[Question #8638] Latest information needed / concern for wife
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41 months ago
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Hi Doctors.
I’m really sorry to be here and asking what is undoubtably a boring question for you. I have tried not to ask because I know this is the most asked question on the site and loads of information already on here (even recently) but I do find my self reading differences of opinion and that is because each situation is different so I need a risk assessment for myself.
My situation is the unprotected oral sex one. This happened over a year ago at a Xmas party. No idea how I’m not gay but ended up in the toilet getting oral sex from a gay man (50’s but unknown man and no idea of history). I am married so I have relied on your site as well as others for comfort as testing is hard.
Luckily I have read and understood that my risk was low and in absence of symptoms that is probably safe to move on so that’s what I did.
However me and my wife are trying for a second baby and it’s not happening. Each month this continues the more worried I get I have introduced some kind of STI to the family from this event. Especially with us finding the first conception so easy.
I guess the single most common STI that would cause us to have trouble is Gonorrhoea. And this is the confusion I have read that it’s either 10%, 5% and 1 in a 1000 all quoted to be asymptomatic by Dr Hook and Hansfield. What’s correct with this. I find if it’s 1 in 10 or 1 in 20 then this is probably not as low risk as I have come to believe.
I’m a blood doner and they test for hiv and syphillis in the uk so happy it’s not that.
My wife’s period cycle has been fairly irregular late / early but that has settled down now.
Just wondering all been said. Whats the odds Of STI here and what do I need to do going forward. What would you advise?
Thanks
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41 months ago
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Just a quick addition. Sorry.
My wife around 3 months after the event got a cyst/lump in her vagina (sorry I’m no expert in women anatomy) but it was just in the inside toward the middle/top. It was not painful but uncomfortable and after about a week popped with no recurrence. Not sure if this is anything to be concerned around. My wife certainly wasn’t.
As far as symptoms go for the both of us this is it to date.
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Edward W. Hook M.D.
41 months ago
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Welcome to our forum. I’m sorry that you found the responses that Dr. Handsfield and I have provided in the past to be confusing. In fact Dr. Handsfield and I are in total agreement in terms of my responses and the proportions of infections that. Please realize however that your risk of acquiring an STI from receipt of oral sex on a single occasion is both context specific and very low. While I have said recently that somewhere in the neighborhood of 10 percent of penile Gonorrhea is asymptomatic in men, please also remember that most people do not have gonorrhea, particularly gonococcal pharyngitis, and the transmission of oral Gonorrhea, when present, to the penis is notoriously inefficient. As a result, while up to 10% of penile gonorrhea may be asymptomatic, your risk of having acquired gonorrhea from the episode you described is certainly less than 1% and probably more like one in 1000 (0.1%) or less. I certainly would urge you not to be concerned about the single episode that you describe which occurred over a year ago. At this time I see no reason for what you say for you to test.
I cannot comment on the cyst which me which occurred in your wife’s vagina in the past. This is something she should discuss with her obstetrician/gynecologist.
I hope this information is helpful. Please don’t worry. EWH
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41 months ago
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Thank you so much doctor.
It’s reassuring to have that assessment gave.
Once again sorry for the boring question.
Don’t worry I didn’t want you to comment on the cyst it’s long gone now and my wife is not concerned. I just read online about cyst been a sign of Gonorrhoea in women. So just wanted you to have a full picture. While you don’t want to diagnose it is it not a concern in regards to Gonorrhea ?
Finally our fertility issues are not a concern in your eyes?
Unfortunately I see no reason to test too as I have recently been hospitalised with Covid and while in hospital I got an infection that was treated with some very strong and broad antibiotics. So I doubt it would be any good anyway. So it’s a good thing you say not to be concerned.
Your saying move on without testing. And to be confident I haven’t introduced anything nasty into the family then I’m happy with that.
Thank you.
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Edward W. Hook M.D.
41 months ago
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If the cyst were related to gonorrhea or another infection it would not have resolved spontaneously.
No, I would not have concerns about your fertility issues in related to possible gonorrhea or any other STI related to the encounter you have describe.
I support your plans to move on without continuing concern. Take care. EWH
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41 months ago
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Thank you doctor very reassuring. Just to complete the thread and get my moneys worth so to speak can I ask a few questions? That may be slightly of topic but I would find it interesting to know.
Just for your information we have had a telephone appointment about our fertility issues and he has arranged blood tests and sperm tests he also wanted to do STI tests but my wife flat out refused so that’s not happening.
1) remember I said about my wife’s cycle been all over the place. Have you ever seen an STI show up this way.
