[Question #5179] UTI / STD / NGU

24 months ago
Hi, hope you are well. 

I had a wild night last Thursday (21st March) into Friday morning and had unprotected Oral with two different girls give and receive. Since then probably due to burning candles at both ends I developed what my Dr assumed was strep throat and have been on co-amoxiclav since Monday 25th and slowly been getting better. I have had no genital symptoms or anything indicative of an STD. 

I write to you because the day after (Saturday morning) I had unprotected sex with my regular partner. On my side nothing unusual but on tues/ weds she mentioned she had a feeling of cystitis (She has had before and her sister too). She took some sachets (not sure the usual for cystitis / UTI) and felt better, said it went away. On Saturday (yesterday) after us having sex again later that day she complained of stinging when peeing plus a frequent urge to urinate but not much happening when she tries. This is consistent with other cystitis she has had and also had a heavy night drinking the night before. This morning she says she feels much better and tomorrow will see a Dr to get an antibiotic for cystitis (I guess). 

Logically I am assuming that the two events are likely to be unrelated, but I reach out to you due to the timing of these events to wonder if you can shed any light. My main questions are: 

if she had somehow acquired some form of STD from me do the symptoms tend to come and go? 
Would it be possible for symptoms to improve from a sachet and then get worse again 3 days later?
Do STD symptoms tend to progressively get worse or can they bounce around?
As far as she has told me her symptoms where frequent need to urinate and discomfort plus stinging when urinating. No noticeable discharge or anything like that, But I haven't investigated ! 

Thank you for the help 





Edward W. Hook M.D.
Edward W. Hook M.D.
24 months ago
Welcome to the Forum.  Your question arrived while I was on the site so you are receiving a response a bit earlier than is usual.  My sense is that your questions can be distilled down to: 1. did you possible get something from receipt and performance of oral sex on two new partners on the 21rst? and 2.  If so, could you have given it (perhaps repeatedly) to your GF to account for her symptoms the following day.  If I got hose questions wrong, please let me know

For question 1.  Obviously it is not possible to know if either of your casual partners had STIs- most people do not on a statistical basis.  Further, the sex acts you describe- giving and receiving oral sex  are relatively "inefficient" routes for acquisition of STIs.  From receipt of oral sex you can get gonorrhea or non-chlamydial NGU and, very, very rarely chlamydia.  Cunnilingus is even lower risk for acquisition of STI and the only STI there is meaningful risk for is from cunnilingus is oral gonorrhea which is typically asymptomatic.  It sounds as though other than for the sore throat, you are otherwise asymptomatic making having an STI of any sort unlikely although if you really want to know, you should have an oral test for gonorrhea and a urine test for gonorrhea and chlamydia (the diagnosis of NGU typically requires a penile swab looking for inflammation).  the antibiotics you took for your sore throat might cure as much as 50% of gonorrhea if present but should not be counted on.  bottom line- STI of any sort is unlikely.

Question 2.  For your GF to develop symptoms the day after sex is unlikely to be due to an STI as it typically takes several days.  OTOH, there is an association between sexual activity and cystitis in women so this may have happened.  Further, when women get STIs they rarely present with your GFs symptoms.  My guess is that her symptoms were not due to an STI although it may have contributing to her symptoms.  

Hope this is helpful.  If any of this is unclear or I missed the point, please follow up for clarification.  EWH
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24 months ago
Thank you for the swift reply. Everything you say makes sense. 

Sorry, to clarify what I was asking; 

The symptoms my partner reported, which were like cystitis (Frequent need to urinate, stinging when urinating) occurred 3 days after our sexual contact, which was one day after the episode I described. She then took some sachets for cystitis and it cleared it up for another 3 days, until it returned on Saturday after we had sex again. 

Are the symptoms and the fact that they cleared up for 3 days before returning enough for me to assume that I have not given her some kind of STD?

and, is it normal for Stds which provide symptoms such as stinging when urinating to come and go like that and be relieved with Sachets for cystitis / uti?


Thank you, I guess I am trying to rule out the scenario that I gave her something, seems unlikely given as you said low risk encounter plus no symptoms from me (I was on antibiotics so not sure if that would have affected things)






Edward W. Hook M.D.
Edward W. Hook M.D.
24 months ago
thanks for the clarification on the timing.  Cystitis symptoms could, possibly be due to an STI but they are relatively uncommon and the majority of cystitis symptoms in women are due to the other, non-STI bacteria that more commonly cause bacterial cystitis in women.  You cannot be 100% sure that you did not infect her.  I cannot comment on the sachet as I do not know what was in it although there are some sachets designed to address symptoms which do not cure infections if present.

Bottom line- tough to be sure. You have to make a decision regarding whether or not to raise the issue with her or to get checked in the manner I described above.  As I said, the antibiotics you were taken would reduce but not absolutely prevent infection if you were exposed.  If you had an STI, the testing I suggested would clarify things and is really the only way to be sure.  EWH.  
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24 months ago
Thanks. Last question is blood in urine indicative of an STI or UTI? Thanks
Edward W. Hook M.D.
Edward W. Hook M.D.
24 months ago
Blood in the urine (of a woman I presume) is more consistent with a UTI than an STI.

As you know this is my 3rd response to your questions.  Thus, as per Forum guidelines, this completes this thread which will be closed shortly without further replies.  I hope the information I have provided has been helpful.  EWH
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24 months ago
thanks for all of your help. all the best