[Question #5925] Questions on STD symptoms

18 months ago
In 2016 I had unprotected vaginal sex with a 21 year old women she was in a relationship for 8-9 months when this happened. Then a week later I had sex with my GF. symptoms appeared about a month or more later which were painful urination, left testicle pain, as well as yellow underwear stain twice, I’m assuming from urethral discharge. Also develop a skin rash on my penis head which were tiny red dots. The discharge and symptoms disappeared in a week and half and never came back. I continue to have sex with my GF for months in which we then both took antibiotics and had sex again 4 days later.  I learned about STDs and for very scared so I tested to chlamydia/gonorrhea RNA/TMA which were negative this in May.My gf hasn’t tested but I have and it was negative. My gf and I have constant sex. My symptoms have never returned.
My questions are
1.Can I assume we are both negative since me and my gf have constant sex and I recently tested negative?
2.Can the symptoms have been caused by NGU or something else? 
3.I reached out and spoke with the women I had unprotected sex with today and says she has has/been tested and has never had anything. Should I believe that? 
Edward W. Hook M.D.
Edward W. Hook M.D.
18 months ago
Welcome to our Forum and thanks for your question which is a bit challenging to answer. Without testing your GF, I cannot 100% assure you that at some point you and/or your GF had acquired an STI.  Your post however indicates that you have both taken antibiotics (I assume for some other reason but you do not tell me why) and that sense then you have had negative RNA TMA testing for gonorrhea and chlamydia which, given the fact that you and your GF have regular sex, suggests that neither of you currently has an STI.  let me answer your specific questions, then make another comment or two:

1.  about 40% of chlamydia and 5-10% of gonorrhea in men, and a higher proportion in women are asymptomatic.  Your negative tests indicate that you were not infected at the time you were tested which, given your repeated unprotected exposures to your GF, makes it unlikely that either of you are infected. The only way to be 100% sure however is for her to test (FYI, when women go for their regular sexual health examinations routine testing is recommended so if she has seen a health care provider, she may have been tested).

2.  Your symptoms sound like urethritis- an inflammatory process of the penis which may be due to chlamydia, gonorrhea or other less harmful bacteria.  Without testing it is hard to know.  In you had NGU due to something other than gonorrhea or chlamydia, it may have resolved on your own without causing harm or problems for your GF.  

3.  Yes, why would she not tell the truth.  This history, as well as your own suggests that whatever was going on in the past was not gonorrhea or chlamydia.

Just to wrap up, testing would have been the preferable way to go.  Irrespective the antibiotics you and your GF appear to have resolved the problem since you have not gotten symptomatic again.  Overall it appears that you were lucky on this one.  I hope this assessment is helpful to you. EWH  
18 months ago
Thank you doctor so you think it’s fair to not worry about this exposure from 3 years ago since the women said she was clean and never had anything and I have tested negative along with the symptoms went away? I mostly just want my signifiant other to be fine. Should we move on with no concern? I deeply regret this and will like to move on.
1. Do you think the symptoms could’ve been cause by something other than chlamydia or gonnorhea such as NGU? 
2. What is the most common cause of NGU?
3. Can NGU cause yellow discharge in men? 
4.  Is adeovirus or another virus that make you sick cause these symptoms? I remember I was sick and so was my GF? 
5. What would cause red dots on penis head? 
6. Is it possible I had a reaction to my gf vagina who just started Birth control and was taking amoxicillin for strep at the time?

