[Question #6187] STI/Prostatitis/Anxiety

17 months ago
On 9/4 had less than 60 seconds unprotected vaginal sex with a girl I’ve known for 25 years. We were “friend with benefits” for years until about 4 years ago. Had protected sex maybe 100 times. Maybe 10 or so unprotected. Never any problems. She is 49/married I’m 50 in a relationship. Had immediate guilt, shame, regret, etc worrying what I might pass to my partner. Next day started feeling the need to urinate constantly starting within minutes after I’d pee. 9/6 had normal U/A. Sent it for G/C testing which was negative but it had been less than 48 hours since exposure. 9/8 had external burning and discovered a BB sized, flat red area right in the crease behind the head. Next day another smaller red area was near it. Decided it was fungal. 2 days of Lotrimin it was basically gone but it seemed like there was more in the area  so I kept spraying the general area for a week or so. 
9/11 told my Dr the whole story. 7 days of doxy did nothing. I asked if the fungal thing could be affecting my urethra and he gave me 7 days of diflucan. I took 6 and it did nothing. I was having a horrible urethral sensation about a quarter inch inside that felt like several gnats fluttering around. Did another U/A with microscopic and said that would catch Trich. Both normal again. Went to an urgent care to have G/C/T tests run again since the others had been done so early. All negative but was given 3 days of cipro in case of UTI. Helped maybe 30%. Urologist said Prostatitis. 5 days of Omnicef. Feels a little better but still have to pee all the time. Feels like urine moving in my perineal area. Are there any STIs I should be worried about giving my gf? Is it just anxiety? Or can unprotected sex give you Prostatitis? Could the fungal thing be a factor? Thanks for you time. 
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
 Welcome to our forum. Thanks for your confidence in the information we provide. Thanks as well for detailed explanation of your exposure and testing since then.  Starting at the beginning, urinary frequency is not a symptom of STI's. Further, there are no STI's which would cause symptoms within 24 to 36 hours of sex.  When you combine these facts with your multiple negative tests, your non-response to several antibiotics, and the low risk of nature of your exposure, it is time to set aside the possibility that you acquired and STI through the exposure you described.   I would not worry that this is an STI.

As for prostatitis, prostatitis is not an STI and if this is prostatitis, it is coincidental.  Further, while not all prostatitis is infectious your response to antibiotics is suggestive, often prostatitis needs several weeks of treatment to resolve.  I would discuss your continued symptoms further with your urologist.

I doubt that the fungal infection is relevant to your continued symptoms.

I hope these comments are helpful.  EWH
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17 months ago
Thanks Doctor. I meant to say in the first message that I think I already know the answer to this question. I think I’m mostly looking for reassurance. My gut feeling is that if this is prostatitis or cpps my anxiety probably started it. It just seems like a heck of a coincidence that I’ve never had any prostate issues and then just happened to develop prostatitis the day after this encounter. Unless there is some possible connection to sex. I realize it’s not technically an sti so to speak I was just curious if there was anything, even normal vaginal flora, that could somehow cause it. If not it almost seems like it has to be anxiety driven to me. So you’re  confident I can resume  a normal unprotected sexual relationship with my gf without putting her at any risk? I’ve read about m gen but my dr said it’s a fairly uncommon bug and they don’t even do the test for it. But he said it should show an abnormal U/A but normal culture. And all my U/As have been normal except maybe a trace of protein once or twice. As far as hsv 2, which I realize is low risk in this case, what is the window if you were gonna have initial symptoms? Like when are you “out of the woods” so to speak? And with HPV, which is what caused my initial worry, how is it transmitted from male to female if there is no wart or anything? Does is just hang around on your skin or is it transmitted through semen? Thanks fo your time. 
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago

Thanks for the additional insightful information.  I agree that anxiety is likely to be a major contributor here.  I would be confident that you are not putting your GF at risk through unprotected sex.  Regarding your other questions:

1.  I would agree that with a normal U/A prostatitis is unlikely.  As mentioned above, prostatitis is not an STI.

2.  I agree with your doctor about M. genitalium.  it is uncommon and when it is present and needs to be treated, it causes symptoms other than those you report.

3.  If you acquired HSV, symptoms would develop within 5-9 days after exposure.

5.  HPV is complex.  For more general information on HPV I suggest that read other posts on this site regarding HPV.  The short answer(s) however is that most sexually active adults have HPV whether or not they know it, that HPV is usually asymptomatic, that when HPV causes warts it take several months for the lesions to appear and that the encounter you describe was low risk for HPV.

Put another way and to use your words, I would urge you to accept that you are "in the clear:".  EWH

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