[Question #7477] Concerned

4 months ago
Hi Doc,

I recently had a bit of a MSM episode where I engaged in the giving side of oral sex to him. I went away feeling very guilty and quite ashamed. I am a married man with a 1.5 year child. 

Out of guilt I went a head and tested top to toe for all at a clinic in Melbourne. To my surprise I had oral gonorrhea.. I was promptly treated and tested after to ensure it had passed and was good with the antibiotics recieved all ok. 

I am concerned that my missus might have contracted it from me. We had protected sex at arounweek later and I was in the heat of the moment kissing her upper thighs and pelvic bone near her vagina but not directly on it. I am concerned as the doc I saw warned me about deep kissing as a possible transmission which we did not do. She has experienced pain in her vagina since giving birth this is when we are having sex she said last time it hurt and felt like stretching deep inside her she is still breastfeeding. I am worried this is a sign of infection with gonorrhea as I've read it can cause pain with sex as far as I know she hasn't had any other issues.

Any help would be Stella! 

Cheers 
4 months ago
Oh to clarify the sex was a week after the exposure not the treatment.
Edward W. Hook M.D.
Edward W. Hook M.D.
4 months ago
Welcome to the forum and thanks for your questions.  I’ll be glad to comment.  If you received your care at the Melbourne sexual health clinic, you are receiving excellent care.  This clinic is renowned for the work they do.

Gonorrhea transmission from oral infections through deep kissing (to lead to oral infections in partners) or to other body sites through performing oral sex on an uninflected partner is well described but how efficient (I.e. what proportion of infections are transmitted per exposure) remains unknown.  Cunnilingus is thought to be an inefficient means of transmission.  It is likely however that the major of such exposures do not lead to infection.  If your tongue did not enter her vagina or mouth, itransmission of your oral infection is most unlikely.  Of course, the only way to know if your wife is infected and where she might be infected would be for her to be tested although, in my opinion, it is not needed in the circumstance you describe.

As far as your wife’s discomfort during intercourse, from your description of the “stretching “ sensation is consistent with just that, particularly if you have not had sex recent and she recently delivered.  Lubricant gels should help this.  If they do not, she should see her OB/Gyn.
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3 months ago
Thanks Doctor, no tongue at all.

One last question re testing i have a NAAT test at the clinic i went to made sure it was the first part of urine but I reckon I had peed about 20 mins before.. does that make a difference to the accuracy? 
Edward W. Hook M.D.
Edward W. Hook M.D.
3 months ago
It is recommended that persons collecting urine for Gonorrhea/chlamydial testing wait an hour or more before collecting a specimen for testing.  This is based on theoretical concerns that the time interval allows the bacteria to accumulate in the urethra, improving the accuracy of the test.  Whether this truly makes a difference however is unknown.  I should add however that if your only exposure to your MSM partner was performing oral sex on him, you are not risk for having urethral infection.  As discussed above, there is close to no risk that you transmitted Gonorrhea from your mouth to your wife before you were treated.  EWH ---
3 months ago
Thanks Doctor yes that was all I did. I was just wondering as I've never been told before to wait a certain time ive just always peed whenever I was testing. So just to clarify would it make a difference? Also why is there a recommendation for treatment even if your test is negative when possible exposure? Cheers and Merry Christmas 
Edward W. Hook M.D.
Edward W. Hook M.D.
3 months ago
As you know, we provide up to three responses to each client’s questions.  This is my third response.  Therefore, the thread will be closed shortly following this response without further responses.

The recommended time interval has not been studied and is theoretical.  It would be unlikely to make much difference in the accuracy of the test.  Finally, to be honest, it is probably irrelevant to your situation   The treatment you received for oral infection would have certainly cured urethral Gonorrhea.  

Treatment for persons known to be exposed to a partner with an STI is recommended to assure that there is no delay between finding out about an exposure and the time it may take to get tested and receive test results.

This completes this thread.  As I said before, time for you to move forward.  Please don’t worry. EWH 
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3 months ago
Thanks Doctor merry Christmas and Happy New year.