[Question #5408] Preventing STDs

23 months ago

Hi Dr Handsfield,

Good morning.

I would appreciate that you could help me to allay the fear of contracting sexually transmitted diseases (STDs).

I read from the internet that  STDs are only transmitted in certain ways as follows :-

1) Gonorrhea & Chlamydia are transmitted through sexual contact with the penis, vagina, mouth or anus of an infected partner. AND

2) Syphilis is transmitted from person to person by direct contact with a syphilitic sore known as a chancre.  Chancres can occur on or around the external genitals, in the vagina, around the anus in the rectum or in around the mouth.  Transmission of syphilis can occur during vaginal, anal or oral sex.

Does it mean that NO sex there will be NO risk of getting infected with sexually transmitted diseases such as gonorrhea, chlamydia and syphilis ?

Thank You.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
23 months ago
Welcome and thanks for your confidence in our services.

Your two statements are accurate, except that there are syphilitic lesions other than chancre that are infectious. Such lesions (condylomata lata, mucous patches, and others) occur primarily during the secondary stage of syphilis, after resolution of primary syphilis (chancre) and can be subtle and hard to see. They can involve any anatomic site (genital, anal, ora). So syphilis is a risk with having sex with anybody with syphilis wthin a year or so of catching, with or without visible chancres.

But your bottom line statement is correct. They are called sexually transmitted diseases for good reason:  no sex means no risk. This also applies to herpes, HPV, and HIV.

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

HHH, MD
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22 months ago
Hi Doctor,

I seek your advice on general health of penis head.

Recently I observed that there was white layer of white substance covering the surface of my penis head.

Under the foreskin there was also such white substance at the skin fold on the penis shaft.

The white substance can be rubbed off or peeled off.

No pain at all. Does not affect my urination.

I used soap and water to clear it off and it goes away but sometime the white substance reappears again in a
few month time.

I consulted my doctor but he was not sure what was the substance just instructed me to wash my penis with soap and water whenever such white substance appears.

Check with you whether it is most likely to be SMEGMA ?

If yes will circumcision helps to permanently solve the issue ?

Thanks.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
22 months ago
Indeed, your description suggests normal smegma, which naturally accumulates inside the foreskin of uncircumcised men. It is not a health problem, unless accompanied by redness, soreness, or sometimes strong odor. I see no reason for you to be circumcised based on what you have said.  However, if it bothers you circumcision could be considered. (In addition, being uncircumcised lowers the risk of catching HIV. Depending on your sexual lifestyle, i.e. if at high risk for HIV (e.g. sex with men, frequent unprotected sex with commercial sex workers, and so on), that alone might be reason for circumcision. See a urologist if you would like professional advice about yoru smegma and/or circcumcision.---
22 months ago
Hi Doctor,

Good afternoon.

Many laboratories have requested us to submit our first morning void urine sample
which is the urine sample collected in the morning when we wake up for the test for gonorrhea during our routine annual medical check up.
Seek your assistance whether urine sample collected on the spot at other time of the day and not when we wake up in the morning can also be used for the test for gonorrhea ?

Thank you very much.




H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
22 months ago
First morning void is not necessary and not recommended by the manufacturers of STD diagnostic tests, such as urine testing for gonorrhea and chlamydia. A valid sample is the first ounce (30 ml) of urine (to wash out the urethra), which can be done any time of day for accurate results. (Even this may not be necessary. Even midstream urine usually is valid -- but the test manufacturers' official advice is the first ounce of urine.)

That completes the two follow-up questions and replies included with each new question, and so ends this thread. I hope the disucssion has been helpful.
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