[Question #8628] chlamydia
41 months ago
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mar 2019 ( 3 yrs ago) - stripper gave HJ with saliva, saliva was in contact directly with urethra. 3 months later had normal physical and urinalysis, all normal. 18months later ( sept 2020 ) wife goes to OB and tells him we are going to try for a baby. he said went ahead and did some of the prenatal testing ( including chyl/gono ) both came out negative for her test. 4 months AFTER baby is born so almost 2.5 years after the strip club visit, she has some pale yellow discharge for a day or so.( her OB said could be ovulation starting back and wasnt concerned as long as it didnt smell painful/burn etc ) then 2 months after she has discharge I have a few days of burning at the tip of my penis only during urinations, no discharge at all. few days after burning stopped went and got naat test, negative for chly/gono. just a few weeks ago wife has pelvic exam with yearly pap no issues where found and pap was normal. i only concerned with Chlamydia. questions: 1) I know chlamydia is not as rare in the throat as once believed but still not common. what are the odds of it being transmitted through spit? also how rare is it in throat? 10% 1% less? also Dr hook stated new research found in the throat its not "vaiable" would that mean most of the time when its present its not transmittable? it detectable but not a TRUE infection that's active? 2) we always had unprotected sex BUT i always pulled out. when she was tested for chy we weren't trying for a baby yet so I was still pulling out. if I wasn't ejaculating in her could I have transmitted it? what are the odds of this? me having it for 18 months without sym. but not giving to her yet bc I was pulling out? can it transmit without ejaculation. then giving to her after I start to cum inside for pregnancy but i cleared it by the time i tested and she still has the infection? 3)what are the odds i would have it without symptoms for 18 months before her test? how long can it be asymptotic? forever? or will you eventual get them?
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Edward W. Hook M.D.
41 months ago
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Welcome to our firm. Thanks for your questions. I hope the answers I’m about to provide will provide you with the reassurance you need. You have provided abundant evidence above that you did not acquire chlamydia through the low risk encounters you describe years ago and there is no evidence that your wife was infected either. You both of been tested with some of the most sensitive tests for detection of micro organisms in all of medicine (NAATs tests) and had negative results. Those results should be believed. Without background let’s go to your specific questions:
1. I think you are over interpreting the what you have read. In fact, chlamydia is rare in the throat. In our recently published study of over 2000 men and women at risk for acquisition of gonorrhea and chlamydia, only 0.8% had chlamydia in their throat as opposed to nearly 6% who had gonorrhea. For reasons that are scientifically and clear chlamydia does not seem to like to infect the throat. My way of contrast, please remember that in the genital and rectal sites chlamydia infection is typically 2 to 3 times more common than Gonorrhea.
Further, when chlamydia is acquired in the throat is acquired by through direct contact. Saliva does not transmit gonorrhea or chlamydia, particularly when it is transferred from one persons mouth to another persons genitals on their hands. Hand to genital transmission of STI’s does not occur.
Finally let me remind you that even in the unlikely scenario that the stripper you mention had chlamydia, most exposures to infected partners do not lead the transmission. When you combine the low overall prevalence of pharyngeal chlamydia, the biological inefficiency of transmission to the throat, and your negative test results there is abundant evidence that you did not acquire Chlamydia from the encounters you’ve described above.
2. This question is irrelevant since there’s no evidence that you had chlamydia. That said it is perhaps worth pointing out for your knowledge and that of others who may read this post that STI’s can be transmitted without ejaculation. Withdrawal does not prevent STI transmission.
3. While most chlamydia infections clear from infected persons even without therapy over a period of weeks to months, a small proportion of infections may persist for longer periods of time. Once again, as mentioned above, given your and your wife’s negative test results, there is no evidence that you were infected.
