[Question #8876] Concerned

38 months ago

4 months ago I had protected vaginal enter course and oral with a Asian woman at a massage parlor lasted only a few minutes and didn’t reach ejaculation. Instantly regretted the decision cleaned my entire area with hand sanitizer. Two days following this encounter had very frequent urination and tingling urethra this lasted about three weeks but has come and gone over the last 4 months with not much more than a week between episodes if that. Tested negative for all stds (gonnorhea,chlamydia,trich,hiv,hep,hsv-1 and 2, syphyllis and Mgen) 5 days after minus hsv-1 igg. Treated with doxy(7days although I didn’t finish due to side effects) and metrotazinodale while waiting results(these did not help symptoms). Also took a course of azithromycin no help. Then tested again at 4 months all negative except hsv-1 igg. Is this an std or is it my constant worrying making me think I have symptoms I don’t? Also would hsv-1 igg be the cause even though I tested positive for it so early or likely from a early exposure to hsv-1 as I have read?

H. Hunter Handsfield, MD

38 months ago

Welcome. Thanks for your question.

I'm unclear whether only the vaginal sex was condom protected, or also the oral. It doesn't matter much: even without condom protection, oral sex is highly safe (not perfectly safe, but with low chance of any STI). Your symptoms a few days later are not typical for any STI; they are much more suggestive of your anxieties about the event and STI worries causing increased bladder tension and magnification of trivial symptoms (or even normal body sensations) that otherwise you would ignore or perhaps not even notice. Your negative test results confirm you had no infection that could have caused those symptoms; and their persistence after the antibiotics further confirms no infection was responsible. (Had you been in my clinic, we would not have prescribed any of the antibiotics. They really were unnecessary, especially if examination and lab testing (e.g. urinary white blood cells) were negative, as I am sure they would have been.

Your own conclusion about your positive HSV1 blood test is spot on: "likely from an early exposure to HSV1 as [you] have read." Half of all adults in the US test positive on HSV1 IgG antibody tests. Mostly this is the result of childhood infection, often with no symptoms. In other words, it probably means you were infected with oral herpes sometime in your past life. If you're having no symptoms (cold sores, fever blisters), probably you never will. The positive result only a few days after the sexual exposure proves you didn't catch it at that time; it take up to 3-4 months to develop a positive result. In any case, this has nothing at all to do with the sexual exposure described or your transient symptoms.

So all is well and I recommend against any other testing.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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38 months ago

Sorry I didn’t specify. Both were protected encounters and the there was no evidence of wbc in urine in two urinalysis as well both came back clean all the way around. Any recommendations on how to proceed from here? I also meant to ask if hpv could show up in the urethra 3 days after an exposure I have read it would take 1-3 months or longer. I am just trying to rule out all possibilities as I am fixated on this. Thanks again

38 months ago

I only ask beacuses I have this itchy /tingling feeling in urethra still(sometimes feels like there is something inside urethra) and frequent urination still. I had a digital exam of my prostate and was told everything was fine but wasn’t having symptoms when finally got in for that appointment.

H. Hunter Handsfield, MD

38 months ago

Thanks for clarifying. I understand the symptoms you describe, but I stand by my best guess that you're dealing with anxiety magnifying feelings and symptoms that do not indicate infection or disease of any kind -- which is also supported by saying "I am fixated on this". It's also supported by the symptoms being intermittent: if due to infection or inflammation, they would be continuous, i.e. would not have happened to clear up when you had your medical appointment.

HPV causes no such symptoms, and you are right that HPV doesn't even show up (e.g. warts, abnormal Pap smear) for several weeks or months.

Do your best to move on without worry.

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38 months ago

Thank you for your time and the service you provide!

H. Hunter Handsfield, MD

38 months ago

You're very welcome. Thanks for the thanks -- that's why we're here. Perhaps you'd like to consider further supporting the American Sexual Health Association (the forum sponsor) in its broad mission to promote and protect sexual health. If interested, you can find a donate link at www.ashasexualhealth.org.

Best wishes and stay safe.

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