[Question #4117] Chlamydia and oral sex looking for expert advice

33 months ago

Dr. Handsfield / Dr. Hook

Thank you taking the time to look at my question, 9 months ago i received oral sex from a woman, i was extremely guilty and had what i can only describe is a mental break down and decided to buy a dual treatment for gon and Chlamydia without testing, this was the second biggest mistake of my life and can’t believe how stupid i was. After 8 months of mental hell i decided to contact the girl who told me she was clean at the time but had vaginal Chlamydia in May and was treated. This really scared me because i cannot get a clear answer to weather Chlamydia is transferred oral to penile, reading old forums, i have seen you state numerous occasions that Chlamydia is not transferred that way ,I trust your opinion highly on this but there is a few websites cdc mainly that state that Chlamydia can be transferred this way , i also read in the oxford handbook of genitourinary medicine that there is currently no data on Chlamydia  infectious transmitted from the throat. Some websites say it can be and some websites say that it just doesn’t happen. so my question is this , what is the right answer to the transfer of Chlamydia oral to penis and why so many mixed answers on this subject? I just want to make sure my partner is safe ,we have had sex 21 times since the antibiotics is reasonable to think i would of contracted Chlamydia back? looking forward to your response

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
33 months ago
Welcome to the forum. Thanks for your question.

I can confirm what you have seen me and Dr. Hook say on this forum:  chlamydia transmission oral to genital is very rare. Until a few years ago, it was thought to virtually never happen. With more accurate testing, it is more clear that it sometimes occurs, but remains very rare. For example, if men without symptoms are tested for chlamydia, among those who regularly have vaginal or anal sex, 1-5% (1 in 100 to 1 in 20) are chlamydia positive. For those whose only exposures are by oral sex, it's under 1 in a thousand, maybe less than one in 10,000.

Second, that your partner had vaginal chlamydia a few months later doesn't mean she was infected at the time of your exposure. And if she had a vaginal infection, it's still unlikely she had it in her mouth or throat. Oral chlamydia is rare compared with vaginal or rectal infection.

Third, you were treated. If your "dual treatment" included either azithromycin (single dose) or doxycycline (7 days), you would have been cured. And even without treatment, chlamydia is cleared by the immune system, probably usually within 2-3 months in men (longer in women). So even if you were infected 9 months ago, there is no realistic chance you still have it.

Fourth, if somehow you still had chlamydia, you probably would have symptoms. Asymptomatic urethral infections aren't rare, but most people do have abnormal discharge and sometimes painful urination. 

So all things considered, there is no chance you have chlamydia at this time. Your partner is safe. You really needn't worry about it.

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

HHH, MD

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33 months ago
Thank you for the quick reply , I have tested and can confirm I'm sti free , I'm so scared because I had sex with my partner one time before taking the the antibiotics,  this has worried me that I may of given chlamydia to my partner,  after having unprotected sex with my partner 21 times and not contracting anything back can I safely assume that she does not have the infecation? I'm so worried for my partner and obviously will tell her if I feel she may be at risk here, she has no symtoms,  I just need to let this go I'm a new first time dad and feel awfull I just want to put this behind me and be a good dad and partner thank you 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
33 months ago
You received oral sex. That alone makes it exceedingly unlikely that you acquired chlamydia and could not have infected your partner.

How much time was there from your casual sexual encounter before you had sex with your regular partner?
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33 months ago
6 weeks after my encounter , Dr could I not expect this back after 21 times of unprotected inter cource with my partner ?  Recently did a test awaiting results ,  I have read there is no immunities to it , I'm trying to use logic before I go make a mistake and ruin my family but I wouldn't want to risk my partners health , if my partner does have it when would you notice symtoms ? She has had a smear test and cbc blood tests and all is fine , I can put a date when will this be over,  how long can woman expect to have this before it clears without treatment , many thanks for the detailed insight, im losing my mind not sleeping or eating it has been a long 9 montha so far thank you
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
33 months ago
Having no symptoms after 6 weeks even further lowers the chance you had chlamydia (or gonorrhea). Your new test will be negative.

Not sure what you mean by "I have read there is no immunities to it". Most likely the writer meant that chlamydial infection does not create immunity to new infections, which is true (although it somewhat reduces the risk, i.e. partial immunity). This has nothing to do with the immune system clearing the infection, which indeed happens in just about everybody. It takes longer than with antibiotics, but this is the truth about the large majority of human infections, STDs and others:  clearance by the immune system over time.

As for "a date when this is all over", you're already there.

You came her for our expert advice and reassurance, and I can say with all honesty that there is no more expert opinion anywhere in the world. Please do your best to accept it and move on. If you cannot, professional counseling may be in order. It is not normal to remain so anxious about something after the reasoned, science based reassurance you have had. I suggest it from compassion, not criticism.

That concludes the two follow-up comments and replies included with each question and concludes this thread. Let's not have another one on this topic; the answers would not change. I hope the discussion has been helpful.

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