Concern (Gonorrhea/Chlamydia)

[fajk434]

Hello. I recently had a one night stand with a woman. I received oral sex without a condom and then we had sex with a condom. During sex, I noticed a very strong "fishy" odor from her vaginal fluids. Even though we used a condom, I am afraid that I did have some of her fluid on my hand and while cleaning up afterward may have had contact with the tip of my penis (I also used a wet wipe to clean around the area and may have dabbed the tip). Starting the next day, no more than 15 hours or so, I started feeling a slight burning after urination. This continued on for the next week or so. After urination, I would have a slight burning sensation, and it would be more pronounced if I tried to constrict my urethra (like when you hold in urine). Also, the tip of my penis seemed reddish, and even today there is redness (nearly two weeks later). I have not noticed any sort of discharge from my penis. Now, I am very worried that I may have contracted either gonorrhea or chlamydia as they seem to be the most likely based on my symptoms.

Now, I have a few questions. I have read that incubation periods for Gonorrhea range from 2 to 10 days, and even longer for Chlamydia, so would it be possible for me to exhibit symptoms less than a day after sex? Also, how likely is it that I may have transferred the std to myself while cleaning up after intercourse? I realize it could have been the oral sex itself, so how likely could it be that if she had gonorrhea in her throat I could have contracted it through unprotected oral sex? Are there any other stds or causes that you may think could be causing me these symptoms (such as her "fishy" fluids)? Finally, I am scheduled for a men's health appointment this Friday so will be able to find out soon enough, but I am very nervous right now. Thanks for your help.

[Edward W Hook, MD]

Welcome to the Forum. The questions you are asking are some of the correct ones to be asking for the answers are the reason that it is unlikely that you have an STD.  Let's go through things step-by-step.

Your partner may or may not have had an STD but it is statistically unlikely that she did.  In addition, even if she did, STDs are transmitted to sexual partners on no more than 20% of singl;e exposures.  Furthermore, your genital sex was condom protected and thus virtually no risk if the condom was used throughout the exposure.  Oral sex may rarely lead to NGU in men or gonorrhea but not chlamydial infection. Thus the chances that you are infected are small.  As for your symptoms, non of the common STDs have the onset of genital symptoms within 24 hours of exposure so it unlikely that your symptoms are due to STD acquired through the exposures you describe.  Chemicals such as the ones used in cleansing wipes can however be quite irritating and this may be the source of your initial irritation.  Unless made worse by repeated application however, any symptoms due to chemical irritation would have gone away in a day or two. For symptoms after that the major possibilities are increased detection of normal sensations due to concern over the exposure or, perhaps NGU although this is unlikely for the reasons noted above.

My guess is that you do not have an STD  Your men's health examination will give you the information you seek but to be sure it does, I suggest that you be sure to tell the person who examines you of your exposure and concerns.  

Finally, with regard to the fish odor, your partner may have had bacterial vaginosis, a common alteration of vaginal flora in women which is not an STD and is not transmissible to sexual partners.  Bacterial vaginosis is a common cause of a "fishy" vaginal odor which may get worse during or following sex.

Hope these comments are helpful to you.  

Take care.  EWH

[fajk434]

Thank you, doctor. Unfortunately, I had to cancel my appointment and am now scheduled to go in on Monday next week. I had a few more questions I wanted to ask one last time and I promise not to bother you again. First off, if I did catch something from her, I think trichomoniasis seems to fit best. I think that is what I can attribute to her “smell”. What are the rates of infection for trich? We did use protection, but I am sure that I wasn’t cautious in the least bit when the condom was off. I did touch her genitals with my hand and after the sex I probably had contact with the tip of my penis with my hands (and the wipes that I used to clean up afterward, both her fluids and mine). Now my second question would be how likely is it that a std such as trich or gonorrhea can be spread through touching of the genitals and fluids outside the body? The more worrisome thing for me is that I did sleep with someone else after this initial encounter, but she wasn’t just a random hookup. Here I used protection again, but yet again wasn’t being safe with my hands, as I fingered her during sex (and I might have gotten my own fluid on my hand, who knows?). I am feeling quite a bit of guilt for this because I should never have slept with anyone before getting myself tested. She has told me that she’s been having symptoms of a UTI where her urine is cloudy, smelly, and painful (she has had UTIs previously). I would definitely like to think that the odds are against me right now. The odds of me getting an std from someone and then giving it to someone else consecutively while using protection seems unlikely, though certainly possible. Also, I still have some redness below the tip of my penis and it has been almost two weeks since the first encounter, so I’m inclined to believe it wasn’t the chemicals from the wipes. However, the pain during urination went away after around four or five days. If you could provide any insight on any of this, I would greatly appreciate it. Thanks.

[Edward W Hook, MD]

You still need testing.  For you to be trying to guess whther you have something and what it might be is asking for trouble.  Trich does not cause an oder so for you to say this "fits" really dioen't make sense

Your sex was protected, therefore it is most unlikely that you got anything.  Transfer of STDs by a person's hands or by touching does not happen.  

Stop guessing and go get tested.  EWH