I hope the information I provided is helpful to you. I find myself wondering why, years after the encounter you describe above and after negative tests, these questions have arisen. I hope my explanations will help you to move on. There is no indication or reason for additional testing or concern of any sort. EWH
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41 months ago
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Dr hook, thank you for the reply. The reason my concern has come to me after all this time is because of the recent symptoms in my wife and I. Yellow vaginal discharge ( sign of chy) then 2 months later I have a burning sensation on urination ( another std sign) with chlamydia commonly being asymptotic this started my recent fears. Just to clarify a few things. I know in science and medicine you can never say never but your best educated guess from your knowledge what do you think the chances are of the following: which is my concern based of the recent symptoms as a couple we have had. My concern is I didn’t transmit it to my wife until after she was tested then i gave to her, she has yellow discharge etc. she gave it back to me and that’s why I burned etc but I waited a few days after the burning stopped to get tested so couldn’t I have cleared it again? Not showing positive on test when I took the test? And she still has an active infection? What are the odds of this in your eyes as an expert in this field? I know you cant say 0 bc I could also be stuck by lighting BUT is it the similar odds.? I just thinks it’s wired we both had symptoms of an std around the same time. Also she has some irregularities to her cycle after the baby but then again I know that can be normal after birth. Trying to put all possibilities out of my mind.
Also, I have a more irrelevant to my situation question that through studying all this made me curious. If stds aren’t spread through saliva then how does a std go from throat to cervix? Without saliva being involved isn’t that pretty much impossible? Please understand I am not trying to argue but only trying to understand how it’s possible for chy/or gono to be transmitted that way without saliva being involved. Do you ever see cases of stds from oral sex preformed on a vagina? Thank you again for all the insight from the first response.
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Edward W. Hook M.D.
41 months ago
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Much of your follow up is repetitive. The answers will not change, nor will your test results. Your are seriously overthinking this, perhaps fueled by guilt. You do not know the stripper had an STI ( and certainly the activity she performed for you was virtually no risk), both your and your wife’s symptoms are nonspecific, and you both have negative tests.
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Transmission in saliva OR by masturbation is virtually unheard of, as is spreading chlamydia through cunnilingus.
No change in my assessment or advice. Your options are to test again (I’m confident it will give negative results), seek mental health counseling for your unwarranted, perhaps guilt driven concerns, and/or talk your concerns through with your wife. EWH
41 months ago
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thank you, Dr. Hook. I am pretty sure my wife and I are in the clear based off your statements. I was not trying to over think this, but my only concern was Chlamydia from it being generally being asymptomatic and body able to clear infection naturally. I had come up with a possibility of ping pong it back in forth and since we were tested 18 months apart that maybe it was missed. thanks for clearing it up for me and appreciate your time answering the questions. If I may ask a few questions just for my own knowledge's sake (when trying to research all this on the internet it is amazing how much conflicting information you can get) so wanted to know the facts based off your expertise. (it's hard to get clear answers online) then we can end the thread if that's ok.
1) how long do males usually take to clear chlamydia without treatment? for example would 50% have it over a year or only 5% still have it over a year long? I know woman can carry it for years but how long can men carry it before they clear it?
2) if a male carried it for a long period of time, wouldn't they eventually develop symptoms? or can a male have an infection for years and not know it?
3) as you pointed out chy of the throat is rare. is there any data on transmission rate from throat to penis when in contact with infected person?
thanks again for the help. I apologize if I was overthinking this i just didn't understand the likely hood of missed infections being asymptomatic etc. then we are both tested but being so far apart, just didn't know if we could have been cleared at the time of our individual test, but other person had an active infection etc. I'm going to do my best to move on and not over think the issue with unrealistic sitautions. thanks again.
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Edward W. Hook M.D.
41 months ago
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Thanks for your follow-up questions. As you know we provide up to three responses to each clients questions. As this is my third response this will be will conclude this thread which will be closed a few hours after I submit this response:
1. Data on the rate of spontaneous clearance of chlamydial infections are limited. As you point out there are far more data for women than men. Men may clear the infection more quickly than women but this is not certain. As a generality, within 2 to 4 weeks of diagnosis of infection about half of chlamydial infections have cleared. This information has been determined by people who test positive and then take that amount of time to return for treatment.
2. There are even fewer data to inform you on the time course development of symptoms. Many people with asymptomatic infections however do become symptomatic over time. Please remember that some of the symptoms we’re discussing our subjective and different people have different thresholds for what they call “abnormal”
3. There are no specific estimates of what proportion of chlamydial throat infections can be transmitted to another person channels following a single episode of oral sex. The rate is certainly low, less than 5% of the time.
I hope the information I provided is helpful. Take care. Please don’t worry. EWH
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