18 months ago
Also I assume if I were reinfected they would appear as my original symptoms correct? 
18 months ago
Also doctor you said “Yes, why would she not tell the truth.  This history, as well as your own suggests that whatever was going on in the past was not gonorrhea or chlamydia.” I can be 100 percent confident the cause was neither of these STIs? 
Edward W. Hook M.D.
Edward W. Hook M.D.
18 months ago
My goodness, three follow-up questions in 7 minutes.  Please relax, read my responses carefully (asking redundant questions serves little purpose) and realize that your actions (not testing early, taking antibiotics for some, unknow reason subsequently, testing late) make it impossible to guarantee you anything other than the fact that your recent tests show that you do not have gonorrhea of chlamydia.  On to your questions:
First set of questions:
I do think you should move on from here. Short of making sure your GF is tested to be completely sure, you have little choice.
1.  A bit redundant. Yes, I said this earlier.  About half of NGU is caused by bacteria other than chlamydia.
2.  Chlamydia causes 30-40% of NGU.  In about 40% of cases there is no clear bacterial cause.
3.  Yes
4.  Yes adenovirus could do this.  There is no way to tell if this is what you had.
5.  Difficult to say- many possible causes including trauma and fungal infections.
6.  Unlikely

Second questions:
Most likely

Third questions:
No you cannot be 100% sure this was not gonorrhea or chlamydia but as I told you above, given the facts you have shared it is unlikely.

Not sure what has created this concern three years after an encounter outside of your relationship.   Whatever it is however, as I said, time and antibiotics have muddied the water but it is unlikely that you or your GF have an STI at this time. EWH
18 months ago
Sorry doctor the concern has came from anxiety and connecting everything my GF feels or has to the exposure. I am confused as what to do from here sorry if this question is redundant.  I didn’t test because I was unaware of such infections if I am being quite honest.
Could period like cramps in lower region in my gf be a cause of a concern? Or can that be caused by a many of things? She recently had her annual exam and her Pap smear came back normal and they told her everything look normal, do the annuals usually test? 
Another question I don’t know if you made clear or not I am kinda confused. With my recent negative test after about two months worth of exposures to my gf before taking the test and it being negative as well as speaking to the other women and her saying she has been tested in the past and currently and has had nothing before shouldn’t this not likely be either chlamydia or Gonorrhea? 
So your advice is to confess the mishap which will most likely end this relationship? 
18 months ago
I also had bad pink eye and bad upper respiratory I infection which cause me to spit phlegm before the genital symptoms came on of this plays a role? I took a zpack and as well as my gf for this lingering cough months after the gential symptoms appeared. 
18 months ago
Also I didn’t test because I’m not sure what happened that night other then sex happened and woke up during it due to being drunk. I  also know NGU is always a STI and if chlmydia isn’t the cause and others causes are unknown what do I and my gf test for? 
18 months ago
Sorry to add on I just re read your reply and had another question. So you are saying it’s also possible me and my gf are sharing an std and the test missed it? As in I was negative at that time but if I test again maybe I’m positive?
Edward W. Hook M.D.
Edward W. Hook M.D.
18 months ago
These will be the final answers to your continuing question.  After this reply, the thread will be closed without further replies.  I should also remind you that this forum does not except repetitive, anxiety-driven questions and maintains the option of not replying to such questions and not returning your posting fee.  Repetitive, anxiety-driven questions are of little benefit to clients and provide little knowledge to others who may read forum responses for information on STIs.

Lower abdominal discomfort and cramping in women has many, many causes, including STIs.  If your GF's symptoms are severe enough to seek care, her doctor should consider and test for STIs.  That is a medical decision and I cannot make that judgement on-line.  As already mentioned twice, while your guilt over your dalliance makes you worry that you could be causing whatever symptoms she might have, that you have negative tests despite repeated unprotected exposures makes it less likely that she has an STI at this time.

I'm not sure why your GF would take a z-pack as part of treatment for your cough.  Azithromycin, the antibiotic in the z-pack, has activity against chlamydia and gonorrhea and may have cured a chlamydial infection if present even though the dose of medication in the Z-pack is less than what is recommended for chlamydia.  

The most important tests for your GF in terms of your possible NGU are gonorrhea and chlamydia.  There is little reason to be testing for other organisms.  

The tests you had for gonorrhea and chlamydia are very accurate.  They prove that you were not infected at the time you were tested.  Given your lack of symptoms, it is unlikely that you have been re-infected since that test.

This ends this thread.  EWH