[Question #94] Concerned

38 months ago
So glad to see you on here, have read through your help Medhelp forums in the past!

13 days ago, I had brief protected vaginal and some unprotected oral sex with a female I did not know the sexual history of (night out).  I probably touched myself after touching her vagina.   I am male.

Just over 24 hours later, I felt a sensation in my penis, not really a burning but maybe not sure what that feels like.  My lips were very dry, I felt a bit unwell and my foreskin looked a bit dry in one area.  Urination didn't cause burning and there was no discharge at all.  I googled and it said it is very unlikely to be an STD after this time so I left it.

After 7 days still felt the same so I decided to go for a check up, the doctor at the clinic said there is a risk for gonorrhea and chlamydia due to oral.  I had a swab and everything came back negative, including NSU.  I had a urine test which was negative as well 

2 days later the pain was still there and the red patch was a bit worse (it went white and dry) so I went back, given another swab which was negative.  I pointed out the red patch on my foreskin and was given an anti fungal cream but for my reassurance more than anything.  The doctor said the pain was likely from anxiety, like a tension headache which did relieve me a bit.

4 days later, it is maybe better I think but I still get occasional burning sore feeling, what feels like is inside my penis.  The area behind my scrotum feels tingly on occasions (prostate?) and it kind of feels like when I urinate there is some left over but only a little.  The red rash is still there, not sure if it looks any better and my penis head is definitely always moist when I go the loo.  I took a warm bath and it seemed to relieve my symptoms a bit I think.

I am at a loss what to do!  Should I get the red patch investigated further?  Should I go back to the GUM clinic or maybe a GP instead?  Or should I leave it and see if it settles down itself?  Could this still be an STI, as I read Chlamydia can take 2 weeks to show up?  Could this be a UTI or a prostate infection?  Or is this all really in my head and anxiety causing flare ups?  I think the irritation and soreness is causing me some anxiety because it feels like I can't get this sorted. :(  Would really appreciate your advice from your experience.

Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago

Welcome to the Forum.  it sounds as though you have been well evaluated by your doctor and I would urge you to have confidence in his assessment that you have not acquired an STI from the single exposure you have described.  Please remember that most persons do not have STIs, that it is uncommon for an STI to be transmitted on a single exposure, that your condom provided good protection from infection during your vaginal exposure, and that STIs are uncommon following receipt of even unprotected oral sex.  Further, that you noted symptoms the day following this exposure also makes STIs unlikely- there are no STIs that cause symptoms just one day after exposure. finally, you had the right tests and they were negative, proving that you were not infected.

So, what could be going on?  Two things.  First the red patch, scaling and itch that you have noticed may very well be a fungal infection.  it sounds like it but to be sure, you should be seen by a clinician who can make the diagnosis and treat if need be,.  If you have a fungal infection, you likely had it even before the encounter and have just noticed it now.  Second, you are looking too hard- the more you look, the more you are likely to detect sensations that you would otherwise not notice and that are normal.   I hope these comments are helpful to you.  EWH

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38 months ago
Thank you, your words are very re-assuring.

I am from the UK, the sexual health clinic really didn't seem too keen to check the skin issue further.  They gave me Clotrimazole 1% cream but I don't think it has helped really, they advised as well it was just to make me feel better.  Would you suggest a GP visit for a skin condition or the clinic still as it is the penis?

As for the other symptoms pain etc.  I do keep checking and googling etc (how I found this forum actually!).  Should I just try to take my mind off it even when I feel pain, should it all calm down eventually, I just want to get back to normal life?

Just want to add a thank you for taking the time to assist people on the forums over the years!  Its a great service for people like me who feel a bit alone.
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago

Good questions.  There are times when clotrimazole is insufficient to treat a fungal skin condition and doctors do vary from one to another in terms of how they manage these problems.  In some instances it is better to see the same doctor so they can see the lack of progress as a prelude to doing something different, in other situations a "fresh look" is preferable.  Which approach is best for you, I cannot say but I do think you need another look. Also, and related to my earlier answer- itching in particular is one of the most common consequences of hyper-vigilance.  If this is your major problem, trying to find a means of distracting yourself may be the best course of action.

Your symptoms should improve and resolve over time.  The more distracted you are the better.  You will go on to get back to normal, of this I am confident.  Too much internet time, on the other hand, can act to fuel anxieties and concerns.  I would be cautious of this.  

Thanks for your thanks- we want to help.  EWH

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38 months ago
I decided to keep away from the web since I posted and already my symptoms are calming down.  It is truly amazing what anxiety can do to your body..

I will finish my course of cream for another week and go back to the GP because it is very difficult to see the same doctor at the clinic unfortunately.  Will start with some fresh eyes and then I think someone checking progress if it doesn't improve will start working as you suggest.

Anyway, time to keep off the internet from today as per advice because it does increase my anxiety significantly.  For peace of mind and closure I will probably go for a full check up 6 weeks after then hopefully can move on with a clean bill of health.

Hit my question limit now but this thread can be happily closed down.  Thank you :)


Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Thank you for the follow-up.  I'm pleased my counsel was helpful.  EWH
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