[Question #3043] Oral STI transmission

38 months ago
Hello-
I have read through many past questions addressing this issue but could use some reassurance. I am a heterosexual male. Approximately 24 days ago I received unprotected oral sex. For the past 3 weeks, as far as I know I have been asymptimatic. I have not had any noticeable discharge. Maybe one or two small bumps towards head of penis but honestly don’t know if they are unusual. Last night(day 23), all of the sudden I started getting a burning pain at the tip of me penis. 12 hours later it has not subsided. From what I have read from your answers, gonorrhea can be transmitted orally, though rare. It seems you have indicated chlamydia is EXTREMELY unlikely to be transmitted via oral sex. It also seems gonorrhea presents in the first 7-10 days. Given I didn’t experience any obvious, visible symptoms during that time, and considering chlamydia is rarely if ever passed orally, what are chances of STI considering first any symptoms manifested were over 3 weeks after exposure? Thank you very much for your help.
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Welcome to our forum, I'll be glad to comment.  Thanks as well for taking the time to look at earlier interactions with other clients.  Our goal is to provide useful information to more than just the person who asks the question. To preview my recommendation I think you need to see a trained clinician who can examine you and do some tests.

You have summarized information about Gonorrhea and chlamydial risks accurately.  It would be unusual for this to be a presentation of either Gonorrhea or Chlamydia but strange things do happen.  Another STI-related possibility is that this could be the beginning of a herpes infection acquired through the exposure you describe although this too seems unlikely given the amount of time that has passed since your exposure.  Further, if this is heroes I would expect you to develop easily detected water blisters or ulceration switching 24-36 hours of the onset of the discomfort.  The most likely scenario however is that this is unrelated to the sexual encounter you describe.  If the sensation passes in the next day or so, I would not worry further however if the sensation persists, I would seek evaluation and testing for Gonorrhea and Chlamydia.

 I hope these comments are helpful.  EWH
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38 months ago
Thank you for the response. A follow-up question: if only engaged in oral sex, if I did have gonorrhea would symptoms present in the anus? I have had some anal discomfort, but have had frequent hemorrhoids in the past. Can it spread from the penis to anus with no sexual contact? Also, can you speak to relative frequency/ease both chlamydia and gonorrhea can be transmitted via receiving oral sex? I realize you can’ t give exact percentages or with any absolute certainty. Regardless, I’m getting tested, just hoping to get some answers why I wait for the results. Thank you!
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
No, gonorrhea is a local infection which only causes symptoms at the site of exposure.  If you had acquired gonorrhea from receipt of oral sex, you would have penile symptoms, not rectal symptoms. 

With respect to your other question, even if your partner was infected (and you do not know that she was- infect, even most "high risk" persons do not have infection), most exposures to infected partners do not lead to infection.  I am confident that your tests will be negative.  EWH
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38 months ago
Thank you Doctor. As an update, my tests did in fact come back negative. Thanks you for your answers and the service you provide.
38 months ago
One last question if you don’t mind(I believe this is my 2nd and last follow-up): Given I tested negative for the more common STIs and HIV is not transmitted through oral, my only major concern would be syphillis. My question is: can syphillis be transported by me to a partner if there are no visible lesions on my penis. From what I have read on this forum, syphillis is transmitted penial to vaginal only if there are visible sores. While I realize my chances of having syphillis are almost nil, I wanted a little more clarity on whether I would need to worry about transmitting over the past 28 days to a partner when there are no visible lesions/sores. Thank you again so much!
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
You are correct, syphilis is transmitted only through direct lesion contact and your risk for Syphilis is infinitesimal.  I would not worry in the least.

This will conclude this thread.  Take care.  EWH
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