[Question #2898] Likely STD?

39 months ago
Hi,

I am in a panic.  I will skip further apologia, but I am married  and had unprotected oral sex with female sex workers and protected intercourse as well.  I never had unprotected intercourse.   Probably 5 or 10 times.  My wife and I rarely have intercourse, but had sex twice since the relevant incidents, both times unprotected (to the extent it mitigates any risk, I pulled out both times before climax).  My wife recently started complaining about  significant pain in her pelvic region.  About a month ago (after she could have been exposed) I recall her complaining about painful urination during her period.  I did not think I had any obvious std symptoms, but now I am worried.  I did have a persistent itch on my scrotum and have had intermittent mild discomfort in my urethra.   I have  no discharge and no pain associated with urination.  

I was tested last week for Gonnorhea, Clamydia and HIV and am awaiting the results.  

Although I realize it is just a broad estimate, with this set of symptoms, what is the likelihood my wife has an std from me?  What is the likelihood I have an STD?
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
Welcome our Forum.  I will do my best to help. You have done the right thing by testing.  If the tests are negative, you have no further reason for concern but, because gonorrhea and chlamydia can both occur without symptoms, it is best to rule out the possibility of infection.  I anticipate that your tests will be negative as protected vaginal sex is safe sex unless the condom is not worn throughout the encounter or breaks (which would be obvious- condoms do not leak "a little") and STIs are rarely acquired from receipt of oral sex, even if your partner did happen to be infected. 

Pelvic pain and painful urination in women can have many causes, including being due to UTIs (which are not STIs) so if your tests are negative, I would not worry,

As for your scrotal itch, this is a common problem but is not a symptoms of any STI.

I hope these comments are helpful.  It is unlikely (very) that you have an STI and even more unlikely that you have an infection that you transmitted to your wife.  EWH
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39 months ago
Thanks much for the reassurance.  I will await the test results with somewhat less panic.  I do have a couple of quick follow up questions.  As i mentioned, I have intermittent mild discomfort on my urethra, (this is towards the tip of my penis.)  Could this be a sympton of an STD when there is no discharge or would it be highly unusual to have it as the only symptom? Also could I have an NGU that is not chlamydia?  I saw one of your colleague's post about adenovirus being acquired through oral sex.  Also, might it be a fungal infection that was causing both my scrotal itching and mild penile discomfort.  That was my uneducated guess before my wife's complaints.

Finally, I have read elsewhere that this can be associated with Trichomonas, for which I was not tested.  Since my wife's complaints, it has been more noticeable discomfort, but I assume that is psychosomatic.  But, just to close the loop, should I also be tested for Trich?  I know it is not easily acquired through oral sex, but could protected sex and external grinding without a condom cause it and could I have passed it along, putting her at risk for pelvic inflammatory disease or anything of the sort?



39 months ago
FYI, as you predicted my tests for gonnorhea and chlamydia came back negative.   I am still somewhat nervous about other possible stds
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
I think this is your guilt speaking.  I urge you to believe your test results.  Current tests for gonorrhea and chlamydia are amongst the most reliable tests in all of medicine.  EWH
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39 months ago
Sorry, I am not nervous about those STD's but rather the possibility of some sort of NGU or Trich.  Did you see my earlier follow up questions? 
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
Your genital exposures were condom protected and therefore close to no risk and your gonorrhea and chlamydial test have ruled out the important STIs.  If you feel you must, there are urine tests available for trichomoniasis but this infection is not acquired from receipt of oral sex. Similarly, NGU following receipt of oral sex is typically symptomatic and there are no data to suggest that partners of men with non-chlamydial NGU develop symptoms or complications.  I really think that you wife's symptoms are not related to your extramarital exposures.  EWH
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39 months ago
Thanks.  I know the internet is filled with overly conservative statements on the risk of STD transmission, but because there is some suggestion that Trich can be passed through non-intercourse,  I want to make sure I am understanding your expert opinion.  So it seems you are saying that if I did not have unprotected intercourse, the risk for Trich from protected intercourse and unprotected grinding  is effectively so remote that I need not worry either about having it or passing it on?  I think that is what you are suggesting and don't want to submit to an unnecessary and expensive test - I just want to make sure that is what you are saying though.


Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
Your interpretation is correct.  There is a lot of mythology regarding non-sexual transmission of STIs but there are few, if any, data to suggest that trich is transmitted through non-penetrative sexual contact.  I really do not see a need for testing in your circumstance.

FYI, our Forum guidelines call for up to three responses (the original and two follow-ups)..  I have kept the thread open because I may have mis-interpreted your earlier follow-up question.  I will keep the thread open for a bit longer and then the thread will be closed.

I hope my responses have been helpful. EWH

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