[Question #378] Unprotected oral sex at massage parlor

34 months ago
First a little context about me and my situation: 34 yrs old married male in good health who on 12.9 made the mistake of going to  a massage parlor while on a business trip with the hope of getting a proper massage and a hand job. During my visit, the masseuse unexpectedly and without notice began to perform unprotected oral sex on me for approximately 5 seconds without ejaculating. I was stunned and immediately asked her to stop. She was even more stunned because apparently this visit included intercourse with its non negotiated (or discussed) package and it seemed very few people walk away taking advantage of this offering. I was dressed and out the door a few minutes later feeling a lot of shame, guilt and shock about what had just occurred. 

Flash forward a couple weeks later and my paranoia has gotten the best of me. On Sunday 12.20 I began to obsessively think about my mistake and what implications it could have on my health and marriage, doing a variety of internet research about chlamydia and gonorrhea. Suddenly I began to notice a persistent clear drip after urinating and throughout the day. Then a small ache in one of my testicles.  Then an itch in my eye. And a pain in the small of my back. In short, EVERY possible symptom outside of a colored discharge or fever noted with both of these STI’s. Every 15 mins I was looking for more articles and insight online with the symptoms becoming more “intense.” This coupled with having sex with my wife within a week of the visit and the ongoing holiday season, my last week has been a living nightmare mired with guilt and intense shame. 

Fortunately I came across the Medhelp’s forums and a handful of posts responded by Dr. Handsfield that put me at ease. According to multiple responses to similar posts, the chances of contracting an STI via oral sex is extremely low risk especially given my exposure. I also knew that psychosomatic symptoms are a very real thing (genital anxiety) having gone through a similar incident of paranoia 14 years ago in college. With all of this insight, I feel a bit better but have a few questions including:

1) These “symptoms” feel very real (i.e. a tenderness in the head of my penis, slight ache in my testicles, a clear drip that I haven’t seen persay but feel in my boxers). Could my anxiety and shame be actually creating physical symptoms or is this all in my head? Because even though I am a bit less anxious, my genital area feels “different."

2) Some forums suggest waiting till 6 weeks to get tested. Would you recommend I only get tests for gonorrhea and chlamydia given my “symptoms" or do a more comprehensive serious of tests? And should I wait a few more weeks to hit that mark or go as soon as I can (I am with family through the holiday until mid next week)?

3) I have rehearsed this conversation with my wife no less than 100 times in my head since last week and I am terrified to confess this indiscretion but will do so if my health (and potentially hers) has been compromised. For reassurances, given my minimal exposure, what are the odds/percentages I could have caught something? And why have doctors suggested NOT even getting tested when only oral sex has been performed as to me it seems better safe -and sure- than sorry.

 I have learned a tremendous lesson here and hate that even though I didn’t go seeking anything beyond a rub n tug, what happened happened and I need to face it head on. Standing by and eager to hear your teams thoughts. Thank you. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
Welcome to the forum. However, I'm afraid your question is well over the limit of 2,000 characters (about 400 words), clearly shown in the statements you saw before posting. Either you cut and pasted from another program, which bypasses the required limit, or the limitation software may need to be tweaked. Anyway, I haven't yet read your question with care. I will do that and reply after you re-post it in a follow-up window, edited down to a maximum of 2,000 characters including spaces. Thanks.

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34 months ago

sorry about that..... 34 yrs old married male in good health who on 12.9 made the mistake of going to a massage parlor. During my visit, the masseuse unexpectedly & without notice performed unprotected oral sex on me for approx. 5 seconds. I was stunned and immediately asked her to stop. I was dressed and out the door a few minutes later feeling a lot of shame, guilt and shock about what had just occurred. 

 Flash forward a couple weeks later and my paranoia has gotten the best of me. On Sunday 12.20 I began to obsessively think about my mistake and what implications it could have on my health and marriage, doing a variety of internet research about chlamydia and gonorrhea. I began to notice a persistent clear drip after urinating and throughout the day. Then a small ache in one of my testicles.  Then an itch in my eye. In short, EVERY possible symptom outside of a colored discharge or burning while urinating. I had sex with my wife within a week of the visit so now I am in a living nightmare mired with guilt and intense shame. 

I know that psychosomatic symptoms are a very real thing (genital anxiety) having gone through a similar incident of paranoia 14 years ago in college. I have a few questions including:

 1) These “symptoms” feel very real (i.e. a tenderness in the head of my penis, slight ache in my testicles, a clear drip that I haven’t seen persay but feel in my boxers). Could my anxiety and shame be actually creating physical symptoms or is this all in my head? Because even though I am a bit less anxious, my genital area feels “different."

