively look for "lesions" they are likely to detect normal variations in skin which have merely been overlooked in the past
3. I see often you guys say “most people do not have STI’s.” Is there a decrease in STI’s in the population?
There are no STIs other than HPV which are present in more than 1% of all sexually active persons. In addition, here in the US, for the past two years, reported STIS (gonorrhea, chlamydia and syphilis) have declined in prevalence. The exception, HPV, which as you know from reading on the Forum is of little consequence for nearly all who are infected.
4. Does a woman’s ejaculation cause STI’s? If I’m fingering a girl and she “squirts” on my hand and then I rub my penis head transfer anything?
No. A woman's "squirt" is merely genital secretions and contact does not put a person at increased risk for infection
5. I watched a YouTube video that syphilis is on the rise from a urologist. Is this true even for heterosexuals?
Actually, while syphilis rates have risen over much of the past 15 years, for the past two years syphilis rates have declined. While most of the increase in syphilis occurred among men with other men as sex partners rates also increased somewhat in heterosexual men and women as well.
6. Do I need to test after after oral experince?
Probably not. The most common STI acquired following receipt of oral is gonorrhea which is not all that common and when present is symptomatic in about 90% of infected persons.
I hope that this information is helpful. EWH