[Question #2277] Risk/Partner Symptoms

46 months ago
I want to first say that I do suffer from an anxiety disorder, and am sufficiently self aware to realize the chance that this colours my current perceptions. 

I have in the past visited sex workers occasionally. A few years ago, my partner discovered this, which lead to a difficult period in our relationship. We stayed together, and I assured her that I would cease this behaviour. However, approximately two months ago I again saw a sex worker, a fairly highly paid escort. I have no justification for this, and am deeply ashamed.

We engaged in unprotected oral and protected vaginal sex. I did not immediately note any symptoms of any STI. Approximately two weeks ago, I began to perceive what I would describe as a "hot" feeling while urinating. I would not describe it as painful. There was no discharge. This also occurred while I was thinking somewhat obsessively about my actions. After I calmed down, I no longer noted symptoms.

I have been generally avoiding sex with my partner since my encounter with the sex worker. We have had unprotected vaginal sex once and unprotected oral sex once. She recently began complaining of rectal pain, which she saw her GP about. Her GP thinks she likely has an internal hemorrhoid. She has also noted some back pain, and I recently noticed in the shower that she has begun using a product for vaginal odor, which she has never used before.

Since she told me about her symptoms, I have become very concerned about the possibility that she is suffering from PID. I have just gone for testing for chlamydia and gonorrhea. I have been perceiving an uncomfortable feeling in my penis since I learned of her symptoms, both while urinating and when thinking about my situation. Again, no discharge.

My questions are: Is there a realistic chance that I have contracted a STI? Should I abstain from sexual activity with my partner pending the test results? Is there any other testing or action you would recommen
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Welcome to the forum. I think I can help.

You really needn't worry. You had a virtually zero risk exposure, with a partner unlikely to have an active STD anyway. Escorts -- i.e. expensive female sex workers by appointment -- are believed to be at low risk:  they know the score, generally choose low risk clients (men like you), do their best to protect themselves, and get tested regularly.

Second, you used a condom for vaginal sex, and oral sex is low risk for all STDs and zero for some.

Third, a "hot" feeling without discharge, and without actual pain on urination, isn't an STD symptom; and from what you say, I'm pretty confident this was strictly emotional in origin. Real urethral inflammation definitely would not stop causing symptoms by not thinking about it. Not to mention its reappearance when you began to worry about your wife's health. All the same applies to an "uncomfortable feeling" int he penis.

Finally the main symptom of PID is abdominal pain, not rectal pain -- and I see no reason to doubt her doctor's diagnosis of hemorrhoids. As for vaginal odor, it's something experienced by all women from time to time. Back pain isn't an STD symptom.

From a strictly medical/risk perspective, you don't need STD testing at all. But I suggest you get tested anyway:  negative testing will reassure you more than my advice based on probability and statistics, and this is going to eat at you until you know you're home free. The only possible STDs that amount to anything in relation to your wife's symptoms are gonorrhea and chlamydia, and a standard urine DNA test result should be available in a couple of days. Your wording implies testing has already been done, but if not, see a doctor or clinic and do it soon. While you're at it, have blood tests for HIV and syphilis. Those also will be negative.

In the meantime, should you continue to avoid sex with your wife? I really don't think it's necessary. But if you hold off, it probably only need be a couple of days.

I hope all this is helpful. Let me know if anything isn't clear.

Really, there is virtually no chance you were infected, so do your best to mellow out. I would be happy to comment further if you'd like to report your test results.

Best wishes--  HHH, MD