[Question #5687] STD Anxiety due to symptoms

19 months ago
Hello Doctors.  3 weeks ago I had protected oral and vaginal sex with a CSW in Aruba (she was from Venezuela working in Aruba as a CSW).  Both oral and vaginal sex were protected.  I was not concerned about anything after this sexual experience.  Admittedly, this was a moment of weakness as I am a happily married man to my wife.  Upon my return from my trip, my wife and I had unprotected sex a couple of times since.  As mentioned, I have not been concerned about any STDs until yesterday when my wife informed me that she has redness in her outer right labia and feels a large lump inside and is experiencing pain.  I am now concerned about what I might have done and transmitted to her if anything or could this just be some other infection she has that is coincidentally occurring after my CSW act.  What are the risks of STDs from my actions and what should be the next steps to take for me and for my wife as far as testing is concerned?  Many thanks for reviewing this question and answering.
19 months ago
To add to the above, the protected sex was with a Latex condom.  Also, about 4-5 days later I did develop a minor sore thoat and chest congestion with cough.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
Welcome to the forum. Thanks for your confidence in our services.

Painful redness and swelling of the "outer labia" is most likely a skin infection, like an infected sebaceous cyst, abscess (boil), or something similar -- and not likely an STD. However, location is important:  if inner labia or near vaginal opening, it could be a bartholin gland abscess. (All women have two bartholin glands, one on each side of the vaginal opening, which produce sexual lubricating fluid.) Bartholin infections are often, but not always, caused by gonorrhea.

While I agree you had a safe sexual encounter, condoms are not perfect and there is always some chance of infection. And the timing of your wife's problem is consistent with an STD from your extramarital event. On the other hand, if you have had no symptoms yourself, i.e. urethral discharge or discomfort when urinating, it is unlikely you have gonorrhea. Chlamydia can be asymptomatic, but it's a less likely cause of your wife's symptoms. (Your cough and chest congestion don't count -- no STD causes such symptoms.) 

It simply isn't possible to know with confidence what your wife's problem is; she needs to see a doctor about it ASAP. If I were you, I would not mention your other sexual experience to her; that may become ncessary, depending on what is found when she is evaluated. In the meantime, you could also see your doctor or a local STD or public health clinic for a reassuring examination and probably urine testing for gonorrhea and chlamydia.

All things considered, I doubt either you or your wife have an STD. But don't take chances -- better safe than sorry.

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

HHH, MD
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19 months ago
Many thanks for the quick and detailed reply Doctor.  Should I get HIV testing done as well?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
HIV isn't a possible explanation for your wife's problem. But as long as you're getting STD testing, HIV should be included, as a matter of routine. Also a syphilis blood test.---
19 months ago
Thank you again Doctor. I’ll go by and do the tests today. I will report the results in a few days.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
OK, understood. Normally threads are closed after two follow-up comments and replies, but I'l leaving this open so you can report your test results and the outcome of your wife's evaluation, if you choose to do so. But I won't have any further comments until then.---
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
18 months ago
Any results to report? The thread will be closed in two days.---