Could I have transmitted Chlamydia?

[bk95]

I had unprotected sex with a female and about 6 days after developed symptoms of chlamydia.  Went to the doctor and was given 1g dosage of azithromycin and another dose of suprax and i took both of them immediately.  About 5 days after this, my ex-gf and I decided to get back together.  We did not have penetrative sex and as far as i could tell there was no direct genital to genital contact, but i did notice that there was a little bit of semen on her stomach area.  The duration was also very short.  I did my best to ensure that our genitals did not come into contact and I ended the encounter because i did not want to infect her.  However, that said, I guess i cant be 100% sure that my penis did not touch her vagina at all, but like i said, i dont think that it did.
After I took the antibiotics, many of my symptoms such as discharge and burning seemed to get much better.  There was still a little bit of burning inside my urethra, however, it did not burn when i urinated or anything like that and there was no discharge after taking the meds.  I did masturabate though and I think that is what brought on the increased irritation.  Is this possible?  I noticed that the irritation was worse on days after i masturbated.  Seemed to start calming down if i just left it alone down there.  My doctor has me on a 10 day course of minocycline now cause I told him about this.  Not sure if this is overkill or not.....

My questions are :

1.  What are the chances that i  transmitted chlamydia to my gf?

2.  Is it possible to for masturbation to increase inflammation in my urethra, given that it was already inflamed from having chlamydia?

[H. Hunter Handsfield, M.D.]

You don't say whether or not you were tested and your symptoms were known for sure to be due to chlamydia.  But for purposes of this response, I will assume you indeed had chlamydia.  And even if you had nonchlamydial, nongonococcal urethritis (NGU), the reply would be the same.  Your doctor treated you for both chlamydia (or NGU) and for gonorrhea (the Suprax).

For 2 reasons, there was no risk of transmittting chlamydia (or gonorrhea or the other bacteria that cause NGU) to your girlfriend, for two reasons. First, your infection probably was effectively cured -- at least with no ability to transmit it -- within 24 hours of taking the azithromcycin.  Although the routine recommendation is to avoid sex for a week, that is a conservative precaution.  Second, even if you had not been treated, it is not possible to transmit chlamydia without penetrative sex.  Getting semen on the skin carries no risk.  Same for gonorrhea and NGU.

Masturbation will not increase inflammation.  Most likely your symptoms would have continued to improve gradually even without further treatment, but it wasn't a bad idea to give you a second course of treatment with minocycline.

I trust you have informed the partner from whom you acquired the infection.  She needs treatment to protect her health and that of her other sex partner(s).

Best wishes--   HHH, MD

[bk95]

Thanks for your reply....helped to put my mind more at ease.  

So am I correct in saying that mild symptoms may persist for a while even after the infection has been cured?  

Yes, I informed the partner from which I acquired the infection immediately after I noticed symptoms so that she could get treatment as well, although she was tested negative for chlamydia and gonorrhea right before our encounter and had not been with anyone else....which is kind of confusing.

[H. Hunter Handsfield, M.D.]

Yes, symptoms often take up to a couple of weeks to go away completely.  That there has been signficant improvement shows the drugs are working.

[bk95]

Just a follow up question as I have been thinking a lot lately about this....if I touched my genitals (I was checking to see if any fluid was present, which there was not) and then touched my partner's briefly, (but without penetration), is it possible to transmit an STI like chlamydia?  i am still worried about this....I had taken azithromycin (1g) and suprax (400mg) 5 days before, which seemed to bring an improvement in my symptoms but they were not gone completely......

[bk95]

sorry one more addition to my question....does azithromycin have a high success rate at treating NGU and chlamydia? I am just still nervous....

[bk95]

I am sorry to keep adding comments.....i just thought that I should add that i was tested 6 days after the encounter that could have infected me and it was negative....the partner i possibly got this from tested negative right before having sex with me and also has been tested negative after.....i had some definate symptoms and dont really understand how that is possible...unless NGU is undetectable by urine test

[H. Hunter Handsfield, M.D.]

The indirect contact you describe (genital to hand to partner's genitals) is believed to have little or no risk.  Don't worry about it.  Azithromycin is the drug of choice for both conditions and is over 95% effective against chlamydia and probably about 90% for nonchlamydial NGU.

There is no test for nonchlamydial NGU in women.  Female partners should be treated, even if all exams and tests are normal.

[bk95]

Thank you for the additional information.  I am just kind of worried because my girlfriend said today that she was not feeling well and it has been one week exactly after the contact I described above.  But it sounds like there is little chance that I could have infected her.

[bk95]

Just want to make sure that is ok to have sex again....like I said earlier I had a 1g dose of azithromycin and then followed that up with 10 days of minocycline 100mg twice per day.  I have taken all of the pills.  I have no symptoms.  I am guessing it is safe to assume my infection is cured now and I can not transmit it to anyone?

[H. Hunter Handsfield, M.D.]

Yes. It would have been safe within a couple days of starting therapy.  Definitely no risk of transmission now.