[Question #8645] STI risks from these behaviors
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41 months ago
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Dear doctors:
Today I was flabbergasted to learn from my wife that she has an infection in her Fallopian tube. It seems most such infections are caused by gonnorhea or chlamydia, and she is adamant that she has had no other partners. The only sexual conduct I have had that I have had with anyone else where happy ending massages, a couple of which a finger was inserted into my anus.
Prior to that, the last interaction I had apart from her was covered in my Fall 2018 question #4404 (very brief receipt of fellatio). I got an STD test and was told it was negative. Some years prior to that I had performed analingus on someone and gotten a negative STD test. I beleive both tests included for gonorrhea and chlamydia. By memory, they were urine tests, not blood draws.
So the questions are, is it possible the recent incidents could have given me either disease, with no symptoms. Otherwise, is it possible these incidences from 2018 and before (also no symptoms) could have had false negative tests and that I years later am infectious with one of these infections? In short, is it possible these could have led to me giving my wife an infection which is presenting now? Her symptoms are just some pressure inside but she also has fibroids and Endometrial hyperplasia and has very heavy periods.
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Edward W. Hook M.D.
41 months ago
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Welcome back to our forum. I’ll be glad to comment. I reviewed our interaction from more than three years ago before responding today and my assessment is unchanged further you are now more than three years out without symptoms and with negative tests which should be believed. I am entirely confident that your wife’s problem is unrelated to the brief receipt of oral sex that we discussed three years ago.
I share your surprise at your wife’s diagnosis. I would be interested in knowing whether her physician took cultures or precisely how the diagnosis of infection (as opposed to other sources of information) was made.
---That of course raises the question of what might be going on here. The additional information on your wife’s gynecological medical issues may be a clue. Endometrial hyperplasia is sometimes associated with inflammation and I would presume can mimic a smoldering fallopian tube infection. In addition, while it is not common, other bacteria either from the genital tract or elsewhere in the body (even the respiratory tract) can occasionally cause low-grade fallopian tube infections. In some lower income countries, tuberculosis of the fallopian tube is relatively common. I would suggest that you seek more information from your wife’s physician. A diagnosis of a low-grade Fallopian tube infection without doing a surgical procedure called laparoscopy is very, very difficult.
Irrespective, I remain completely confident that your wife’s current problem is unrelated to your brief receipt of oral sex more than three years ago.
EWH
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41 months ago
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Thanks for providing helpful feedback in a non-judgemental zone. You might have missed the second sentence in my first paragraph which said "The only sexual conduct I have had that I have had with anyone else
where happy ending massages, a couple of which a finger was inserted
into my anus." These were a couple of interactions that happened more recently, although still many weeks or months ago. From what I read online, only HPV, which we've both had exposure to in our youth, can be transmitted this way, not gonnorhea (sp?) or chlamydia which are the concerns here with the fallopian infection. I wouldn't think any of this was dangerous activity, but since she has a diagnosis that every web article starts by saying it was probably caused by chlamydia or gonnorhea, it does cause some alarm, and did prompt her to get a test for those two STIs. Hopefully no false positives come back (and of course no true positives). Do you think I can rather safely assume they won't?
She is on a regimen of doxycycline, by the way. She does not douche but she is extremely careful about hygiene, so the main things that would cause this seem really unlikely, so unless you think the digital stimulation described above could cause me asymptomatic STI I would guess it is something along the lines of what you suggest.
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Edward W. Hook M.D.
41 months ago
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It is absolutely appropriate that she be tested for STI‘s. To not do so would be inappropriate. Having said that, based on your history including the additional details you provide, I am confident that her tests will be negative and that the etiology of what is going on is due to some other process. Once again, I suggest asking her doctor of the questions I mentioned above. EWH---
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41 months ago
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Thanks. Tests came back and no gonhorrea or chlamydia of course. However, she is upset to learn that she has antibodies for HSV-1, and her score is 46.10 whereas it says above a .9 means you have been infected. This was a blood test. I have seen on here that you discourage blood tests for HSV-1, and it has us both searching all kinds of websites about it. I see you say 60% of Americans have it. Neither of us has had noticeable outbreaks. She still seems bent on the idea that this is somehow my fault even though she has had several sexual and kissing partners prior to me (albeit 20+ years ago). I am guessing we can never know how or when she got it, but she wants me to get the HSV test she got to see if I'm positive, and to ask the doctor if this could be affecting her fallopian tube situation, because one of a thousand websites viewed said something along the lines that it could. From what I read, we might actually be lucky if we're both infected and have not had outbreaks, as it means we can't transfer it to the genitals from oral sex with each other. Is that correct? I guess I'll get the blood test to appease her regardless. To be clear I am asking if encounters I described which included brief receipt of fellatio in 2017 and prior kissing and analingus are likely the reasons my wife, and I am guessing I, have HSV-1, and also what either of us having it implies for our sexual future, ie any behavioral changes necessary assuming a monogamous future.
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Edward W. Hook M.D.
41 months ago
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As you know, we provide up to three responses to each client. As this is the 3rd response, the thread will be closed later today without further response. Your assessment about HSV-1 is correct- over 60% of Americans have HSV-1 and most do not know it, having acquired infection in childhood. Importantly, there is NO association of HSV-1 with infertility so out those concerns aside. Further, the likelihood that you acquired HSV-1 from the encounter of concern is lower than your risk of being struck by lightening.
I cannot imagine any reason for you sexual future to change because of the biological effects of HSV-1 which you are both quite likely to have. Even if your test is negative, I see no reason for change.
Hope this helps. So sorry you are having these challenges. EWH
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