[Question #1426] Need some advise for my tingling problem

82 months ago
Hi Drs,
You would of heard this story a million times before,I had unprotected oral sex outside of my relationship,it was with someone I know,white female 40s from the Uk.
There was some dry humping as such and my bare penis was against her knickers,she was on her period so no penetration of any kind.
She the gave me oral briefly on a few occasions over a few hours until I ejaculated,it was not in her mouth.
The next night I had brief unprotected sex with my regular partner then protected,the condom didn't split but when I took the condom off I noticed a very red angry looking blotch where I had the friction burn.
The next day it had gone but my penis felt sore,then in the next 2 days the skin pealed on my penis under my foreskin,I used cream which didn't help,the skin healed but then I had this tingling burning feeling,which I still have now,nearly 7 weeks later.
A week or so after sex with my regular partner she came down with thrush,which I thought I had also but the canesten cream and pill did nothing for me but it cleared for my partner.
I've had no discharge,pain while urinating,leasions,rashes other then sometimes under my foreskin looking reddish.
2 weeks after the incident I went to a GUM clinic and got tested for gono/chlamydia/ngu & a hiv quick all negative.
I then had a urine test done at my GPs and which also came back fine.
So now my anxiety that I caught something is freaking me out,I have spoken to the woman who gave me oral & she said that she hasn't been with anyone since March of this year & that she was always careful,i have no reason not to believe her.
Any sexual contact after this incident was all protected with my gf.
So I waited another 4 weeks & went to the Gum clinic again yesterday to get tested again.
So waiting for the results now.
I made a mistake which I feel awful about,sometimes I hardly notice the tingling,burning feeling but it's hard not to think about.
I know HIV is not transmitted through oral sex or it's a very low risk.
Do you have any idea at all what this could be as it's driving me crazy coupled up with the guilt it's a horrible feeling.
I keep reading about genital focused anxiety,is this a real thing that can cause this type of feeling?
Any ideas of what it might be would be great,does this sound like an std if not what do you think?
Thanks again 

Edward W. Hook M.D.
82 months ago

Welcome to our Forum.  I'll try to help.  It is clear from the testing that you've had that you did not get any sort of STI from the encounter you have described.  The "tingling" you describe is precisely the sensation that persons focused on their genitalia and "looking" for symptoms experience as they become aware of normal sensations that they otherwise would not notice.  Genitally focused-anxiety is a reality and my sense is that is precisely what you are experiencing.  there are several ways to address this- these include accepting my reassurance and moving forward, perhaps with the help of a professional counselor or, alternatively, by acknowledging your misstep to your regular partner and working through things with her.  There is certainly no need for further testing or therapy.

I hope this perspective is helpful. This is not an STI.  EWH

81 months ago
Thank you dr Hook,your time is very much appreciated the work you guys do is brilliant helping out people like me without judgement.
I'm guessing with all the info you can get online it's hard what to believe what's fact and what's not.
I will have use the results of my tests for reassurance and move on,though I am slightly nervous about my hsv2 status I don't think I've tested for that in years since my younger days I'm 35 now.
I just found it hard to believe that anxiety can cause these symptoms my GP didn't seem to know a great deal when I asked.
I just wanted to ask a few more questions if that would be ok? 
As I believe the more you learn about something the better, some may seem silly,but better to ask then not.
1. If someone engaged in vaginal intercourse with some who had HIV and the condom was used properly there would be no risk? Only with genital warts/hsv/syphilis (which I believe is rare in the U.K. Amongst heterosexuals?)
2. What are the transmissions rates for stds via oral?
3. Do you see a lot of people with the same issue as me with the penile tingling? Can this also cause frequent urination?

Like most others I always go to the worst case scenario that I had caught something terrible or incurable without thinking about the science behind it all,the Internet though useful can be a dangerous place for wrong information.

Again thank you so much for calming my nerves and the good advise.

Edward W. Hook M.D.
81 months ago

Thanks for your thanks.  Straight oto your follow-up questions:

1.  There are a handful of cases in which persons claim to have acquired HIV after sex with a properly used condoms but whether the condoms were truly used properly or not is difficult to say.  When studied, condoms reduced risk for HIV more than 99.9% and since the estimated risk of infection if exposed to an HIV infected partner without protection is 1 infection per 1000-2000 exposures, it is safe to say that with a properly used condom, if exposed, the risk of HIV acquisition is substantially less than 1 in 1-2 million.

2.  There are few good studies of STI transmission risks from oral sex.  Certainly lower than for genital sex.  Further, oral STIs are less common than genital infections so it is certainly safe to say that STI risk from oral sex is substantially lower than for genital sex but how much is difficult to estimate.

3.  Yes, complaints of penile tingling, as well as urinary frequency are both common complaints in uninfected persons who are worried about STIs following exposures that they have come to regret. 

I hope these further comments are helpful.  EH

81 months ago
Hi DR.Hook I hope you are well.
Thank you for answering my questions.
I thought I'd ask a few more questions as it's not everyday I get to speak to an expert in this field.
I know my encounter was low risk,your reassurance has helped and I'm barely noticing the tingling now so thank you very much.
It's in regards to HIV and the ARS symptoms some people may have and if they do would any of the below apply (I know you can't diagnose by symptoms) just some conflicting info I've read over the years & wanted your take on things as I know some people notice nothing at All,just wanted to know when they did.
1. Do you always have a high fever?
2. How long could this period last?
3. In your experience what can the main symptoms be?
4. Can diarrhoea/vomiting a symptom on its own? 
5. Would/can all the symptoms would come at once?
6. Can anxiety/stress also cause people to think something is sore/tender like lymph nodes under arms/neck?
The reason I ask this,I have read lots of posts on medhelp and there are hundreds of people with anxiety issues with low risk exposures just like mine asking the above sorts of questions.
I know you used to also help people there too.
I would happily refer them to this website as you really have helped me understand the science above the anxiety/stress.
Again thank you for taking the time to answer my questions it is much appreciated.

Edward W. Hook M.D.
81 months ago

Please find the answers to the conflicting information that you have found below.  The conflict you are experiencing is a probable consequence of looking as disease-related symptoms on the internet where the majority of the information provided is presented out of context or just wrong.  Going forward, the best possible advice I can offer you is for you to not seek health related information from internet sites.  Now, on to your questions related to HIV and the ARS.:

1. Do you always have a high fever?
Virtually. there are no absolutes in medicine but the vast majority of persons with the ARS have high fever, typically accompanied by muscle aches, a sore throat and tender lymph node swelling. 

2. How long could this period last?
Less than a week -typically 4-5 days

3. In your experience what can the main symptoms be?
Please see above.

4. Can diarrhoea/vomiting a symptom on its own? 
No, not for the ARS.

5. Would/can all the symptoms would come at once?
Yes they do typically occur together

6. Can anxiety/stress also cause people to think something is sore/tender like lymph nodes under arms/neck?
Swollen lymph nodes are non-specific and virtually everyone has them.  Further, "searching for them" often makes them tender.  Anxiety or stress does not clause swollen nodes but as I mentioned, most people can find swollen lymph nodes if they look hard enough.

I hope my comments are helpful.  Our Forum policy is to allow up to three questions.  This is your third and therefore my final reply.  this thread will be closed later today.  My final advice is once again, for you to move forward without concern.   EWH