[Question #6200] Real Concern or Anxiety

17 months ago
Hello doctors,  I'm hoping you can help ease my mind about an incident I had.I am a 32 year old married male.  On Thursday 10/17, I received unprotected oral from a 49 year old, married, white female while on a business trip, big mistake that i regret.  She says she is clean.  The next day i felt some irritation at the tip of my penis and had frequent urination.  I would describe the feeling as a mild itch inside the tip.  It isn't a constant feeling and I've had no discharge of any kind that I've noticed and no painful urination.  I haven't noticed any bumps or sores either.  

On the evening of Sunday the 20th I took 1g of Azithromycin, the next morning I took 400mg of Suprax.  An online doctor prescribed them for me as a precaution based on these apparent symptoms.   On Tuesday the 22nd, about 4 and a half days after the incident, I took a urine based test for gonorrhea and chlamydia, the result of both of those was a negative.  I received a urinalysis at my regular doctors office yesterday as part of my yearly physical.  The doc said there were no signs of bacteria or WBC in my urine and everything was normal, only trace amounts of Ketones were found. 

I have read on this forum that Trich is not transmitted by receiving oral sex so I was not concerned with a test for that.

Today I resumed unprotected sex with my wife, that is 5 days after taking the Azithromycin and 4 days after the Suprax.  I'm still feeling a bit of a tingle at the tip of my penis but nothing else in regards to a potential symptom. Could this be anxiety based?
1.  If I had been exposed to gonorrhea or chlamydia, would the medicine I took have been enough to cure both of them?
2.  Are my negative test result reliable?
3.  Could I have been exposed and cured by the meds, resulting in the negative test result?  And if that is the case, is my wife at risk of exposure given that I finished the 1g Azithromycin 5 days before and the 400mg Suprax 4 days before we had sex? 

Thank you
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago

Welcome back to the Forum and thanks for you question. Before I address your questions, let me point out that your partner, on the basis of her age, marital status, and self report was low risk for having any STI. Further, for any sort of single exposure, most exposures to infected partners do not lead to infection.  Finally, amongst possible sexual activities, receipt of oral sex is relatively low risk for STI acquisition.  To these statements, I would add that no STI would cause symptoms only 1 day after exposure and that neither tingling nor urinary frequency are symptoms of STIs.  Thus the likelihood that you were infected are miniscule.  As for your questions:

1.  If I had been exposed to gonorrhea or chlamydia, would the medicine I took have been enough to cure both of them?
Yes

2.  Are my negative test result reliable?
Yes

3.  Could I have been exposed and cured by the meds, resulting in the negative test result?  And if that is the case, is my wife at risk of exposure given that I finished the 1g Azithromycin 5 days before and the 400mg Suprax 4 days before we had sex?
This is another way of asking questions 1 and 2.  The answer does not change.  You should believe your test results and not worry that you had an infection that was missed.

Hope this helps.  EWH


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17 months ago
Thank you for the answer doctor.  In your opinion then my wife is at no risk?  Also,  is it true that trichomoniasis is not transmitted from oral sex? 
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
Correct, your wife is not at risk for STI from your recent dalliance.

You are correct as well that trichomoniasis is not transmitted,by oral sex.  EWH
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17 months ago
Thank you doctor.  In your opinion is there any need for additional testing or concern?  Could these apparent sensations be anxiety or guilt based?  
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
Already answered.  There is no reason for further testing and no reason for concern.  

The tingling sensation you are experiencing could very well be due to anxiety/guilt.  I would not worry further about the possibility of having been infected with an STI. 

THIS IS MY 3rd response to your question.  Therefore, as per forum guide lines the thread will now be closed.  Take care.  EWH
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