STDs Expert Forum
Do I Still Have It?
About This Forum:

The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

Do I Still Have It?

Ive been dealing with this nightmare now for over 4 months. It all started last year when I had a single encounter; unprotected vaginal sex with a co--worker. 8 Months later I developed pain in my right testicle and was diagnosed with mild orchitis by my GP. I was prescribed 7 days of Doxyclycline (100mg 2x Daily). The pain did seem to subside but never fully went away. I never experienced any other symptoms that would lead me to believe I had an STD, but chlamydia seems to be the main culprit for this condition.  7 days after I was done with the Doxy, I did a full STD screening, blood and urine. All tests were negative, but I understand that this could be a false negative because I tested too soon after taking antibiotics.

The pain continued and I was refereed to a urologist. He wasn't able to see me for 3 months so until I could get in, he refilled the Doxy. I just completed the 3 month course of Doxycycline (100mb 2x daily). The urologist did not seem concerned at all about my condition because of the relative mild symptoms I was experiencing and I was dismissed without further help. Now a week later (and a week off the Doxy), the discomfort has gotten worse. I can not say its a pain, just a noticeable feeling of infection in my epididymis and groin area and occasional mild pain in my right testicle.

I'm very concerned that I am still infected. I am planning on getting another std screening in a few weeks when I can be sure there is no medication in my system, but I'm not sure if I should let this thing continue without being treated in some way.

Could I still be infected with chlamydia and/or gonorrhea after such a long Doxy course????

Thank you!
Related Discussions
239123_tn?1267651214
Welcome to the STD forum.  I'll try to help, although given the amount of evaluation and treatment you have had, I doubt I can settle anything in a definitive way.

Most likely you never had anything that was in any way related to your sexual encounter. Acute epididymitis due to STD -- i.e. gonorrhea or chlamydia -- would start to cause symptoms within a few weeks (usually under 2 weeks) after exposure, not 8 months later.  Any gonorrhea or chlamydia you caught would most likely have gone away within 8 months, without treatment.  Second, sexually transmitted epididymitis doesn't cause the relatively vague symptoms you describe, but instead results in an acutely painful/tender testicle, often with fever.  Isolated pain in the testicle isn't a likely presentation.  Also, you don't mention any other symptoms that would typically go along with epididymitis due to STD, especially penile discharge or pain/discomfort when urinating.

Further, the lack of response to unusually prolonged antibiotic therapy is strong evidence that no infection of any kind is responsible.  And in response to doxycycline making STD tests false negative:  it doesn't work that way.  Antibiotics turn tests negative because the cure the infection.

As far as non-STD causes of such symptoms, I suggest you look into the male chronic pelvic pain syndrome, formerly considered a form of non-infectious prostatitis.  For some excellent information about it, google CPPS (spell it out) and start your reading with the excellent Wikipedia article and the information from the Stanford University Department of Urology.  If the symptoms etc seem to fit, this is something to discuss with your urolgist.

Finally, whatever is going on, I am inclined to agree with your urologist:  nothing serious; even if your symptoms persist, I see no realistic chance you have anything that will ever be an important health risk to you or any current or future sex partners.  You can be very confident that you have no STD and nothing that is related to the sexual exposure last year.

Good luck--  HHH, MD
6 Comments
Blank
Avatar_m_tn
Dr,
Thank you for your response. I have to say I feel much better after reading this. I will continue to research the CPPS; at first glance im not sure it made sense, one thing that did stand out is that it can be triggered by anxiety, which I have had issues with in the past, and very much so over this ordeal. I did have allot of regret and stress over the sexual encounter last year.

I was surprised to read that Chlamydia / Gonorrhea can go away by itself? I was under the the opposite impression. For arguments sake, if I did have them, would the doxy alone be enough to cure them?

Also, based on your test comment, can I trust the test I had a few months ago that I don't have chlamydia?

Thank you!!!!!!
Blank
239123_tn?1267651214
Chlamydia and gonorrhea are bacterial infections, and most bacterial infections clear up on their own.  There are exceptions, e.g. tuberculosis and syphilis.  But the immune system eliminates things like staph, strep, gonorrhea, chlamydia, etc.  For example, in the pre-antibiotic era, 90% of people with bacterial pneumonia recovered completely.

Doxycycline for 1 week is 100% effective against chlamydia.  Some gonorrhea is resistant to doxy, but still would not persist despite 3 months treatment.

Finally, the current tests for gonorrhea and chlamydia are highly reliable.  You never had it.
Blank
Avatar_m_tn
Thank you again doctor,
One last follow-up. Everything Ive read about Epididymitis and epididymo-orchitis is that its almost always caused by std.

Prostitis isnt something that I considered seriously and I will talk to my urologist about this. Do you think that another antibiotic may be helpful? Cipro or other?

Thank you again
Blank
Avatar_m_tn
One thing I should add, the Epididymitis/Orhcitis was diagnosed via an ultrasound that suggested infection.
Blank
239123_tn?1267651214
You read wrong about epididymitis and epididymo-orchitis.  STDs (gonorrhea and chlamydia) are common causes but by no means the only ones.  There are immunologic causes and cases caused by non-STD infections, plus those resulting as side effects from certain drugs.

I'm not an expert on the reliability of ultrasound in diagnosing the condition, but I know it's an imperfect test.  That's something to discuss with the urologist.

That's all I'll have to say.  Best wishes.
Blank
Continue discussion Blank
This Forum's Experts
239123_tn?1267651214
H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
469720_tn?1388149949
Blank
Abdominal Aortic Aneurysm-treatable... Blank
Oct 04 by Lee Kirksey, MDBlank
242532_tn?1269553979
Blank
The 3 Essentials to Ending Emotiona...
Sep 18 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Control Emotional Eating with this ...
Sep 04 by Roger Gould, M.D.Blank