[Question #1801] Could I have an STD from this

42 months ago
Good Morning Doctors,

I have been browsing the site and I couldn't find anything that matched up with what my exposure was/symptoms and I was hoping you could shed some light.

On February 13th, I met someone for a massage, where she heated up lotion that looks like it was in a bowl for a while (Probably used the same bowl for multiple people). She then proceeded to rub my back with it, then I flipped over and she started giving me a handjob with it. During the handjob, she took my hand and placed it on her vagina. We mutually masterbaited each other for a couple minutes, then I masterbaited myself with the same hand that I was masterbaiting her with till completion. I then cleaned myself with wet wipes. Since then I haven't had any classic symptoms of herpes/anything else, but I have been noticing things that I thought I should ask. 

1. Could an exposure like this cause any STDS? Especially from touching her vagina and then directly touching my penis.
2. I noticed a bump on my inner thigh lastWednesday, it hasn't changed much, just red and raised like a pimple. Yesterday I went to the gym yesterday and did a heavy workout and today I noticed around the bump there were 6-8  dried blood color spots/bumps around it in a cluster. the almost look like scabs. I do get chafing and thought I felt some, but I dont remember it looking like this. Is this something to be concerned with. 
2. My wife mentioned that my semen looked off-white almost yellowish the other day, and I did have some pain when ejaculating. Noticed it twice, but it had been a while since I had ejaculated. Could that be from anything acquired here? What else could it be?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
Welcome to the forum. Thanks for reviewing similar questions before asking your own. 

My first reponse is to congratulate you for having only safe sex during this event. In reviewing other questions, you may have missed our frequent statements that there is no significant STD/HIV risk from massage or from hand-genital contact, fingering, etc -- even when genital fluids are used for lubrication. While we can't say the risk is zero -- almost nothing is absolute in biology or medicine in general -- in our 35-40 years each in the STD business, neither I nor Dr. Hook recall ever seeing a patient with any STD whose only exposure was like yours. Even with unprotected sex, most STDs are transmitted inefficiently, i.e. most exposures don't result in transmission. With hand-genital exposures, not enough infected fluids or STD bacteria and viruses come into contact with susceptible tissues for infeciton to take hold.

To your specific questions:

1) No measurable risk; see above.

2) No STD is a likely cause of this sort of a firm red bump. However, herpes comes to mind because of the cluster around the original bump, but this is the wrong location for newly acquired genital herpes. Generally the first outbreak is at a site of significant friction during sex, because the virus must be massaged into susceptible tisses for infection to take hold -- and that parobably would imply your penis, not the inner thigh. That said, a cluster of scabs could be herpes, but if the dry scabs were preceded by blister-like bumps or open sores. If it is herpes, almost certainly it is a recurrent outbreak of a longstanding infection, long before the exposure only 2 weeks ago. Although initial genital herpes in men normally appears on the penis, recurrent outbreaks can involve any site in the "boxer shorts" distribution, including upper-inner thighs. Still, if the timing and appearance seems consistent with chafing, that also argues against herpes. More below about next steps.

3) Colored semen with painful ejaculation can indicate seminal vesciculitis, i.e. inflammation/infection of the semen collecting sacs (where semen accumulates between ejaculations). This is almost never an STD, however, and is unrelated to the sexual exposure described above. It also is unrelated to the possibility of genital herpes. If this continues after a couple more ejaculations, I would suggest seeing a urologist.

Aside from possible testing for herpes, I would not recommend any STD testing based on your exposure or symptoms. Assuming the dry scabs are healing, it's too late for a culture or PCR to test for the virus. You could consider a blood test. If positive for HSV2, it would tend to confirm a chronic infection. This is also something you can discuss with a urologist, if you go that route to address the colored semen.

I hope this information has been hellpful. Let me know if anything isn't clear.

HHH, MD

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42 months ago
Thank you for the information.

To add more information, I inspected the area yesterday after working out to try and pop the pimple and didn't notice anything there, then when I checked it this morning is when I found the scabs/marks around it. Would that indicate that it is more consistent with chafing, not herpes? Especially since the bump has not changed since last Wednesday
42 months ago
Also,

I was last tested for Herpes in April of 2014 which was negative for both 1-2, and since then, I have not had unprotected sex with anyone but my wife. The only other exposures I have had, had been ones like the one I posted about, and a few instances of oral sex, 3 at the most. Since the last instance of oral sex, I got a urine test done for chlamydia and Gonorrhea, which came up negative. Hopefully this would disqualify HSV-2
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
Yes, this expanded information seems to support chafing more than herpes. And the additonal history about blood testing and exposures also argues strongly against either a new or recurrent HSV2 infection. All things considered, I'm now 90-95% confident it isn't herpes. But herpes is highly variable and atypical cases are not rare. If you want to nail it down with 100% certainty, have another HSV2 blood test 3-4 months after the massage event. However, I would not recommend holding off that long on sex with your wife. The chance it would be positive is very low.

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42 months ago
Thanks for the follow up.

I've been pretty hyper sensitive about symptoms, to the extent that I was checking the pimple daily and inspection the region daily, so that's why im pretty sure its not herpes, but anxiety got the better of me. Its sometimes hard to think rationally. Im a larger man so chafing is something common. 

Im not going to worry about testing for HSV, unless I have other unexplained symptoms.

As for the semen discoloration and pain, when I looked at it, its looked like it has always looked like to me, off white color with a little hint of yellow, and the pain might have been because I was hypersensitive. It was only a short brief pain that didn't linger, and today it didnt hurt at all. Ill follow what you said below, if problems persist, ill see a urologist.

Thanks   
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
OK. If your semen really isn't any different in appearance, I agree you can let that go. Same for herpes.

Thanks for the thanks about our services. I'm glad to have helped. That completes the two follow-up comments and replies included with each question, and so concludes this thread. Best wishs and stay safe.

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