[Question #1660] insertive oral, multiple episodes, more than 3 months ago

45 months ago
hey doctors:

this question relates to having had multiple episodes of unprotected insertive oral sex with females of unknown STD health, some CSWs, starting more than three months ago.

since i have had zero symptoms of ghonorrea, or anything for that matter, i have not tested for any of this.

my understanding is that there would be symptoms within 2 weeks post exposure and if symptoms did not appear,  i could safely continue unprotected sex with my wife.

is my analysis correct?

should i be doing anything differently?

if no symptoms, can i assume i do not have ghonorrea? or anything else for that matter?

i have had herpes years and years ago, so know that exists in my system already.

thank you
45 months ago
i cannot see the reply?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
I was doing a couple of edits and my reply was temporarily down. Here it is.

Welcome back to the forum. But I'm a bit puzzled about why you felt a need to return. Essentially the same questions were answered by both me and Dr. Hook in reponse to 3 previous questions the past 7 months.

Your understanding and analysis as stated above are correct. You could re-read the other replies if you have any more uncertainties about it. The only slight nuance has to do with testing. Each individual exposure was low risk, and absence of symptoms is good evidence against gonorrhea; and chlamydia is very low risk (if any at all) from insertive oral sex. Therefore, no testing is required. On the other hand, we always recommend periodic testing for people with relatively high risk sexual lifestyles. Given your multiple extramarital exposures, you might wish to consider getting tested once a year for gonorrhea, chlamydia, syphilis and HIV, even though each individual exposure was very low risk for all. If you do so, you can expect negative results.

Best regards--  HHH, MD

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45 months ago
thank you.

i have done a few HIV oraquick tests, all negative.  not surprisingly.

but i have not done ghonorrea,

i had assumed if no symptoms, no reason to test for it.

perhaps my guilt is getting a hold of me? 

is there a medical need to test for ghonorrea at this point?

thank you, sir.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
No strict medical need and if somehow I were in your situation, I wouldn't do it.

Please note that repetative questions are discouraged. You haven't learned anything with this thread not covered in your previous ones. Let's limit future questions to different types of exposure and/or other STDs not discussed in four threads. OK?

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45 months ago
ok, i hear you.  my only confusion stems from the CDC site/page regarding ghonorrea, and it cites a study by you which indicates it can commonly be asymptomatic in men.

Handsfield HH, Lipman TO, Harnisch JP, Tronca E, Holmes KK. Asymptomatic gonorrhea in men. N Engl J Med, 290(3), 117–123 (1974).

have theses changed since this study?  just concerned, that's all.

thank you!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
The results of that 40 year old research study remain valid. But that study said absolutely nothing about how frequently people develop symptoms when they catch urethral gonorrhea. Because of lack of symptoms, asymptomatic cases accumulate in the population, so at any point in time, many men with gonorrhea are symptomless. However, it is also true that 95+% of men with new urethral gonorrhea develop obvious symptoms. In other words, lack of symptoms remains strong evidence against urethral gonorrrhea. In any case, this doesn't change my advice above, in which I recommended that you have occasional testing for common STDs, even though all your individual exposures were apparently safe.

Please note that the forum does not permit repeated questions. This will have to be your last one; future new questions on this topic will be deleted without reply and without refund of your posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers; because experience shows that continued answers tends to simply prolong such anxieties, when the real answer normally should be professional counseling; and because such questions have little educational value for other users, one of the forum's main purposes. I trust you will understand.

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