[Question #1969] STD Concern

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84 months ago

Doctors, I will 1st describe my encounters and then as my question.  I’m a 36yo male and I received oral from a stripper late Dec.2016.  No immediate symptoms, I then had unprotected vaginal sex with my current partner 2 weeks later.  Started getting penis chafing on shaft and irritation on head.  I treated it with some lotion and I think I made it worse because the skin irritation seemed to spread but mostly cleared up once I left it alone.  In late January, I received oral again from the same stripper and immediately experienced symptoms same day/next day.  This time, the irritation caused redness around the entire head, and the meatus was inflamed, like two raised lips.  Some minor internal pain and discomfort followed inside my penis.  No discharge or pain while urinating.  Went to GP and had a full STD panel test done 10 days after the second exposure (1.5 months after 1st exposure).  All came back negative but meatus and glans irritation symptoms persisted.  It would get worse especially after masturbation, and even had a dermatologist take a look, who wasn’t concerned either.  But then urinary symptoms began- frequency and difficulty starting stream and emptying bladder.  I also noticed a decrease in semen and less forceful ejaculation.  I went to a Urologist who didn’t seem concerned about the physical appearance of my penis.  He said the meatus looks normal, but I’m certain it didn’t look this way before my encounters.  Out of caution and assumption of NGU, he prescribed me 2 weeks of Doxycycline which didn’t help, he then prescribed me 4 weeks of Levaquin after noticing that I’m not emptying my bladder very well during ultrasound.  Both drugs are working OK but I’m still not 100% and worry that whatever I may have picked up is now wreaking havoc with my prostate.  I trust this urologist but I wanted to ask STD experts... Should I be concerned about passing STDs to my current partner even though tests are negative?  As stated before, we had unprotected sex after my 1st encounter, and before antibiotics, but I’ve been using condoms ever since experiencing symptoms.

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H. Hunter Handsfield, MD
84 months ago
Welcome to the forum and thanks for your question.

I am confident you do not have, and hever had, any STD from the oral sex exposures you have described. Oral sex is properly viewed as safe sex -- not completely free of risk, but all STDs are far less common than from vaginal or oral sex, and some are no risk at all. Further, there are no STDs likely to cause any of the symptoms described. Regardless of how your penis feels, its normal appearance according to both a dermatologist and urologist is firm evidence that nothing was physically wrong. Nongonococcal urethritis does not cause the urinary symptoms you describe:  its main symptom is discharge, sometimes with mild discomfort on passing urine, with definitely without the alterered urinary stream, bladder emptying, altered semen, etc. That doxycycline didn't help those symptoms is additional evidence against NGU. And there are no other STDs that are known to cause thinkgs like "skin irritation", abnormal ejaculations, or irritation of the head of the penis. If anything physical was going on there, I would ascribe it to nonspecific irritation from your partner's saliva or something like that -- or even from your regular partner's vaginal fluids or, even more likely, perhaps perfumes or deodorants she might use.

And I suspect your urologist didn't really suspect NGU at all, but some version of prostatitis -- since s/he undoubtedly knows that levofloxacin is not the normal treatment for NGU but is routinely used for prostatitis. But even there, I'm pretty confident s/he would agree that chronic pelvic pain syndrome (CPPS) is more likely than true prostatitis -- that is, not an infection of any kind. Antibiotics are often tried, but often don't help -- so don't get your hopes up for the long term. I am inclined to ascribe just about everything you have had to genitally focused anxiety (which might be viewed as the acute version of CPPS).

So all is well in regard to STDs. Your best bet is to continue to work with your urologist about any continuing urinary/genital symptoms. But in the meantime, I would advise resuming unprotected sex with your regular partner. Whatever is going on, I am confident you have nothing that can possibly harm her. And regular (and normal) sexual activity often is just the thing needed for men with symptoms like yours. I suspect your urologist will agree with this.

I hope this has helped. Best wishes and stay safe--  HHH, MD

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84 months ago
Thanks Doctor and I truly appreciate your quick reply and expertise.  I'm sure that the guilt and anxiety are big factors as well. 
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84 months ago
Doctor, you stated "not completely free of risk, but all STDs are far less common than from vaginal or oral sex".  I'm assuming you meant anal, not oral?
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H. Hunter Handsfield, MD
84 months ago
Thanks for the thanks, and for your understanding about the likely role of guilt and anxiety.

Yes, anal not oral. Sorry for the typo!

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