[Question #3496] Worried Oral Sex Encounter

34 months ago
First off, let me tell you that reading through this forum has been very helpful in calming down my anxiety and making me feel 10X better than I did before. I wanted to post my question, even though i'm hoping to get similar answers as other have on this thread, but it will make me feel even better hearing one of the doctors answer my specific question:I am a 32 yr old male who has only been with one partner in the past 6 years. Last week, I had unprotected oral sex with a provider and i've been freaking out ever since. It was only Oral. About 3 days after this one encounter I started feeling a little tingle in my penis. It has never hurt noticeably when I pee, in fact the tingle usually happens after I pee. Its somewhere between a tingle and a light burning sensation, but it does not burn noticeably when I pee. I assume that burning from an STI is painful? No discharge I freaked out and I feel like thinking about it is making it worse. I have bad anxiety about it. Today I went to the Urgent Care and took a UTI test (negative) and they took a urine test for Gonorrhea and Chlamydia, also gave me a 250mg shot of intramuscular ceftriaxone AND 1g of oral azithromycin. Test results wont come back for 2-3 days which makes me even more anxious. Doctor looked at my penis and said was healthy no signs of herpes, he did say I had very slight inflammation at the tip which I guess could be caused by multiple things. My questions:-Today is day 6 since my encounter, I have had zero discharge and it does not burn when I pee. If I did have an STI would I have already seen symptoms?-Since I got treatmen-I just want to validate what the % of catching an STI from a one time oral encounter is?-Lets just say I DID have an STI... I did have unprotected vaginal sex with my partner 3 days after my oral encounter. Could I have passed it to her? I'm going to avoid sex until I get the test results back, hoping everything is negative. Just trying to cure my anxiety until test results come in
Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago

Welcome to our Forum and thanks for your confidence in our assessments and advice.  Thanks as well for reviewing other posts on our site- one of our goals is to provide assessments that will be relevant to others.  The exposure you describe was low risk for STIs.  As you have seen in other posts, as a starting point it is important to point out that most commercial sex workers do not have STIs and oral sex only relatively rarely leads to infection.  When it does, the most common problems are either gonorrhea of non-gonococcal urethritis NGU) caused by mouth organisms introduced in to the urethra during sex.  When symptoms occur they typically occur within a week following sex.  The symptoms can be mild or more intense.   The sensations you describe however are not suggestive of STI- discomfort after voiding is not a symptom of an STI.  Symptoms of the sort you describe however are consistent with being "hyper-aware" of normal sensations which they otherwise filter out of their consciousness.  My suspicion is that  your tests for gonorrhea and chlamydia will be negative.  If you have the non-chlamydial NGU that sometimes occurs after receipt of oral sex, I should point out that this syndrome is not clearly an STI in the traditional sense, is not readily transmitted to sex partners like other STIs, and in not associated with complications.  In the United Kingdom, many specialists do not treat NGU associated with oral sex.  When treated, oral sex-related NGU typically resolves quickly.


In response to your other questions:
Since I got treatmen-I just want to validate what the % of catching an STI from a one time oral encounter is?-Lets just say I DID have an STI.
The best data on acquisition of STIs suggest that, IF your partner was infected (unlikely) about 1 in 5 genital infections would lead to infection.  The biological efficiency of oral sex for transmission of infection is less than for genital sex.

I did have unprotected vaginal sex with my partner 3 days after my oral encounter. Could I have passed it to her?
Unlikely.

Finally, I assume that your tests will be negative and the your regular partner is not at risk.  I would also add that the treatment that you got "just in case" would certainly cure gonorrhea, chlamydia, or non-chlamydial NGU if you happened to have it.

I hope these comments are helpful.  EWH
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34 months ago
Thanks Doctor!

Follow up, in my previous question I mentioned that the urgent care doctor looked at my penis and said it looked healthy. But he also said I had slight inflammation at the tip (I assume this is called the urethra glands) he didn’t say it looked like anything bad. 

Went down a rabbit hole on the internet and found an STD called MGen? Could I have gotten MGen from one oral sex encounter? Could this have caused my slight inflammation at the top of my penis and therefore tingle slight burn after peeing because urine touches it? What exactly are symptoms of MGEN?

Again I am hoping that I am completely off track but just worried. I also saw MGen doesn’t appear in std tests for gonorrea and chlamydia. Is this true? Lastly can I pass this to my partner even though it doesn’t look like an open sore or anything 
Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
The internet is not your friend.  I suggest you stay away from it.  As you indicate, it really is a "rabbit hoe".

Mycoplasma genitalium is a topic of much research right now and its role as an STI is unclear.  More importantly for you, it not transmitted through oral sex.  It is not a concern for you.  EWH
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34 months ago
Dr hook, great news my std urine test came back negative. I feel a lot better now. 

So the test covered Gonorrea, Chlyamidia, and NGU.... should I be worried about possible HSV 1 developing? I only had oral so I imagine I am clear of HSV2. What are chances of getting HSV1 from 1 oral  encounter? I do not remember seeing any cold sores 

From your professional opinion is it safe to go back to sex life with my partner and go on with me life? Or should I test further

Lastly I am so grateful for this forum. It was comforting to read through others situations and in most cases everything turned out ok. Really helped me get through this scary and high anxiety week. I hope you understand the great service you and the other doctors provide 


Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
Glad to hear but not surprised at your test results.  I hope that they will allow you to move forward without concern.  Your risk for getting HSV-1 (or -2) are negligible and should not worry you at all.  There is no reason for testing of any sort (including blood tests for herpes). 

I would urge you to put your concerns behind you and to move forward without concern.  There is no apparent reason for you to abstain from unprotected sex with your regular sex partner.  There is no need for further testing related to the exposure you have described. 

Thanks for your thanks.  Our goal is for this forum to provide information and advice to clients.  I'm glad my comments seem to have accomplished this.

As you know, we provide up to 3 replies to client's questions.  This is my 3rd reply. thus this thread will close later today without further answers or comments from me.  Take care.  EWH
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