[Question #2769] Possible STD?

41 months ago
Approximately 2-3 weeks after a sexual encounter, I experienced an intense tingling near the tip of my penis that lasted for 2 weeks.  The sexual encounter involved brief unprotected oral and vaginal before we “wised up” and used a condom.  No discharge, no burning, no lesions, and I was looking pretty intensely.  It was unusual because I was fine one minute but then immediately after masturbating (really at the moment of climax), I felt the intense tingling.  It was on the top left of my glans, not near the urethra, and in a spot that wouldn’t require any effort to see if there were lesions.    Also, I don’t think this was anxiety induced tingling.  It was obvious, localized, pretty intense, and if I rubbed the spot I could feel it even more intensely.  I figured I hurt myself from being too rough while masturbating and didn’t think too much about it.  But again, there was no chaffing that I could see.

Months later, about 5 days after a 2nd, different encounter involving protected vaginal, unprotected oral, a small red spot near the base of my penis, on the shaft, appeared.  It was tiny, didn’t hurt, and disappeared after a couple of days.  Both a Dermatologist and another clinician who examined the spot the same day I noticed it said it was not an STD, specifically Herpes.

Then, 2 - 3 weeks after the 2nd encounter (spot near base), a slight itching/tingling around the same area as the original intense tingling (near the tip) mentioned in the first paragraph.  This time the tingling only lasted 2 days, was off and on,  and again no lesions.

Does this sound like Herpes or another STI?  From what I’ve read and have been told, the tingling would be accompanied by overt lesions for herpes.  I looked hard in both cases and saw nothing.  Also, it seems the red spot I did have cleared up too quickly to be Herpes and it was not near the location as the tingling.  Could this be something else?  I’m a little older, could an intense tingling be caused by prostatitis?  I'm seeing
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
Welcome to our Forum.  I will be glad to comment.  The tingling sensation you describe, occurring on one side of the glans penis which has now occurred several times following both unprotected and condom protected sex does not sound like herpes or any other STI or STI complication.  The fact that it occurred several weeks after a sexual encounter, a bit outside the typical  incubation periods for most STIs, suggests to me that it may not be an STI at all but some other problem within the penis.  You seem to have not completed your final sentence but you may be already seeing a urologist which is what I would suggest in this instance, wondering if there is something going on in the glans itself. 

For informational purposes, let me comment on the things that do not make me think this might be herpes.  In addition that you have not had an outbreak in the area where you experience this discomfort, your first episode occurring 2-3 weeks after your last exposure, is at the outer limits of when initial HSV outbreaks occur following acquisition of infection (the norm is 7-10 and nearly always within 14 days of exposure) makes this unlikely to be herpes. Similarly the absence of lesions does as well.  Further the "on and off" nature of the discomfort is more compatible with a vascular or neurological cause of these problems than HSV.  I should mention to you that, should you choose to test for HSV and have not had blood tests for HSV in the past, a positive test may not mean that the discomfort you have had is herpes.  Rather it could be a "true-true-unrelated" occurrence in which you might have gotten HSV in the past and, like the majority of persons with herpes, was unaware of your infection until you tested.  I am not sure I  would recommend testing for HSV at this time.

Finally, I should comment on the small red spot you mention at the base of your penis which went away in just a few days. While I did not examine you for this, two other clinicians have an felt it was not HSV.  It may have been folliculitis or some other self-limited benign process but again, this does not sound like HSV and I suspect it is unrelated to that abnormal sensations you are experiencing in your glans. 

I hope these comments are helpful to you.  Feel free to comment and follow-up with additional questions if parts of this are unclear.  Up to two follow-ups are permitted.  EWH
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41 months ago
Thank you for the prompt reply Doctor!  A quick follow-up.  If I am off on the original timeline of 2-3 weeks, would it significantly change your answer?  It was several months ago and I wasn't 100% on the time between my encounter and the tingling.  It could have been less than two weeks.  Again, I was fine right up to the point of climax while masturbating (I was rubbing that area and feel like I would have felt it before) , climaxed then immediately felt the tingling.   No lesions ever, no burning while urinating before or after I masturbated, and never any discharge or other discomfort aside from the tingling.  When it happened, it seemed so tied to me climaxing that I didn't even think STD until several days later when the tingling subsided a little (but was still present) and of course the googling began...  And you are correct, while fine now I plan to see a urologist to discuss the sensation.  I could convince myself it seemed a little swollen on that side when it happened.  Thank you again!
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
Even if your timeline was off, this really does not sound at all like an STI.  The fact that you experience the sensations more prominently went you are close to ejaculation may signal some relationship to blood flow and erections but this is not my area.  I would suggest that you raise this, perhaps as a question, when you speak with a urologist.  In general, the better you can describe these sensations- when they occur, how long they last, what makes them more or less intense, the more your urologist may be able to help.  To do this, I would suggest keeping notes of a log  on the occurrence as all too often our memories do not provide the precision that taking notes might.  EWH
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