Confused and wondering what I may have? NGU, Herpes, etc...

[ctowner]

I am a 37 yr old male and recently received unprotected oral sex from a sex worker and then had protected vaginal sex with her. The next day I noticed slight urethra pain/irritation and the urge to urinate more frequently.  This occurred approximately 10 days ago and I am still experiencing those symptoms.  I have not had any discharge from penis.

I have been tested for Gonorrhea and Chlamydia and both came up negative and was examined at a clinic.  Yesterday I started Doxycycline as a treatment for possible Urethritis but have not seen an improvement yet but would not expect to so soon.

I have been focusing on this non-stop and wondering what the possibilities of getting Herpes or HIV from this could be.  I have had no visible signs of Herpes to date but for some reason think I may gotten it but have no idea.  How common is it to have Herpes with no visible symptoms other then slight burning during urination and irritation at the tip of your penis.

I will be going in to for a Herpes blood test in 4 weeks to hopefully get some conclusive information but for I was hoping to get your thoughts on possibilities I what my risks are and what could be going on.  A spermicide was on the condom and a lube was used as well, could this be causing this type of irritation as well.

Thanks

[H. Hunter Handsfield, M.D.]

The next day is too soon for any STD.  No sexually acquired infection can cause symptoms the next day; it takes 2 days minimum, usually longer.  Also, "slight pain/irritation" without discharge usually doesn't mean an STD unless there also is discharge from the penis; and frequent urination isn't the symptom of any STD.  I don't think you have herpes, NGU, or anything else physiologic.  I see no reason for a herpes blood test; if positive, it won't mean you caught it during the exposure you describe or that it explains your symptoms.  Your symptoms are most suggestive of anxiety over the event, not an infection of any kind.  I say forget it, with the expectation the symptoms will fade with time.  But of course continue to follow up with your health care provider if symptoms persist.

Happy holidays--  HHH, MD

[abcba]

Doctor,

I thought frequent urination is symptom of STD including Herpes (Lots of websites state this).  Is this not the case?

[ctowner]

Thank you for your reply.

Is lower left abdomial (abdominal) pain above the shaft of penis common of Herpes or could that just be a reaction to the Doxycycline.

As far as protected sex goes shoudl wait a certain period of time?

[H. Hunter Handsfield, M.D.]

If you have no STD, there is no reason not to have unprotected sex with a regular partner.  Those symptoms do not suggest herpes.  Doxy can cause diarrhea with cramping, but that doesn't sound like what you have.  Doesn't sound like anything important.

By itself, urinary frequency is not a symptom of herpes or any other STD but sometimes frequency occurs in combination with discharge or painful urination.  Also, frequency only counts as a sign of infection when it is urgent urination with small volumes.  Just peeing a lot, with substantial amounts of urine, isn't a symptom of any infection.

This is an important lession about web-based health information:  almost every symptom described, for any disease, is more complex than can be conveyed in just a few words.  Just  reading a symptom and saying "I have that, I must have [disease X]" is rarely justified.

HHH, MD