[Question #3463] Curiosity- oral sex/ngu

36 months ago
I know I’ve posted a couple of times and I really hope you will answer these.  My symptoms have not really subsided so I hung around the forum hoping to find a post similar to mine and view those q and a.  I found that post with #3330 and it seems like some answers differed from ones I was given so I wanted to clarify.  

My contact was with a female.  I have tested negative for 10 panel and trich.  I was put on doxy last week - 2 times per day  x 10 days.  It seems to be working, but can’t really tell yet.    My main question is:  if I did have non chlyamidial NGU from oral sex,  is it possible that I could have had unprotected sex with partner and not passed it on?  We have had unprotected intercourse approx 4 times in past 2 months and she has not complained of any pain.  

Another question I have is dr hook stated that with on post 3330, some NGU there will be no discharge and little pain with urination, but on one of my questions dr hhh stated the primary symptoms of Ngu are discharge and pain with urination.  Could this be clarified please?

Last one:  how long after starting doxy am I no longer contagious if in fact I had something?

Thank you.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
Welcome back, but sorry you found it necessary once again.

Your symptoms did not and do not suggest any STD, and treatment for possible NGU is not recommended when there is no objective evidence of urethriits, i.e. visible discharge on examination or increased white blood cells in a urethral swab or the initial part of the urine stream. If these were not found, you should not have been treated. In any case, NGU from oral sex is generally harmless and probably is often not transmitted to partners. (It is likely that many cases are due to entirely normal oral bacteria that are not harmful to sex partners.) But in any case, I am confident you do not have and never had NGU.

It is true that some NGU causes only scant discharge that can be difficult to confirm on examination. But absence of discharge plus absence of WBC is strong evidence against infection. And as already stated, it's probably a harmless condition for both infected men and their partners.

If somehow you had something that could be transmitted to a partner, probably any possiblity of transmission would be over within 2-3 days of the first dose.

Since you have decided to not follow our advice on this forum and are now under the care of a doctor who apparently disagrees with our recommendations or approach, there's not much more we can do. I suggest you follow up with the doctor treating you. But in the meantime, I truly believe you are continuing to overreact, have no infection from the exposure you are concerned about, and can safely continue sex with your regular partner.

Please let me know if anything isn't clear. Best wishes--  HHH, MD

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36 months ago
Dr. ,

Thank you for your reply.  I feel like I am on an island and this is the only place I can go to get answers.  I have read through your many discussions on medhelp and those have helped as well.  It’s just hard for me to get past the fact that if I had not committed this act, I would not feel like this or feel pain in that area so it is hard to believe nothing is wrong.   I was diagnosed by a doctor through a virtual visit and described symptoms basically so I could get on an antibiotic just to ease my mind about the whole thing.  It didn’t last longer than 10 minutes.  I wasn’t going to them to get a diagnosis, I was just hoping to get a prescription.  

Anyways, as far as the WBC go, would the UTI test and urine culture and all the other urine test I had detect those if they were present?  I guess it wouldn’t make any sense to go get a swab since I have been treated already.  

Also, it seems like the pain is most prevalent when I have to urinate.  Once I urinate it goes away and does not burn on uriniation?  Is this a symptom of any std? 

I look forward to your reply and will most likely use my last follow up if anything else pops up and that will be it.  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
No, I'm afraid the tests you had would not detect NGU or any other STD. I agree the value of a swab for urethral WBC would be of little help now; a negative result would not say whether you previously had a problem now being resolved with the doxycycline, or never had anything at all.

No STD is a likely cause of such a symptom. I remain confident it is not due to any physical cause related to your recent sexual exposure. Any connection is more likely psychological, as discussed in your earlier thread.

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36 months ago
Are you speaking of the UTI tests I talked about?  I also had two NAA tests for gon and chla and one NAA test for Trich, all negative.  These certainly would detect those correct?  

I have white spots at the base of my penis.  They are not elevated and do not hurt.  They could have always been there, I’ve just never paid this much attention.  Are these anything to be worried about?  

Once during ejaculation I thought I noticed some yellow colored sperm that was clumpy.  Is this anything to be worried about?  Only happened once.  

My final questions are: 

If I had pain during urination, would I know it?
If I had discharge, would I know it?
If I had herpes pains or lesions, would I know it? If I had any symptoms of HIV, syphilis, hep, would I know it?  I just want to make sure I am not leaving any details out that may change your mind about anything.  I’ve only had this pain and it’s not constant, but flares up from time to time.  Never had it before the exposure.   Basically, it’s been 10 weeks since the exposure and I just want to know if I had anything, would the symptoms be so obvious that I couldn’t ignore them and I would be able to properly explain them to you and you would be able to recognize any possible STDs by symptoms alone?   

Also, if my partner had contracted anything from me, would she already know it?  We had sex 3 weeks following exposure, a couple weeks after that, a couple after that, and last Friday after I had been on the antibiotics for 4 days.   

I appreciate the reply doctor.  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
I was answering your question "would the UTI test and urine culture and all the other urine test I had detect those if they were present?" And by "those" I assumed you were still speaking of NGU. You weren't at risk of a non-STD UTI and it didn't enter my mind as a possibility.

You are over-interpreting every little thing you notice and feel about your genital tract as if it could somehow be related to the sexual event described. This is unnecssary.

"If I had pain during urination, would I know it?" Huh?? Would you notice if you had pain? If you don't notice pain, you don't have pain!

Discharge is easily visible. It's hard to miss mucus or pus dripping from the penis, or the stains in underwear.

All the STDs mentioned can be asymptomatic. But you were tested and negative. Beause all STDs can be asymptomatic, absence of symptoms in you or your partner doesn't prove you aren't infected. But it does lower the chance by a large amount, and you have been given several other reasons why you can be confident you have no STD and thus could not have transmitted one to your partner.

No STD causes pain, discomfort, or other symptom that is "not constant, but flares up from time to time". You didn't notice it before you became anxious about the exposure, and such intermittent symptoms are typical for a psychological origin. Your anxiety about a sexual exposure you regret is magnifying trivial symptoms or even normal body sensations that you otherwise would disregard or not even notice. And that's all that's going on here.

If you continue to have these feelings and remain concerned, I would first advise you to re-read every word in the replies you have had in this and your other threads; and if that doesn't help, get professional counseling. I suggest it from compassion, not criticism. This is not normal.

Please note the forum does not permit repeated questions on the same topic or exposure. This will have to be your last one; future new questions about this exposure, testing, and your fears about HIV or other STDs will receive no reply and the posting fee will not be refunded. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. I trust you will understand.    
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