 2). Would you recommend I only get tests for gonorrhea & chlamydia given my “symptoms" or do a more comprehensive serious of tests after 6 weeks?

3) For reassurances, given my minimal exposure, what are the odds/percentages I could have caught something? And why have doctors suggested NOT even getting tested when only oral sex has been performed as to me it seems better safe -and sure- than sorry.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
Thanks for the shorter question. 

Questions about STD/HIV transmission risk from oral sex are among the most common on this forum, including the question immediately before yours (#377). Please see that reply for some general comments about overall risk of STDs by oral to penile exposure and which infections are low versus virtually zero risk. In your case, the risk was especially low, with only a few seconds of exposure.

However, your question is more directly about your symptoms. My first comment is that you really have not had "EVERY possible symptom" other than colored discharge. I don't believe any of your symptoms are especially suggestive of a urethral infection.

1) I'm not much of a believer is "psychosomatic" symptoms. However, anxiety certainly can magnify both normal body sensations and trivial feelings that you otherwise wouldn't notice. For example, scant entirely clear discharge after urinating that you "feel" but can't even see either is a bit of urine or, more likely, nonexistant. Urethritis doesn't cause a aching testicles, but anxiety does that very frequently. And I don't know where you heard that itchy eyes is an STD symptom, but it almost never is. Most important, symptoms like these never are due to actual urethral inflammation.

2) From a medical or risk standpoint, or on the basis of your symptoms, I do not recommend testing for any STDs -- that is, I agree with your doctors. However, it is possible that some negative lab tests would help you accept emotionally, not to mention intellectually, that you didn't catch anything. If so, have a urine gonorrhea/chlamydia test. You can do it now -- the tests are valid any time 5+ days after exposure. But for sure I don't recommend any other testing at 6 weeks or any other time.

3) I'm not sure if you are referring to specific doctors you have seen for these symptoms (you don't mention that you have actually been examined or tested) or if you are referring to doctors in general. In fact, professional advice on this is all over the map, and many doctors would in fact recommend testing. Some believe that oral sex is higher risk than it is, and others indeed take a "better safe than sorry" stance, which is similar to my comment above about the potential psychological benefit of testing.

I hope these comments have been helpful. Best wishes and happy new year--

HHH, MD
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34 months ago
I appreciate your reassurance. To clarify itchy eyes because of developing pink eye due to my hands having traces of something and then wiping my eyes. And then I was referring to research online and doctors suggesting that testing is not required. Can you elaborate why you would recommend against testing? Is that because of treatment that may accompany the test in advance of a diagnosis unnecessarily? Or because of the unneeded anxiety people experience while waiting for results? I want peace of mind but would prefer to put this behind me if it really is that unlikely. Thanks doctor. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
Conjunctivitis (pink eye) doesn't cause itching without visible inflammation, like pus and redness (hence "pink" eye). And it is extraordinarily rare that any STD is the cause of conjunctivitis.

Experts in STD or any other medical field typically recommend against testing when the likelihood of a positive but false result is higher than the possibility of a true positive result. The same debate has been on display publically in recent years in regard to PSA for prostate cancer and mammography for breast cancer, and that's how I would characterize testing in your situation for HIV, syhphilis, herpes, or any other STD detected by blood test. (To some extent, it also applies to gonorrhea and chlamydia testing, but those are more borderline and a case can be made for it, especially gonorrhea.) OTOH, if you are tested and the results are negative, as they probably would be, you might find the results reassuring. And of course you are free to be tested for whatever you like. It's a free country and you certainly don't need my permission!

It seems clear you have transposed your anxieties about an unexpected and undesired sexual encounter (maybe one you could have done more to predict or prevent) with fear of STDs. But the two aren't the same. Deal with the former as you need to, but you truly needn't worry about the latter. And simple assurance you don't have an STD probably isn't going to truly deal with it. Can I give an absolute guarantee you weren't infected with something? No. I also can't guarantee you won't be struck by a meteorite, but I wouldn't advise you to take any precautions against it.

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34 months ago
Ha. I appreciate your tone and candor. Sincerely. It's a great service what you and the other doctors are providing here and it's shocking how misinformed people - myself included-about these matters. Thanks for allowing us all to sleep a bit better and make better decisions moving forward. I've learned a tremendous lesson as no sort of pleasure or escape is worth this worry. Happy holidays doc. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
Thanks for the thanks. I'm glad to have helped. Best wishes and happy new year!

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