[Question #7362] Chlamydia Risk Assessment

5 months ago
Hello. I recently did something very stupid and had unprotected sex with an acquaintance a little over two weeks ago. I honestly did not expect it and while I wasn’t intoxicated, the details are kind of a blur to me because it was not something I anticipated happening. I can’t really say what the duration of intercourse was, but I do know that he did not ejaculate inside of me. I’m a 34 year old female and he’s a 40 year old male.  While he’s not a stranger, I wouldn’t say I know his personal history extremely well. 

This has been weighing on me because, while we may be separating soon anyway, I am married. My husband and I have had very little sex this year and there is not a concern for STIs there. I also have not had sex with my husband since well before this recent exposure. I had chlamydia in the past and I’m sort of having what I’d almost describe as PTSD from that experience. I’m extremely nervous to test. Yesterday I started noticing some vaginal irritation that feels almost like a yeast infection (which I do get somewhat frequently), and now I’m terrified about this encounter.  In the past, I’ve actually had similar symptoms without any real diagnosis because I get so anxious about potentially having chlamydia again. 

I guess my question is how likely it is to contract chlamydia from a single episode of vaginal intercourse with a male if there was no ejaculation (assuming he has it, which I have no proof of).  Also, is general vaginal irritation a common symptom?  There is no discharge. I do realize that it can be passed without ejaculation and that it’s not impossible.   I am considering testing anyway, though I can’t foresee being sexually actively again any time soon, although the thought of just having the test again makes me feel nauseous. In fact, I even get nervous about the test and the results when it’s routine (for example, they tested me before I got my IUD) because I recall the positive test results years ago. Thank you. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
5 months ago
Welcome back to the forum. Thanks for your continued confidence in our services.

On one hand, this could have been a very low risk exposure. But lack of ejaculation probably doesn't matter much one way or the other. The main thing that makes this riskly may be your overall sexual lifestyle and your chlamydial infection a few months ago after what seems like a similar exposure history. Having had chlamydia once marks you and your social network as one at likely higher than average STD risk.  This gets into the concept of sex partner networks. Once someone who has a particular network of friends, co-workers, and other acquaintainces that includes sexual exposureds, having chlamyida once makes the risk of another infecrtion far higher than it would be otherwise. In other words, having had chlamyida once after such an event makes it more likely you also have it now. That doesn't mean you're definitely infected -- in fact, I would expect your test to be negative. But you cannot take the chance.

I don't understand your statement "I’m extremely nervous to test." You know you have no choice; you just have to do it. When people delay necessary medical tests for fear of the result -- not just STD or HIV testing, but also things like mammograms, colonoscopy, etc -- anxiety always declines when the test is finally done, even if the result is the feared one. Not knowing and worrying about it are more stressful than knowing, even with a positive result. And for chlamydia, it's no big deal -- treatment is easy and effective. We're not talking about cancer or something highly dangerous, at least not in the short run. So just do it! When you do, also make sure gonorrhea testing is included (it's usually automatic with chlamydia testing).

In the meantime, speak with your partner from two weeks ago. It would be reasonable for him to be tested as well, and to be aware of your concerns.

Your symptoms don't help at all. Your anxieties about this may be the main reason you're aware or concerned about your minor symptoms. Anyway, chlamydia doesn't usuallly cause itching and irritation.

That's all I'll have to say unless and until you have been tested and report the result. I'll be happy to comment further at that time. Good luck.

HHH, MD
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5 months ago
Thank you for your reply. It did push me to get tested right away instead of delaying further. Results for both chlamydia and gonorrhea were negative, and I do have a yeast infection.  My partner doesn’t have his results back yet but I am pretty confident they’ll be negative as well. 

I will certainly re-evaluate the way I conduct myself in the future to avoid this type of emotional and physical stress. Believe it or not, I am typically very health conscious and this is just a reminder of why I can’t allow myself to be pressured into things. 

However, thanks again for the reply and the push to get the test done without delay. That saved me from agonizing over it for longer. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
5 months ago
Excellent -- I'm glad you were tested and for the happy result. Thanks for the thanks-- I'm glad to have helped!---