Bleeding after sex

[worriedinillinois]

Good Morning and thank you in advance for your help.  I have been having a sexual relationship with a female coworker (I am male) for the past 6 months.  We have used a condom with every sexual encounter until two weeks ago where we got carried away and did not stop to put one on. In the past she will bleed some after sex, approximately one out of five encounters.  I have read in postings that bleeding after sex could be a sign of Chlymedia or Gonorreha.  After this last encounter the was some blood again.  That same day I was at the doctor and had received Levaquin 500mg to be taken daily for sinus infection.  I took my first pill right after we had sex.  I also have a somewhat serious girlfriend that I have been dating for two years and we do not use condoms.  Two days after having sex with my coworker I had sex with my girlfriend.  I had been taking the medication for two days at that point.  One week later I had sex with my girlfriend and there was some blood.    I am not sure if this matters but period is to begin Monday or Tuesday.  I am not concerned that I may have past something on.  My questions are:
1. How reliable of a sign is bleeding for a STD?
2. If there was a STD would my coworker bleed everytime?
3. If I had acquired an STD would I be able to pass it along after two days or is there some kind of incubation period?
4. Would the fact that I was taken the medication for two days have stopped an STD before it really got started?
5. Is Levaquin effective against any of the STD?
6. Is the fact that both have bleed a certain sign of an STD?

Thank you again for your help and this excellent website.

[H. Hunter Handsfield, M.D.]

Spotty bleeding after sex is an occasional symptom of cervicitis, which can be caused gonorrhea, chlamydia, and other causes. Still other causes also are fairly common, but I'm not a gynecologist and cannot speculate further.  Given the cirucmstances, you are right to be concerned about STDs, especially chlamydia. it would be good for your coworker partner to be tested or it (and gonorrhea).  It's too late to test you; if you were infected, the levaquin would cure and/or prevent it.  To your specific questions:

1) Not a reliable sign; a possibility, nothing more.

2) She probably would not bleed every time; intermittent would be more typical.  But that applies to all other possibilities as well.

3) Chlamydia and gonorrhea probably are transmissible almost immediately after being acquired.

4, 5) Yes; see above.

6) No definite conclusions are possible.  Personal evaluation by a health professional is required.  If there was even a single episode of unprotected sex with your casual partner then with your regular girlfriend before you took levaquin, your girlfriend also needs to be examined and tested.

Good luck--  HHH, MD

[worriedinillinois]

One last question.  Was taking the levaquin for only 2 days at 5oomg enough to have cured me if I have gotten an STD from my coworker?  The reason that I am asking is that I had sex with my girlfriend after being on that medication for two days and would I have passed it to her?  Do I need to have her tested?  Thank you again.

[H. Hunter Handsfield, M.D.]

That dose and duration of levaquin would prevent either gonorrhea or chlamydia, if in your system when exposed, and it would cure established gonorrhea.  It would not reliably cure an established chlmaydial infection.

In fairness to your girlfriend's health, if there is any doubt she was exposed, she should be tested.  But it would be OK to wait for your coworker to be tested first; if she is negative, and if her provider finds another plausible explanation for the bleeding, you don't need to worry about it.

HHH, MD