[Question #6268] Practiced safe sex, but odd coincidence - should I still get tested?

18 months ago
I'm a straight male and I'm with a partner, but have been seeing less than a half-dozen escorts (mid-higher end female escorts, all white, in the west coast) for the past few months.

I've always used a condom for penis-vagina sex and I'm covered even when I receive oral. Once an escort spat on my bare penis while giving me a handjob but  I don't do anything else - no kissing, no cunnilingus... nothing. The condoms never broke (or at least I didn't notice it breaking).

A few days ago, my partner felt itching on her vagina and noticed it was irritated and red. She went to the gyno and the gyno took a swab and said turns out it was a yeast infection, although it was odd in that the gyno said it was really hard to see since there were only trace amounts. The gyno gave her two pills to take. During this same time, the tip of my penis has felt weird, almost like a tingly sensation with a very slight itch. It comes and goes and honestly is barely noticeable - making me wonder if it's in my head or not.

The yeast infection pills my partner has taken has cleared up her vagina (it's been 3 days) for the most part but she still feels a slight tingle.

My questions are
  1.  Is it possible the red/itchiness on my partner's vagina was NOT from a yeast infection, but rather (or in addition to) an STD?
  2.  Is the weird tingle / slight itch on my penis head yeast infection that I received from my partner, an std, or just something in my head?
  3. Based on the totality of the circumstances, would you recommend me getting tested, to see if it's possible that I have an std?
18 months ago
To clarify: I use a condom with the escorts but am unprotected with my partner. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
18 months ago
Welcome to the forum. Thanks for your question.

Genital yeast infections are extremely common in women -- probably almost all women have yeast infection at one time or another, often several times. Second, yeast symptoms are typical and diagnosis straightforward -- even if yeasts cannot be easily seen under a microscope (the usual test in doctors' offices). And her nearly complete resolution of symptoms in 2-3 days is additional evidence the diagnosis was correct. So almost certainly your partner indeed has a yeast infection, and no STD. There is no reason to suspect her problem has anything to do with your outside sexual activities. Also, it is common for the male partners of such women to get penile rash or irritation due to the yeast. It will clear up as her infection resolves; or maybe hold off on sex with her for a couple more days.

Those commetns address questions 1 and 2. As for STD testing, I would always recommend periodic testing for anyone with your sexual lifestyle. With consistent condom use and the type of partners you describe (probably low risk for active STDs), the chance you are infected is very low. But it isn't zero, and it would make sense for you to have a urine test for gonorrhea and chlamydia and blood tests for HIV and syphilis, perhaps once a year or thereabouts. Assuming you have not done this in the past year or so, this would be a good time, while it's on your mind. Not because of your partner's symptoms, but just as common sense practice. You can expect negative results, but better safe than sorry!

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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18 months ago
Thank you doctor! What you said makes a lot of sense and you're right I should probably get tested just as a matter of habit.

Out of curiosity and better understanding of the odds of transmission - you mentioned that the odds of someone like me having an STD is not zero. Forgive me for asking (I'm a stats major and a Vegas man) but what would you put the odds of me having an STD?

From what I understand, ghonorrhea, chlymidia and HIV can only transmit if the condom is broken (which I don't believe has happened to me) and syphllis is extremely rare in the west.

I'm curious to see what theoretical possibility could leave me in having an infected. (Just to better understand transmissions)
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
18 months ago
Sorry, I really can't put a number to your risks. True that intact, properly used condoms are virtually 100% protective against gonorrhea and chlamydia, and indeed heteroserxually transmitted syphiils is rare in most of the country, including western states. But exceptions occur, as do unrecognized condom failures. Looked at another way, "safe sex" has never been 100% protective (except for sexting, phone sex, or masturbation). As I said, you can expect negative results, but it still makes sense to be tested periodically as long as your sexual lifestyle continues as it has been.---
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17 months ago
Thanks doctor that makes sense. 

Regarding my SO, she took two pills 24 hours apart for the yeast infection (doc said she probably only needed to take 1 since it was mild). She felt better and it seemed to have gone away until today (12 days after treatment first began) when she felt irritation and itchiness again and noticed a few bits of white specs around the vagina and this whiteish discharge-like substance inside her vagina that doesn't come fully out but is visible when she pushes. 

Now my concern is that the yeast diagnosis was incorrect and it's more likely an STD. Is this possible and do the symptoms sound like any STD?


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
17 months ago
The drug she was given is fluconazole (DiflucanĀ®). The clearly good response confirms the diagnosis and there is no reason to suppose your SO has anything else. I can't comment further, except that a) the amount and character of women's vaginal fluids is highly variable, b) it can take time for the vaginal ecosystem to readjust after treatment of any infection, and c) if she is a bit anxious about having had the yeast infection (or if maybe she has her own valid suspicions about you??), perhaps anxiety or other emotions are influencing her interpretation of minor vaginal changes that make no important difference.

For the reasons discussed above, presumably you are having routien STD testing. Obviously if anything turns up, you'll have to discuss it with your SO. And regardless of those test results, of course she should return to her doctor if she believes her vaginal discharge or other symptoms are not normal or if she otherwise remains concerned. But based on the finromation available so far, I doubt she has an STD.

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the disucssion has been helful.
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