2) my wife many moons ago did have chlamydia when we first started dating, she was surprised and it seems likely it was a long standing infection. She was treated and no test of cure performed (was told not needed) I’m wondering if this caused silent PID would the standard treatment for non complicated infection still clear this up, granted I’m aware damage may have already been done but I’m worried if they start doing tests, they find chlamydia pid I’m going to get the blame for that!
3) I can’t really force my wife to STI test without confessing. So I’m thinking of paying for private tests £200 for a battery of tests it seems I can do this under the radar using fake name and pay pal so my wife needent know, my main concern is if my wife had long standing chlamydia or recent ish gonnaria from me then I do need to rule that out and I hate playing the odds. My concern is after been hospitalised with covid and pumped with loads of antibiotics this would have cured me of any infection. We have only had sex 5 times since. Would you think I would have reinfected myself by now or is the £200 a massive waste of money (i know your feel that it’s a waste anyway, “not to test” but I rather not leave to chance)
4) if it does turn out she has PID or damage to her fellopian tubes, caused by old PID and because of her treatment at the time they don’t find chlamydia does this still class as an STI, my wife is a very suspicious person and would instantly point the finger at me (all be I’m not innocent)
5) PID can it really be silent? Or is that an internet myth. Would it cause obvious symptoms especially if causing problems with fatility. Should it be something to be concerned about.
Thank you doctor and look forward to reading your reply’s.
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Edward W. Hook M.D.
41 months ago
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I’m pleased to hear that you will be talking to your fertility specialist. I am disappointed that your wife refused STI testing, not because I think there is any meaningful chance that she has one but because it represents being thorough in her evaluation and would be reassuring to you. Onto your specific questions:
1. No, while irregular periods are often related to infertility they are not caused by STI’s.
2. Indeed, because of its asymptomatic nature chronic, silent chlamydial PID is a reality. On the other hand, I remain confident that any STI testing will show that there is no infection at this time., Recommended chlamydial therapy is very, very effective.
3. I suspect spending the 200 pounds is unnecessary. First, GUM clinics provide highly confidential, much more affordable testing. Secondly as you’ve already pointed out your anabiotic therapy would’ve likely cured a Chlamydia infection of present which I am confident it was not.
4. I’m not sure I follow this question. If chlamydia infection caused silent PID and damage to E fallopian tubes years ago it would be a sequela of her prior STI.
5. Yes, chlamydial PID can be silent and damage fallopian tubes causing infertility.
As you know, this completes this thread. I will leave it open for a few hours in case you want to comment on your discussions with your fertility specialist later today. Should he/she talk about the possibility of Pastor STI, be sure to mention your wife’s chlamydial infection in the distant past. EWH
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41 months ago
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Hi, we have both been to speak to the fertility specialist thanks for keeping thread open. To be honest it wasn’t anything like what we was hoping.
She took a blood test for my wife to check she is still ovulating. And I guess other tests wasn’t really clear.
Sperm test of mine sent to labs.
No physical checks on either of us some basic questions around symptoms etc belly pain, pain in testicals etc. which we haven’t had.
Says be in touch with results so maybe it will be a better chat when we have them. But was very underwhelmed.
STI never came up, I guess they are not concerned. But probably because my wife so strong in saying that we are both faithful but to be fair the doctor didn’t push it at all.
Unfortunately in the UK with the NHS they don’t do any further tests after this if you have had a baby before and we have so if nothing comes back on these tests then I’ll be forever wondering if I caused it. (All be it 1 in 1000 chance isn’t likely)
Sorry I got a bit confusing with PID - what I meant was if my wife’s chlamydia infection did ascend to PID would the normal dose of treatment still clear chlamydia ? The only reason I ask is I see the reccomened treatment for PID is much more heavy than a couple of tablets that my wife took.
Seems strange that we don’t do a test of cure if we need stronger longer meds to clear something that can be silent. Sorry I Just don’t get it.
If she got PID back then and now we found the scarring etc … would PID be diagnosed but cause unknown (as she dosnt have claymidia) or would a longer stronger antibiotic be needed as it’s more aggressive once accends (hope I’m making sense )
Anyway I don’t think there is much more I can do apart from get this oral sex mess out of my head - it really isn’t a realistic chance I agree with your maths and it helps. I’ll probably save my money and not test, maybe testing in a year to check I haven’t reinfected my self from my wife but certainly expect it to be negative.
Thanks for your help doctor.
Any help hints tips or next steps will be appreciated but not expected. Thank you
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Edward W. Hook M.D.
41 months ago
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Thanks. Final response. There is a tendency for health care providers to treat more serious infections (like PID) longer than uncomplicated infections. Whether or not that it necessary is unknown. I would be confident that between the treatment she received and her immune response, your wife was cured.
Take care. EWH
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