[Question #9162] Risk unprotected cunnilingus on a sex worker
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35 months ago
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Hi thank you for this service.
A little over 4 weeks ago I made the very poor decision to visit a "massage parlour" and received a handjob from the sex worker (which i'm not worried about as far as stds go), but i also performed unprotected cunnilingus and anilingus on her for about 1-2 minutes. I'm male and the sex worker is female. I didn't notice any visible sores or lesions on her. I'm very stressed and worried i could have ended my 15 year marriage with a stupid horny decision to go down on a sex worker. I look in my mouth every morning and I haven't noticed any std symptoms until today a little over 4 weeks after the exposure I noticed a burning sensation on the inside of my lower lip this morning. Now 12 hours later it still burns/hurts a bit but it looks like a swollen blisters one about 6mm x 6mm and mostly clear and red border. Could this be a primary syphilis chancre? My city and province both recently declared a syphilis outbreak. does it develop so fast in 12 hours? or is it more likely a canker sore because it developed so fast and painful?
1. what are my other std risks from this exposure? Is Syphilis, Gonorrhea and cold sores (never had one before that I remember) all i have to worry about?
A little over 4 weeks ago I made the very poor decision to visit a "massage parlour" and received a handjob from the sex worker (which i'm not worried about as far as stds go), but i also performed unprotected cunnilingus and anilingus on her for about 1-2 minutes. I'm male and the sex worker is female. I didn't notice any visible sores or lesions on her. I'm very stressed and worried i could have ended my 15 year marriage with a stupid horny decision to go down on a sex worker. I look in my mouth every morning and I haven't noticed any std symptoms until today a little over 4 weeks after the exposure I noticed a burning sensation on the inside of my lower lip this morning. Now 12 hours later it still burns/hurts a bit but it looks like a swollen blisters one about 6mm x 6mm and mostly clear and red border. Could this be a primary syphilis chancre? My city and province both recently declared a syphilis outbreak. does it develop so fast in 12 hours? or is it more likely a canker sore because it developed so fast and painful?
1. what are my other std risks from this exposure? Is Syphilis, Gonorrhea and cold sores (never had one before that I remember) all i have to worry about?
2. Do you think i should get tested given 1-2 minutes cunnilingus on a sex worker and sudden blister/sore inside my lip 4 weeks after exposure? If so should I wait a few more weeks after the exposure to get a more accurate syphilis test? Should I keep avoiding sex with my wife? I'm so nervous of losing my marriage. :(
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Edward W. Hook M.D.
35 months ago
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Welcome to our forum. Thanks for your questions and your description of your situation. I’ll be glad to comment. Before I get to your specific questions, let me point out that among insertive sexual contacts, cunnilingus and analingus are substantially lower risk for acquisition of STI‘s then genital insertive intercourse. Most commercial sex workers do not have STI’s and when they do most unprotected exposures do not lead to infection. There is virtually no meaningful risk of acquiring HIV from the activities you described. There is a very low risk of acquiring classical bacterial STI’s such as gonorrhea or chlamydia. As for your specific questions:
1. Please see my comments above regarding gonorrhea, chlamydia and HIV. FYI most oral gonorrhea infections are asymptomatic and the lesions you described are not suggestive of that problem. Your description of the lesions is somewhat suggestive of oral herpes (cold sores) however most typically if a person is going to acquire oral herpes after sexual contact they develop lesions within 10 days of exposure. Four weeks is too long and acquisition of oral herpes from the activities you describe is vanishingly rare. If these lesions are oral herpes, it is impossible to determine whether you got them from your exposure or it is a recurrence of a long-standing infection reactivated by your anxiety. Four weeks after the episode is about the right time for the development of syphilis lesions but the lesions you describe are not suggestive of syphilis. My advice is for you to see a trained professional to evaluate allegiance for the possibility that they are cold sores. You could certainly get syphilis blood test at that time which, if negative would prove that the lesions you were describing or something else.
2. See my comments above regarding testing. Clearly you are anxious about this episode and you have lesions which a clinician could examine. If the clinician believes these are cold sores, I would encourage you to request a culture or PCR test (not a blood test) to be sure and to determine what type of herpes virus might be present. Until you have seen a clinician you might avoid exposing your wife to the lesions you describe ( does wife get cold sores)
I hope these comments are helpful. EWH
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35 months ago
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I don't think it's herpes because the sores (which have turned white and look more canker sore like now) are entirely inside the mouth. Given the 4 1/2 weeks since i've had any form of sexual contact and the location i'm guessing it's probably not. I'm much more worried about gonorrhea or syphilis than herpes anyway. Have you ever seen herpes with 2 white sores inside the mouth and none on the lips or outside the mouth? I thought cold sores were always outside the mouth/on the lips or just outside the lips
I guess I better head to the doctor. :(
I guess I better head to the doctor. :(
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Edward W. Hook M.D.
35 months ago
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Thank you for the additional information. You are correct that canker sores are more likely to be the source of lesions of the sort you describe inside the mouth while oral herpes typically occurs on the borders of the lips.
As I’ve already explained, the likelihood that this is oral gonorrhea, which is most typically asymptomatic, is very low. As for Syphilis, oral syphilis is very uncommon and your exposure was low risk for this infection. As mentioned above, testing at this time would certainly tell you whether the sores that you have are syphilis or not. EWH
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