[Question #6021] Asymptomatic for years?

18 months ago
Male, received unprotected oral from CSW in Spain 2.5 years ago, and got tested for Chlam and Gonn 48 hrs after the exposure - with negative results. Put it behind me, and suffered no physical symptoms at all.

4 weeks ago, partner started suffering discomfort, swelling, itching, and discharge from vagina - white-ish and sticky. It has been persistently present since. Similar but not the same to her earlier yeast infections. Doctor tested for Chlam + types of yeast infection but all tests came back negative. Didn’t do a Gonn test.

Since tests, there was some early blood-loss, around 4 days prior to normal period. Put it down to a possible scratch from the cream tube that was being used to soothe discomfort. Pain has largely been around the inflamed vagina area as opposed to up inside the belly. It has improved in recent days.

Since she tested negative for Chlam, my main concern is that I have harbored asymptomatic Gonn since possible exposure years ago, which I have now passed on and she’s breaking out in symptoms. 

The complaints seem similar to Gonn, and I know I was on the edge of too early after my exposure to test with full confidence. 

What do you think?



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

Your partner's apparent genital infection has nothing to do with your oral sex exposure more than two years earlier. Gonorrhea or chlamydia conceivably could do this, but the tests for both are highly accurate and reliably show you were not infected and that she currently is not. Also, men rarely if ever carry either infection for more than a few weeks or months; 2+ years is unheard of.

My guess is your partner indeed was tested for gonorrhea, which is almost always done along with chlamydia lab tests. The most commonly used tests automatically test for both. She should ask her doctor about it. If indeed gonorrhea testing wasn't included, it should be done now. (But if found, it's still unconnected with your distant past exposure.)

I would be most suspicious of a yeast infection, despite apparently negative test results for yeast:  the usual test, looking for yeast by microscopy, misses many infections. She might speak with her doctor about a trial of anti-yeast treatment, if that hasn't been tried. She also should have a nucleic acid (DNA) test for Trichomonas, if not done. Trich is an STD, but can be carried for years before causing symptoms. (Should that be found, it's not from your dalliance in Spain:  trich is not carried in the oral cavity and cannot be acquired by oral sex.) And evaluation for herpes also would make sense, especially if there are (or were) open sores in her vaginal area. Have you ever had genital or oral herpes (cold sores)? Although genital herpes is always an STD, it often appears in monogamous couples because of reactivation of longstanding infection, often without knowledge of prior infection. Finally, I need to remind you of an obvious fact:  when one member of a couple finds a need for outside sexual experience, often the other has done so as well. I'm not saying your partner has had other partners -- you know her and I don't. But if she were my patient, I would ask her directly about other possible exposures.

Bottom line:  for sure there is no connection of your partner's apparent vaginal infection with your oral sex exposure 2+ years ago. She should continue to work with her doctor as suggested above. I'll be interested to hear if and when additional testing or treatment establishes her diagnosis. In the  meantime, I hope these comments are helpful.

HHH, MD
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18 months ago
Thank you.

She has now improved and just says it’s slightly irritated in that area, but no longer too disruptive. The symptoms in total have lasted around a month, and have been up and down. Does this chime with Gon, also considering previous mentioned complaints?

I’m not sure why they didn’t do C&G at the same time, but they definitely didn’t. Odd.

The concern I have is whether my test was done too early (48 hrs) and therefore not conclusive. I could then have been without symptoms, passed it on soon after, and she may then have also been asymptomatic for months/years before showing any complaints. Is this possible for women?

I appreciate that there are small chances of C or G via oral, and small chances of having caught it in the first case, but I am fearful that I proceeded with getting back to normality before being sure. As with many of these questions, it comes down to anxiety.

Thank you for the info about the other possibilities, I will look into them. I will save my final follow up question to tell you the diagnosis, but this shouldn’t appear for a couple of weeks at least. Thank you.



H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
18 months ago
The symptoms and the timing of gradual improvement fits most closely with herpes, especailly with the negative tests for other STDs and yeast. It would still make sense to be tested for gonorrhea, regardless of her improvement. But I would recommend you both have blood tests for HSV; and for her to be on the lookout for genital area blisters/sores (or a mild version of her recent symptoms) in the coming months.

Your tests were not done too early. And I stress again that no male has ever been documented to have carried gonorrhea or chlamydia for 2+ years without symptoms. You're not likely to be the first in history! The combination of low risk exposure (oral sex), negative tests, absence of symptoms the entire time, plus that this has neve been known to happen together amount to 100% proof you aren't infected from that event. And we also have your partner's negative chlamydia result -- and, I predict, gonorrhea.
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