[Question #2951] Realistic Concern or Worrying Unnecessarily?

42 months ago
Doctors, thank you for this service. I've read many responses but thought it would be worth it to confirm what I've interpreted. I'm a late 20's M, had one situation where I received oral from an early 30's F whom I know but don't know her exact sexual history, but is in a relationship of her own. She displayed no open sores or obvious issues from what I could tell, and 80 days later I am still without any symptoms, and have never showed anything to make me think otherwise. Just hit with a pang of guilt that I could have potentially passed something on to my current partner. I know you've written about anxiety, and I am nearly certain that's all I am feeling, but suppose I just need some reassurances. My questions are; could I have potentially been asymptotic for either chlamydia, gonorrhea, of NGU for these past 80 days? I believe the potential for any STI transfer from mouth to penis is very small, especially with a brief, strictly oral, one time encounter, but do I have a reliastic concern? Anything worth worrying over, need for testing? I appreciate your help.
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
Welcome to our Forum and thanks for looking at some of our earlier interactions with other clients.  My sense is that they provided you with useful information (that is the purpose of making them available).  I also agree with your assessment of risks as you describe them. To summarize, most people do not have STIs and when they do they are less common in the mouth and harder to transmit to others.  When combined with these probabilities, the absence of symptoms nearly three months after the exposure is strong evidence that your were not infected.  I see little reason for concern here and no need for testing related to this exposure.  On the other hand, as a generalization, we do recommend periodic testing for every sexually active person, not because of risk issues but as part of sexual health maintenance, in the same way that check-ups of other elements of health (heart health for instance) are recommended.

I would not be worried if I were you.  I hope this comment is helpful.  EWH
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42 months ago
Thank you for your response, I have a follow up; in previous responses you and Dr HHH have given hard figures or odds for scenarios like this one.  1) Hoping for some of those for this situation. 2)What would be the order of likelihood for the transmissions in the method described for the three that I mentioned previously, and what are those likelihoods? I am concerned about this because my wife had a brief (one) short episode of intermenstrual bleeding last month, and a potentially abnormal pap (awaiting results), so concern about PID seems possible, 3) is that a serious potential, or more than likely some other cause? I believe the risk is still incredibly low, I simply need the reassurance of your expertise. Thank you.
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
When we provide figures on risk for infection it is typically for HIV in which the risk of different sorts of exposures (i.e. genital-genital sex, receipt of oral sex, etc) has been well studies. There are NO good studies of risk of acquiring other STIs from receipt of oral sex.  it is clear however that receipt of oral sex is a less biologically efficient mechanism for transmission of STIs from person to person than genital contact.  Combining this with the FACT that TIs are less common in the oral cavity than the genital tract, and the absence of symptoms now long after contact, your chance of having been infected is vanishingly low.  If you have a question about a specific STI, I will elaborate further.

Intermenstrual bleeding is a non-specific finding.  To associate this with an STI transmitted by you as the result of your dalliance is inappropriate.  On the other hand, it may be related to her questionable PAP smear.  Either way, neither of these findings is a sign or, nor suggestive of, PID. 

It sounds to me as though you continue to feel quite quilty about your exposure.  I understand this but that is not a reason to attribute the findings you mention to possible STIs. 

I hope this perspective is helpful  Feel free to follow-up with your final follow-up question if I may help.  EWH
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