[Question #2918] General Question STD/Viruses

39 months ago
Dear Dr,

I have a general question regarding STD's/Sexually Transmitted Viruses. There are the most common STD's which are tested for at most health clinics (planned parenthood, STD clinics etc..) which are HIV, HTLV I/II (which i know is very rare and never recommended testing for), Ghon, Chlmaydia, Hep ABC, Syph, EBV, HSV, trich, LGV. I have read a lot of similar stories both on Medhelp as well as on this forum of people who seem to have "non-specific" symptoms i.e. testicular aching, body aches and pains mainly in lower extremities, severe headaches, muscle twitches etc... all symptoms they have never felt before and these symptoms "coincidentally" followed an unprotected sexual exposure of some sort. I have seen responses from both Dr. HHH as well as Dr. Hook stating that they have nothing that can negatively affect them or a current or future sex partner due to the negative tests and no additional texting is needed. Are there not any STD's/ Viruses that can be transmitted sexually outside of the most common tested for that would cause such symptoms? I'm assuming neither of you have experienced someone with such symptoms that was a result of the sexual encounter? The reason I ask is that after reading through all those scenarios (and there are many) I have never seen where there was a diagnosis made or they at least was not posted. Thanks for the answers in advance
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
Welcome to the forum. Thanks for your confidence in our services and for your question. You raise a legitimate issue, and I'm taking the opportunity for a blog-like reply that we can use in response to future questions as well. Apologies if this gives more detail than you want or expected. But bear with me.

How can you prove a negative? Absence of evidence is not evidence of absence, and there is no way to prove that such symptoms are not due to some unknown sexually transmitted virus (or perhaps bacteria, but a virus would be far more likely if there is any infectious cause at all). But the indirect evidence against it is strong.

1) Online claims of persons with unexplained symptoms are the worst kind of evidence. The probable far larger number of people who have no such symptoms following various exposures don't go online to say so. All websites habited by persons with various symptoms or health problems are heavily biased and not representative of most affected persons, or those not affected after particular risks or events.

2) Although onset of symptoms may follow a sexual event, most such persons are ignoring other potential explanations. During the weeks when the sexual exposure occurred, we all experience various non-sexual interactions with other humans (store clerks, co-workers, friends, bus co-riders, etc etc); various environmental exposures; and so on -- just name any of the hundreds of health risks that are part of life. We are unaware of the large majority of them. Although the sexual event may seem unique, there is no particular reason to attribute the new symptoms to that event than to all the other mostly unknown ones. (Except for a potential psychological link: keep reading.)

3) Few if any known infections cause only symptoms like these. The symptoms are reminiscent of conditions like chronic fatigue syndrome, fibromyalgia, "systemic candida", "hypoglycemia", unproved Lyme disease, and many others -- all of which (except of course some true cases of Lyme) have at times been suspected to have infetious origins but for the most part none have been proved despite decades of research. When well documented infections cause malaise, various body aches, fatigue, and so on, almost always there are other symptoms and signs that point to pneumonia, urinary tract infection, osteomyelitis, viral gastroenteritis, etc, etc. Absence of these other symptoms, and often absence of abnormal lab tests, argues against infections in people with only the more vague symptoms.

4) In most such persons, the symptoms are consistent with the well documented physical manifestations of anxiety, stress, depression, etc. In these conditions, and undoubtedly in most of those who look to a sexually acquired cause, the symptoms are real -- not just "in your head". But that doesn't mean they don't have a psychological origin. In other words, with symptoms typical for such disorders, it is reasonable to suspect them in people who develop those symptoms. (Tension headaches have a physiologic explaination, i.e. increased tone in scalp and neck muscles. But nobody argues that they don't orginate with stress, anxiety, etc.)

5) Many of the exposures are of a type that are inherently low risk. On this forum and probably at other websites, a very high proportion are condom protected or otherwise low risk, such as oral sex (which is low risk for all STDs, even if unprotected), mutual masturbation, ejaculation while clothed, kissing alone, massage, etc, etc.

6) The sex distribution of such problems seems predominantly male. I cannot verify this for all websites, but it seems the case on this forum. Certainly some women have such complaints, but far fewer than men. If sexually transmitted, why should the sex distribution be more or less equal? Or one that would favor women, who for most STDs are at higher risk than men?

