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STDs (Expert Forum)
Confused
Answered by
University of Washington
Seattle - WA
This forum does not cover AIDS/HIV issues. This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomonas, Warts, Yeast Infection.
IMPORTANT
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
Confused
by lonedog81, Jan 19, 2006 12:00AM
I posted here las week and things have gotten so confusing. This started out as me trying to have sex with a friend but I could not get hard enough to enter her, tried about three or four times unsuccessful.
About two weeks later I felt a itch in the head of my penis and later that day squeezed a yellowish substance from it, after that time everytime i would squeeze a clear and sometime whitish fluid would come out. The itching stopped but every tome I would squeeze something would come out. I went to the doctors and told them my story and they had me to urinate in a cup, He came back and said I had urethritis and said I problably had chlamydia so he gave me a 750mg levo to take there and a prescription for four 500mg pills of zithro. I took all those and my symptoms did not go away, so after six days I went back to the docs and told him my symptoms had not gotten better, they had me to urinate in the cup again and after wating about an hour in the room he came in and said I had trich. He went on to tell me how rare symptoms are in men and that he had had women in rest homes come to him with trich, he prescribed 5 days of 500mg of alinia. MY question is do you think I ever had chlamydia and what do you think about
the trich develoment. I have been on the meds for two days and I am not squeezing and I am not noticing anythinf in my underwear.
About two weeks later I felt a itch in the head of my penis and later that day squeezed a yellowish substance from it, after that time everytime i would squeeze a clear and sometime whitish fluid would come out. The itching stopped but every tome I would squeeze something would come out. I went to the doctors and told them my story and they had me to urinate in a cup, He came back and said I had urethritis and said I problably had chlamydia so he gave me a 750mg levo to take there and a prescription for four 500mg pills of zithro. I took all those and my symptoms did not go away, so after six days I went back to the docs and told him my symptoms had not gotten better, they had me to urinate in the cup again and after wating about an hour in the room he came in and said I had trich. He went on to tell me how rare symptoms are in men and that he had had women in rest homes come to him with trich, he prescribed 5 days of 500mg of alinia. MY question is do you think I ever had chlamydia and what do you think about
the trich develoment. I have been on the meds for two days and I am not squeezing and I am not noticing anythinf in my underwear.
Doctor's Answer
by H. Hunter Handsfield, M.D., Jan 19, 2006 12:00AM
, Jan 19, 2006 12:00AM
Clearly you had urethritis. You don't say whether or not you were tested for gonorrhea or chlamydia; you should have been. It could have been either one, and your doc treated you for both gonorrhea and chlamydia. But of all cases of urethritis, most are nongonococcal urethritis (NGU), ie not gonorrhea. Off all NGU, chlamydia is the most common cause, but still is responsible for only 25-40% of cases. About 10-20% are due to Mycoplasma genitalium. Trichomonas is the cause of 1-5% of cases. The cause is unknown almost half of all cases of NGU.
If your doc didn't test you for chlamydia (or gonorrhea), you will never know whether or not you had them. However, the fact that your symptoms did not improve at all does favor trich as the main problem from the start. All the other causes would have cleared up (or at least the symptoms would have markedly improved) with the treatment you were given.
I never heard of Alinia (generic name nitazoxanide) until your question, but I looked it up. Interesting you were treated with it. On a quick search, I find it has been found to be active against trich, but there is no published research (in English) showing that its effectiveness has ever been studied, and it is not approved by the US Food and Drug Administration for treatment of trichomoniasis. That doesn't mean it won't work, but I wouldn't have a clue what dose to use or for how long. But your doc may know more about it than I do. The usual treatments for trichomoniasis are metronidazole (Flagyl and other brands) and tinidazole (Tindamax). But you're obviously improving, so hang in there.
The final mystery is where and when you were infected. Trich can be carried for months, perhaps years. I would be somewhat surprised if you were infected during attempted intercourse without successful penetration. If the event you describe is your only sexual exposure in recent weeks, it's a good bet; but conceivably there are other partners who need to be notified and treated. At a minimum you need to tell your friend that she probably is infected.
When trich is found in women in "rest homes", it is either the result of chronic infection, acquired many years previously; or of recent sex, possibly sexual abuse. Trich is not acquired except sexually.
Thanks for sharing your story. I learned from it. Best wishes-- HHH, MD
If your doc didn't test you for chlamydia (or gonorrhea), you will never know whether or not you had them. However, the fact that your symptoms did not improve at all does favor trich as the main problem from the start. All the other causes would have cleared up (or at least the symptoms would have markedly improved) with the treatment you were given.
I never heard of Alinia (generic name nitazoxanide) until your question, but I looked it up. Interesting you were treated with it. On a quick search, I find it has been found to be active against trich, but there is no published research (in English) showing that its effectiveness has ever been studied, and it is not approved by the US Food and Drug Administration for treatment of trichomoniasis. That doesn't mean it won't work, but I wouldn't have a clue what dose to use or for how long. But your doc may know more about it than I do. The usual treatments for trichomoniasis are metronidazole (Flagyl and other brands) and tinidazole (Tindamax). But you're obviously improving, so hang in there.
The final mystery is where and when you were infected. Trich can be carried for months, perhaps years. I would be somewhat surprised if you were infected during attempted intercourse without successful penetration. If the event you describe is your only sexual exposure in recent weeks, it's a good bet; but conceivably there are other partners who need to be notified and treated. At a minimum you need to tell your friend that she probably is infected.
When trich is found in women in "rest homes", it is either the result of chronic infection, acquired many years previously; or of recent sex, possibly sexual abuse. Trich is not acquired except sexually.
Thanks for sharing your story. I learned from it. Best wishes-- HHH, MD
HHH, MD