[Question #511] risks from receiving rough unprotected oral sex

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99 months ago
Hello, I am a man who had oral sex performed on me (without a condom). Due to slightly rough technique, I noticed some sensitivity near my urethra area immediately following the act. Freaking out about it, I applied antibiotic ointment (for 1-2 days, made it feel more sensitive if anything), then hydrocortisone (for 1 day, made it feel better), and then zinc oxide (for 2 days, made it feel better too). To my knowledge there was no skin breakage, bleeding, or abrasion, just sensitivity after the act.

For about two weeks it felt very sensitive near my urethra area and one spot on the top. Maybe a slight pinching sensation with movement, but not significant pain. Now it is about three weeks later and things feel better, just a little bit sensitive (probably more noticeable by my worrying and obsessing). I have not had any lesions, spots, or redness anywhere else on my penis (and maybe only minor redness near the urethra). I have not had painful urination or discharge.

I did receive urine test for bacterial STIs (but have not heard results yet). So given my symptoms and now that it is 23 days later, what are my risks for STIs? What about the discomfort and sensitivity I feel? How long might the area feel sensitive?

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

There is nothing in your exposure history or symptoms that make me suspect you acquired any STD from this event. Oral sex is always low risk -- not free of all risk, but with a much low chance of all STDs and zero risk for some. Second, there are no data to suggest that STD risk is any higher on account of the vigor or "roughness" of the exposure; if there is any relationship, probably it is small. As I think you realize, your initial symptoms had to be from trauma or other physical or chemical irritation; no infection can start to cause symptoms immediately, generally a minimum of 2-3 days. Your ongoing symptoms aren't typical for any STD; without more specific STD symptoms like urethral discharge, painful urination, or visible lesions or sores of the penis. I'm confident you have no STD and that your pending tests will be negative. I'm suspecious you're just more aware of minor discomforts and body sensations due to your concerns about the exposure, and perhaps about a sexual decision you may regret. 

You don't mention blood tests. If your partner was another man, then you should have a syphilis test about 6 weeks after the exposure. There's nothing in your symptoms that make me suspicious, only that syphilis rates are at a worldwide all time high in men who have sex with men. Better safe than sorry.

What about HIV testing? Similar to syphilis:  if you have sex with other men, then you should be tested for HIV from time to time. But not because of this particlar event. HIV is one of the STDs that is rarely if ever transmitted mouth to penis.

If your partner was female and your urine tests are negative, I would suggest resuming sex now with your regular partner(s), if you have been holding off; or maybe wait for the syphilis result. As for your symptoms, if your current tests are negative as anticipated, I suggest just waiting it out, expecting that your symptoms will fade. If not, see a doctor for professional examination.

I hope this has been helpful. Best wishes--  HHH, MD