7) There is no evidence that such problems have serious outcomes over the long term. In the innumerable cases like this seen by me, Dr. Hook, and other STD experts -- both in our clinics and on our forums over the years -- we recall no patients that later came back with documented important health outcomes, i.e. virtually no "I told you so" sorts of messages. Of course some develop the various ills of mankind as the years go by -- cancer, heart disease, diabetes, stroke, and even genital problems like prostate enlargement or infertility -- but these don't seem to be any more common than expected in everybody.

8) Many affected persons, probably a large majority, overtly express regret over the exposure to which they attribute their symptoms. Non-regretted exposures undoubtedly are there as well, but seem to be infrequent, at least on this forum and in our clinical experience.

9) Finally, such cases seem to be limited to mostly sexually inactive or monogamous persons (usually men) following a new exposure, often one that is obviously anxiety producing. In busy STD clinics, a substantial minority of patients spend much of their lives screwing their brains out and have had literally hundreds of sex partners, and often many STDs. But I don't recall ever seeing such a patient who had the sorts of complaints we're talking about here. Why would some undefined STD virus be limited to people who are mostly at low risk but had a particular exposure that worried them?

All these thoughts are off the top of my head -- stream of consciousness as they come to mind. (Maybe as I re-read it over the next couple of days I'll make some edits.) But I think that more or less covers it. I'll be interested to know if you see any flaws in my reasoning:  I'm sure there are some, although I'm pretty confident about the overall theme. Thanks again for the opportunity to put it in writing.

HHH, MD


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H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
Typo in no. 6:  "shouldn't", not "should".---
39 months ago
Dr HHH,

That was a lot to take in and I appreciate the detailed response.  What concerns
Me is that I experienced these symptoms after a sexual encounter many years ago and was told by multiple Dr’s that I had nothing that could harm my health or that of a current and/or future partner. Well these symptoms eventually subsided or just got to the point that I accepted them as my new normal being that they didn’t affect my everyday life and were more of a nuisance at times than anything else. I got married a couple years after the onset and everything was great. We have since had two boys and breast fed both of them thinking we were doing the best thing by them. These symptoms seem to still come and go and I pray that I didn’t give something to my wife that she passed on to my boys via breast feeding. I thought I did everything right at the time as far as STD’s were concerned before I moved on with my partner who is now my wife and kids. Now I just don’t know 
39 months ago
I tested negative for all the std’s I listed in my initial questions and my wife’s blood work at the time of pregnancies never had any issues. That’s why I asked of possible other viruses that could have gone undetected.
39 months ago
I investigated this for over a year after the unprotected sexual exposure and finally decided to let it go due to being told i needed to seek therapy/counseling for not believing my multiple negative tests out to a year. Now i feel as if i let it go to soon. I know my symptoms resulted from the exposure which were testicular aching, rectal discharge, severe headaches, muscle twitching/muscle pains in lower extremities, body aches and pains all over. felt as if something was attacking my nervous system and entire body. 
39 months ago
Dr HHH,

This is actually our correspondence almost 8 years ago on medhelp. This exposure happened when I was in college.


39 months ago
Dr HHH,

It started as a dull ache in my testicle the very next day after exposure and than all my other symptoms followed within two weeks. Sorry for the contributed post but want you to have all info.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
I'm glad to learn your health and that of your family are good. On one hand, you seem to be accepting all I have said above, so I don't understand what your current concerns are. For all the reasons discussed above, I remain confident you have no infection of any kind from the sexual encounter encounter several years ago.---
39 months ago
Thanks for the reassurance.
39 months ago
Dr HHH,

One last question: which of the infections you mentioned above would explain the rectal discharge? Is that a symptoms of all of them?  Again I have never received anything in my rectum. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
Rectal discharge is not an STD symptom if the rectum itself is not exposed, which requires receptive anal sex with another man. If you still are having rectal discharge, it is unrelated to the sexual exposure you are concerned about all those years ago. In that case, see a doctor.

That concludes the two follow-up comments and replies included with each question, and so concludes this thread. I hope the discussion has been helpful. Best wishes.

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