[Question #6212] STD Risk from Receiving Cunnilingus

69 months ago

I am a 41 year old woman. Approximately 9 days ago, I received unprotected cunnilingus from a 49 year old man. About two days later, I noticed the symptoms of what seemed to be a vaginal yeast infection and burning/tingling sensation in my arms, hands, legs, back, and on and around my buttocks.

I have been treating the yeast symptoms accordingly (Monistat), candida cleanse and probiotics, and I seem to be doing better in that aspect. I have also been checking for sores and have not found any.

I am concerned about my risk of exposure to the most concerning STD's that can be contracted from receipt of cunnilingus (HSV, gonorrhea) and am also wondering if cunnilingus can spark a yeast infection. I am so frightened and have not been able to eat or sleep. I have read posts that say the likelihood is relatively low, but I am freaking out!

Edward W. Hook M.D.

69 months ago

Welcome to the forum and thanks for your question. I'll be glad to comment. As a generalization, receipt of cunnilingus is a low risk event. Not all STIs are seen in the pharynx and when they are,rates tend to be low. Further, biologically, cunnilingus is an inefficient way to spread infections. This is not to say that infections are not spread in this way but it is quite rare. I am confident that the tingling you describe is not due to an STI. As for the cunnnilingus causing yeast infections, while we do know that there are yeast in most people's oral cavities, transmission through cunnilingus is not described as a common occurrence.

Bottom line. Your risk for acquisition of any STI from receipt on cunnilingus is very low. I doubt that you were infected but, if you are worried, testing is easy. I am confident that if you get tested, the tests will be negative. As far as herpes is concerned, if you were going to develop herpes from this occurence, you would have developed lesions by this time.

I hope these comments are helpful. I'm glad your yeast is getting better. Please don't worry. EWH

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69 months ago

Thank you so much, Dr. Hook! Are there any symptoms or signs I should look out for that would change your assessment of my risk?

Edward W. Hook M.D.

69 months ago

Signs and symptoms are notoriously unreliable. As I said above, your risk of infection is quite low and personally, I would not worry You noted however that you were quite nervous If that is the case, you might want to get tested for gonorrhea and chlamydia for the peace of mind that a negative test would give you (I am confident that the tests would be negative). I see no reason for any concern, or testing for other STIs, including HIV, syphilis, and herpes.

I hope this helps. Again, I would only test if you feel you would benefit from the peace of mind a negative test will provide. EWH

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69 months ago

Hi Dr. Hook,

Thanks again. With my last follow-up, I wanted to share recent developments and ask some closing questions.

1. I did a urine test for chlamydia and gonorrhea. The test came back negative (as you indicated), but the lab tech did not instruct me to do the first catch or indicate how much urine to collect. I've read some of the posts regarding this issue but I wasn't sure if the posters were male or female and if that even matters with the timing and amount of urine collection. I wanted to confirm the validity of my results based on the specimen being midstream and perhaps more than an ounce. Would either of these factors impact the validity of my results? If so, should I be tested again or do a cervical test?

2. I'm still experiencing some vaginal irritation, which may be due to residual yeast but I'm not sure. In your first response, you shared that if herpes were at play I would have developed lesions by the time of my original post. Again, I have not found any. In your view, can I feel relatively safe that herpes is not an issue?

I apologize if I come across as paranoid or irrational. I would like to resume a normal, healthy sex life with my husband but cannot stop obsessing about this encounter. Thank you again for all of the help and counsel you have provided. Please continue the great work!

Edward W. Hook M.D.

69 months ago

Thanks for the follow-up. Comments below:

1. The reassuring data on the sensitivity of mid-stream urine tests for gonorrhea and chlamydia come mostly from men. In addition, it women the sense is that a voided urine could miss up to 10% of infections when compared to a patient collected vaginal swab, the preferred test. While I sincerely doubt that you have either gonorrhea or chlamydia, as you note and describe your own "obsessing" over this, it might be better to re-test, this time with a self-collected vaginal swab.

2. Correct. Nothing about your symptoms suggests herpes. Please put that concern aside.

Hope this helps. As you note, as per Forum Guidelines, this thread will be closed shortly without further response. I hope that my comments have been helpful to you. EWH

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