[Question #3764] Unprotected Oral Encounter

34 months ago
Hi Drs. thank you again for the service you provide on this forum. After an incident a couple months back I have been especially concerned about acquiring STIs. I had seemed to been able to put that encounter behind me, but on Saturday I received unprotected oral sex from a female for about 10-15 minutes, I ejaculated in her mouth. It is someone I know and she says that she is free of STIs and there is no reason to test. I am still concerned for some reason and have felt general discomfort in the penile region. I also performed very brief (under 1 minute) cunnilingus on the girl. Since the incident I have had multiple loose stools and a slight bought of diarrhea this morning along with a minor sore throat. Would this point to a first sign of any STI? Is there anything for me to be particularly worried about? When can I consider myself in the clear and move on from this situation? I am very concerned about the possibility of contracting herpes and not sure if these initial symptoms can be a sign. Thank you again for your time and response.
34 months ago
Meant to mention, I am 27 y/o Male and partner was 40 y/o Female
34 months ago
Also to note, I just finished 500 mg of Ampicillin 2x a day for Acne for 1 month, and as of today be taking Minocycline 100 mg 2x a day for the same reason (I had some stomach issues with the Ampicillin) - not sure if this effects anything or any testing you would recommend 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
Welcome back to the forum, but sorry you found it necessary.

You discussed the first of these encounters with Dr. Hook last month and I have nothing to add to his reassuring comments about those events.

Unlike that event, which was fairly high risk (even though you were proved to not have caught anything), the more recent sexual encounter seems to have been entirely safe. Your partner's age (40) itself marks her at low risk, and so does her confidence she is STD free. Oral sex is safe sex, with overall risk far lower than vaginal or anal -- low risk for all STDs and zero for some of them. For example, there has never been a proved case of HIV transmitted by oral sex (mouth to penis), or by cunnilingus (in either direction). Ejaculation in the mouth does not increase the risk of any STD, at least not for the ejaculator. (It might raise the risk for the oral partner, if the penile partner is infected with something.)

As for your sypmtoms, you describe nothing that suggests any STD, including herpes. No STD causes "a slight bout of diarrhea" or "minor sore throat".  And tkhe combination of antibiotics have have been taking constitute 100% protection against syphilis and chlamydia, and nearly 100% against gonorrhea and nongonococcal urethritis (NGU).

So you can consider yourself in the clear at this time:  certainly if somehow I were in your situation, or if I were counseling a family member, I would recommend against any testing and would advise them that they could safely continue there normal sexual relationship with their regular partner without risk of transmitting anything. 

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
---
34 months ago
Thank you for the reply Dr. Handsfield, I greatly appreciate the insight and you likening the advice as to what you would say to a family member. Do I need to be on the lookout for any lesions or is this not a concern?
34 months ago
Sorry for the double follow up, should a canker sore in the corner of the mouth be any concern?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
"On the lookout" seems to imply greater attention to one's penis and subtle symptoms than might otherwise occur. In general, the more anxious someone is about having perhaps been exposed to an STD, the more important that s/he NOT "be on the lookout" for lesions. Such persons tend to be prone to see every skin irregularity as possibly worrisome. If you don't develop sores or lesions that are obvious without actual inspection (i.e. that you would notice anyway in showering, urinating, etc), then you can safely assume nothing is wrong. Avoid any inclination to self inspection.

Disregard canker sores occur all the time and are no more common in people with or without HIV or other STDs. (Also ignore "sores in the corner of the mouth", i.e. at the angle where the upper and lower lips meet (angular cheilitis). They usually are not canker sores, but they also are generally nothing to worry about and often maybe anxiety related.)


---
34 months ago
Thanks Dr. I guess I should’ve phrased it more as how much time passing without lesions is a good sign? Or am I in the clear now? I guess I should take your assurances of low risk and take a sigh of relief
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
I understand:  impersonal words like this don't allow the nuance of personal contact, in which case I might have realized you weren't really asking about intense self examination. But you have to admit that interpretation fits everything you've said in two threads!

STDs causing genital ulceration can appear as soon as 3 days after exposure (herpes) or not until many years later (penile cancer from HPV). The chance you caught anything at all from this event remains low, but you can be even more confident of nothing shows up within 6 weeks or so.

Indeed, do your best to accept the reasoned, science-based reassurance I have tried to give. In any case, that concludes this thread, which will have to be your last one of this exposure and your concerns about it.  Best wishes and stay safe.

---