[Question #8149] Post contact anxiety - Chlamydia/Gonorrhea
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48 months ago
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Hi Docs
Looking for some advice here, I am worrying myself to pieces here over an encounter and sequence of events as follows:
- 2x instances unprotected oral and short duration unprotected vaginal sex 11 days ago with american female, 41 yrs old
- I had some antibiotics in my house from previous unrelated events and right away took one 1200mg Rifampin dose and 300mg of tetralysal twice a day for 7 days
- Had sex with my regular female partner 5 days after the event, 5 days into taking the tetralysal and the one off Rifampin
- I haven't had any discharge but have had a vague sore throat and some irritation on my penis head and vague ache in my testicles
I'm terrified that I have acquired Chlamydia/Gonorrhea from the encounters and that the antibiotics have had no effect and that I will have passed these onto my regular partner. I'm trying to tell myself that there are other explainable reasons for the penis irritation (was very active last week in terms of sports in new tight fitting shorts) and that I'm experiencing genital anxiety but can't think about anything else and am driving myself crazy with terrifying worry and anxiety.
Today I've submitted a urine sample via a postal test provider and am praying for a negative result within the next few days but just can't get out of my mind the potential trouble I have caused and stupidity in my actions.
Would really appreciate a view on the likelihood of these symptoms I think I'm feeling realistically being able to persist after the antibiotics I took early on.
Many thanks
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Edward W. Hook M.D.
48 months ago
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Welcome to the Forum and thanks for your question. I'll do my best to provide information. To be honest you did not help yourself by taking antibiotics. Both of the antibiotics have very modest activity against gonorrhea and better activity against chlamydial infections. Given the dose and duration of your tetracycline ingestion, chlamydial infections are not a concern. OTOH, as a rule, it typically takes lower doses of antibiotics to prevent infections when antibiotics are taken soon after an exposure as you did right after the exposure.
Here are a few other facts which may be helpful in assessing your situation:
Your partner is of an age when STIs such as gonorrhea and chlamydial infection are quite uncommon. Other common STIs such as trichomonas do occur and depending on your partners behaviors may or may not warrant consideration. FYI, the antibiotics you took have no impact on trichomonas.
Oral sex is lower risk than vaginal sex. Trichomonas is not acquired from receipt or performance of oral sex. Chlamydial infections are rare with oral sex. Gonorrhea does occur with oral sex and while not that unusual is less common following oral sex than following genital exposures.
Unprotected is unprotected. While it is common sensical that briefer exposures may be less risky, there are no scientific data to assure us that this is the case.
Symptoms. Oral STIs rarely if ever cause symptoms and both irritation of the head of the penis and testicular "ache" are more typically of anxiety-heightened observation of normal sensations than any STI. Had you acquired gonorrhea, you would have most probably developed symptoms by now, 5 days after exposure.
Bottom line/summary. Your risk for infection with any STI from these two exposures is low but not zero. I cannot provide a specific numerical assessment of your risk. Chlamydial infection should not be a concern. The symptoms you are experiencing are unlikely to represent any STI. I anticipate that your test results will be negative.
I hope that these comments are helpful. If there are further questions or anything I have said needs clarification, please don't hesitate to use your up to two follow-ups for clarification. EWH
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48 months ago
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Thanks doc, that’s very helpful and certainly helped put my mind at ease.
Perhaps predictably, my mind has already gone to thinking I’ve had a mild sore throat the last week or so and that my urgency to urinate are indicators that gonorrhea may be at work.
I’ve read your other posts on this forum instating that frequent urination is not an indicator for STIs… is sore throat really a common indicator for gonorrhea? Is discharge a common indicator? I’m pretty sure I would have noticed discharge in my heightened attention to my genitals…
Thanks!
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Edward W. Hook M.D.
48 months ago
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Thanks for your follow up questions.
Most oral gonorrhea is asymptomatic. Most symptomatic so threats are caused by common every day non-STI viruses.
You are also correct that urinary frequency is not a typical sign of STI’s. On the other hand, a urethral discharge in men is typically due to the presence of an STI.. Having said that, let me caution you against vigorously examining yourself or searching for a discharge. It is normal and typical for a modest amount of moisture to be readily visible when the urethra is examined. If a discharge were present, it would typically be obvious and would not require any squeezing, prying apart the opening to your urethra or other manipulations.
I hope these clarification so helpful. EWH
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