[Question #6899] Testing timeliness and anxiety

11 months ago
So unprotected oral and vaginal sex with different than usual partner March 7. Anxiety takes over, most likely cpps / anxiety induced symptoms, take 1g zpack on March 14, then get a full panel test done on March 17. Comes back negative on all C, Gon, Syph. But I had brief oral sex with my long term partner on March 12. 
A. If I took the antibiotics on Saturday morning, would that have affected the test Tuesday afternoon  or if I had had anything would it have still shown up on the test? My concern is that I had something, passed it during the oral sex, took the antibiotics, tested clean then recontracted it from my long term partner during the following month. 
All my symptoms point towards cpps / genital focused anxiety - no burning during urination, just hyper focus on genitals and any feeling that comes to them, feel a light irritation while sitting down or focusing on the head of my penis ( usually whatever is touching it, boxers, pants, etc) but usually goes away when I stand up or and moving around not focusing on the event.  They've come and gone over the last few weeks, and sometimes seem much more real then other times, then fade away entirely for hours.  Sensations are gone in the morning when I wake up but then I start thinking about emerging and the "symptoms" come back. no discharge  over the last 2 months. 
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago

Welcome to our Forum and thanks for your question.  Thanks as well for your thoughtful analysis of your situation. 

The exposure you describe was very low risk - most people do not have STIs and even when they do, most single exposures do not lead to transmission of infection.  The azithromycin you took, while probably curative if you had chlamydia and likely (but not 100%) curative for gonorrhea and syphilis would not have prevented a positive test for gonorrhea or chlamydia 2-3 days later.  Further, the symptoms you describe are not those of an STI.  The timing and nature of the symptoms you describe suggest that your "hunt" for signs or symptoms is leading you to detect normal sensations which would normally go unnoticed.

I hope that this response is helpful.  EWH

---
11 months ago
Dr Hook. Thank you for your time and timely responses. Just a quick follow up. 
I'd there any condition I should be aware of that would cause urethra irritation or a mild burning while sitting but not standing / walking around or come and go but no other symptoms ie. Painful urination or discharge? 
It's just hard because the feeling just seems to have settled on the underside of my penis below the tip but again only really while sitting. Thanks again and sorry for not being able to move past the anxiety
11 months ago
Is it worth picking up an AZO WBC test from.the drugstore?
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago
Positional change in symptom intensity is not a characteristic of any STI.  On the other hand, symptoms which intensify while sitting or during quiet periods may be a manifestation of genitally focused anxiety which occurs as worried persons note otherwise normal sensations.  Such symptoms are typically itching or tingling.

OTC tests for WBCs are insensitive.  I really see no benefit to be derived from such testing.

I hope that this response will help you move on from your concerns.  EWH 
---