[Question #1741] follow up, few more questions please

43 months ago
Dr H:

Thank you again for the discussion of how C and G can clear up over time.

One unfortunate additional piece of information: the most recent of these insertive unprotected oral episodes was more recent than 1 year ago'; in fact, it was more like 6 months ago.

Does this change the idea that: in the absence of any G, C or S symptoms or any others, i can feel confident i did not pass anything along to my wife in the past 6 months?

Regarding Syphilis, i read online that the long term effects can be quite damaging.  Again, i never once saw anything on my penis or had any discharge of any kind, at all.  It seems common consensus that G would have produced noticable symptoms.  But now my concern is Syphilis.

Is it possible i contracted this from the episode(s) of receiving unprotected oral sex from a female CSW and had no symptoms at all?

Essentially, what i have read from your forum and the SF clinic (where I was on business when this occurred), is that post exposure from receiving unprotected oral sex from a female CSW,  absence of symptoms within 6 weeks negates medical need for STD testing and one can return to normal sex life with wife as well.

Is that correct?


43 months ago
again, for some reason, i cannot see your answer?
43 months ago
very odd, it seems you have replied to this question, but your reply is not appearing here for me?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
I didn't reply until now. Be a little patient -- the moderators aren't available 24/7.

You have misinterpreted my replies in your previous thread. If you'll re-read my comments before that, you'll understand that your exposure was nearly zero risk. And absence of symptoms within a couple weeks of each exposure was strong evidence you were not infected. Chlamydia can be asymptomatic, but it rarely causes oral infection and therefore is almost never transmitted by oral sex. Therefore, I agree exactly with the information you were given by the SF STD clinic:  with no symptoms within 6 weeks, you could be confident you had nothing to transmit to your wife. The information about spontaneous resolution of gonorrhea and chlamydia doesn't change anything and you should not interpret it that way. 

Best regards--  HHH, MD

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43 months ago
i see, thank you.  Sorry about that, but the system showed there was an update to my question, apparently erroneously.  Apologies!

But this post was mostly about Syphilis.

Is it also your opinion that no risk of Syphilis for me  given my exposure and lack of sypmtoms?  Is Syphilis very very rarely transmitted via receipt of unprotected oral sex, female to male?

I think one of the most disconcerting things about this stuff is all the mis/conflicting information on the internet.  It makes for much confusion, and I think the massive add value of what you and Dr Hook are doing is really quite huge.

And I thank you once again.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
Oops, I neglected your question about syphilis. The chance was also near zero, first because heterosexual syphilis is so rare (by far the majority of cases, especially in the Bay Area, occurring in gay men); and as you seem to know, absence of a penile sore is strong evidence you weren't infected. I forget whether you had a syphilis blood test. If so, and if it was 6 weeks or more after the last exposure, then for sure you weren't infected. If not yet done, you should have a test now for reassurance. It will be negative.

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H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
The initial update was simply that your question had been assigned to me. Often is is several hours later until a reply is posted, although it was sooner in this case. And I was posting the comment immediately above while you were writing your own reply, so they crossed in the mail. (Most discussions on this forum aren't in real time!)

I agree the internet can sometimes hurt more than help. Anyone can post anything, and on any topic with lots of emotion and stress, which certainly includes sex and STDs, there's a lot of intentional or unintentional fear mongering. If you limit your searching to sites run by professional agencies (academic institutions, public health agencies, professionally moderated forums like this one), you usually won't be led astray. But avoid sites run by and for affected persons, where misinformation is especially common. (The famous statistician Nate Silver, of fivethirtyeight.com, wrote a book "The Signal and the Noise" about how people misinterpret statisitcs. In it he writes, approximate quote, "Give an anxious person a dark room, a computer, and an internet connection, and soon he'll be mistaking his cold for the bubonic plague.")


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43 months ago
I do love 538.com.  That is an apt quotation.

To sum: for each Syphilis, Ghonorrea, and Chlamydia, absence of sores, pus, symptoms after 6 weeks given the insertive oral exposures is enough to discount them as me being a carrier.  No need to worry about testing (unless i have to have psychological assurance), no need to worry about having infected my wife (since i waited 2-3 weeks after each exposure looking for sypmtoms before resuming normal relations with her), and no need to test for any of the three at this point (unless i have to have psychological assurance)?


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
An excellent, accurate summary of my opinions and advice.

Once again, that comletes the 2 follow-up comments and replies with each question, and so ends this thread. Let's make it your last one; repetative questions are not welcome on the forum, and my guess is that any additional concerns that arise have been addressed, directly or indirectly.

Best wishes and stay safe!

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