[Question #577] Can you give me an STD risk assessment?

42 months ago

Hello Doctor.

 

Here is my story (and it is similar to a previous question I posted). I like getting sensual massages (from men). I prefer that the end of the massage have a manual release (hand job). Typically, this has always been the case without fail. But, three times in the last year the massage therapists have decided to start doing oral on me. I politely have them stop, but obviously there is some oral/genital contact (which I am sure presents some risk). The last time this happened was last week.

 

Note: I have been having some prostate problems and have been on doxycycline which ends this Wednesday.

 

Based on what I have described, how much risk have I put myself in (from the last episode)? What is the likelihood of getting an STD? Do you recommend testing?

 

I will try to be better going forward (about putting myself at risk), but just want to know what to expect.


Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago

The exposure and situation you describe today is quite similar to the one described in your last post.  As a result, the answers are likeswise essentially the same.

The exposure you describe was very low risk- most persons do not have STI's particularly oral infections and when they do, transmission of infection is biologically very inefficient.  When infections are transmitted through oral sex, the most common infections transmitted are gonorrhea, non-gonococcal urethritis and rarely, chlamydial infections.  Further, since you are still taking it, the doxycycline you were taking would prevent infection by each of these processes.  Further, your risk of acquiring syphilis is close to zero and your risk of herpes is minuscule.  There is no risk of HIV whatsoever.  Given the situation you describe, I would not worry, would not recommend testing, and see no need to refrain from sex.  As before I see no need for testing.

Having placed yourself in this situation on several occasions, you should likewise either discuss this with your masseuse prior to your massage, or get more comfortable with the situation you seem to atrack.  EWH

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42 months ago
Thank you for getting back with me. For some reason I think my brain is linking my prostate issue with these events and I am assuming I have something. I have had pain or sensitivity in my urethra and my doctor/urologist thinks it is prostatitis (thus the antibiotic treatments).
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
You do not mention it but if your doctor has not done a rectal exam, he cannot accurately diagnose prostatitis.  Further, if you do have prostatitis, it is almost certainly NOT an STI as scientific studies have shown that prostatitis virtually is never caused by STI pathogens.  Finally, in most people with prostatitis, urethral symptoms are not a prominent part of the symptoms.  EWH
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42 months ago

Dr. Hook,

My Urologist did a manual test (every time I am in the office). I also had two cystoscopies (they were a joy). Unfortunately the condition comes back on occasion. This time (as he usually does) he put my on an antibiotic and told me to take Naproxen for a couple of weeks until things subside. He says that pain in the head of the penis and sometimes the urethra is common as there is a nerve that travels downstream from that general area (do not quote me, I am just telling me what he told me).

So, in my head, I somehow relate the incident described with my other condition. (which is usually not present).

Thx. 

Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
Not sure if you are expect3ing a reply of comment.  Glad to hear that your urologist has done the rectal exam.  That said, I still maintain that the symptoms you are describing are not related to the sexual encounter you described.  I would continue to work through this problem with him. Take care.  EWH
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