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STDs (Expert Forum)
Gonorrhea concerns
Answered by
University of Washington
Seattle - WA
Welcome to the STD Forum, which 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.
Gonorrhea concerns
by Jim2006, Apr 15, 2009 11:04AM
Hi Doctor,
I’m a 35 year old married male who had a one-time unprotected oral sex encounter with a gay male 2+ years ago. I was the recipient of the oral sex. In the months following the sex, I didn’t notice any symptoms. I got tested 6 months afterwards for gonorrhea, Chlamydia, syphilis, HIV, Herpes and came up negative for everything.
Fast forward to present, last month (2 years later) I noticed some symptoms of urethritis: slight burning/discomfort after urination (not during), either a discharge or just drips of urine after urinating, and minor testicular pain/discomfort. Anyhow, I got scared that I had passed gonorrhea onto my wife and she had passed it back to me. We’ve been married 10 years now and aside from the one oral sex incident neither of us has been with any other people sexually. I went to the doctor who dismissed an STD and gave clarithromycin. Two weeks after finishing the antibiotics, I still had this drip after urinating but less discomfort so I got tested for gonorrhea and Chlamydia again—both negative.
Here are my questions:
1. How likely is it that I was infected to begin with?
2. Is it possible for me to have resolved the infection before testing and then to have passed it onto my wife who passed it back to me?
3. If one partner brings gonorrhea into a monogamous relationship and it’s untreated will it just be passed back and forth indefinitely from one person to the other? How does it ever resolve?
4. Is two weeks after finishing antibiotics good enough to test accurately or will that still interfere with testing results?
5. Do I need to be concerned about other STDs like syphilis that the infection cleared up in me before testing, but that I passed it onto my wife before then?
6. Given this, in your opinion, how likely do I (and/or my wife) have gonorrhea?
Thanks!
I’m a 35 year old married male who had a one-time unprotected oral sex encounter with a gay male 2+ years ago. I was the recipient of the oral sex. In the months following the sex, I didn’t notice any symptoms. I got tested 6 months afterwards for gonorrhea, Chlamydia, syphilis, HIV, Herpes and came up negative for everything.
Fast forward to present, last month (2 years later) I noticed some symptoms of urethritis: slight burning/discomfort after urination (not during), either a discharge or just drips of urine after urinating, and minor testicular pain/discomfort. Anyhow, I got scared that I had passed gonorrhea onto my wife and she had passed it back to me. We’ve been married 10 years now and aside from the one oral sex incident neither of us has been with any other people sexually. I went to the doctor who dismissed an STD and gave clarithromycin. Two weeks after finishing the antibiotics, I still had this drip after urinating but less discomfort so I got tested for gonorrhea and Chlamydia again—both negative.
Here are my questions:
1. How likely is it that I was infected to begin with?
2. Is it possible for me to have resolved the infection before testing and then to have passed it onto my wife who passed it back to me?
3. If one partner brings gonorrhea into a monogamous relationship and it’s untreated will it just be passed back and forth indefinitely from one person to the other? How does it ever resolve?
4. Is two weeks after finishing antibiotics good enough to test accurately or will that still interfere with testing results?
5. Do I need to be concerned about other STDs like syphilis that the infection cleared up in me before testing, but that I passed it onto my wife before then?
6. Given this, in your opinion, how likely do I (and/or my wife) have gonorrhea?
Thanks!
Doctor's Answer
by H. Hunter Handsfield, M.D., Apr 15, 2009 12:17PM
, Apr 15, 2009 12:17PM
Welcome to the STD forum.
Whatever is going on has nothing to do with the sexual encounter with another man 2 years ago. Gonorrhea never lasts 2 years, and rarely causes urethral infection without symptoms -- i.e., if you had gonorrhea back then, you would have known it.
Your symptoms are possibly consistent with an STD like urethritis (NGU or chlamydia), but they are more suggestive of a possible prostate gland problem -- especially if the "discharge" indeed was urine. "Testicular" discomfort commonly is referred pain originaing in or near the prostate gland. At 35 you're a bit young for that, but old enough for it to be a reasonable possibility. Also, "chronic prostatitis" -- more accurately known as the chronic pelvic pain syndrome -- is a possibility for such symptoms. (If you google that term you'll see information that may describe your symptoms pretty well; start your reading with the excellent Wikipedia article that should show up near the top of the google hit list.)
Of course the other possibility is that you really do have NGU or chlamydia, but that would require that your wife caught it first -- which I assume is unlikely, although you don't say anything about her sexual lifestyle. I'm sorry your doctor apparently treated you with clarithromycin without testing your for STDs -- probably it wouldn't have made any difference, but it makes it impossible to ever know for sure, unless and until your wife also is tested.
Another slim possibility is that you had NGU due to normal oral bacteria, if your wife performs oral sex on you. Because of the normal bacteria aspect, NGU sometimes can appear in monogamous settings. However, that usually would have caused a definitely abnormal urethral discharge; and in any case would be unusual to pop up many years into a relationship. But if that's the problem, the clarithromycin will clear it up.
Those comments cover questions 1-3 and 6. Question 4 also partly addressed above: 2 weeks of clarithromycin will clear up chlamydia and probably gonorrhea, but gonorrhea is a virtual impossibility for the reasons above. Question 5: syphilis is not a consideration here. Having had sex with another man, it wouldn't be a bad idea for you have a syphilis blood test somewhere along the line, but the chance you were infected by a single episode of oral sex is extremely low -- and if positive, it would not explain your symptoms.
Bottom line: Read up on CPPS, and discuss that and the prostate issue with your provider. If you are convinced your wife couldn't have picked up an STD, then you can put traditional STDs aside; this has nothing to do with the event of 2 years ago.
Best wishes-- HHH, MD
Whatever is going on has nothing to do with the sexual encounter with another man 2 years ago. Gonorrhea never lasts 2 years, and rarely causes urethral infection without symptoms -- i.e., if you had gonorrhea back then, you would have known it.
Your symptoms are possibly consistent with an STD like urethritis (NGU or chlamydia), but they are more suggestive of a possible prostate gland problem -- especially if the "discharge" indeed was urine. "Testicular" discomfort commonly is referred pain originaing in or near the prostate gland. At 35 you're a bit young for that, but old enough for it to be a reasonable possibility. Also, "chronic prostatitis" -- more accurately known as the chronic pelvic pain syndrome -- is a possibility for such symptoms. (If you google that term you'll see information that may describe your symptoms pretty well; start your reading with the excellent Wikipedia article that should show up near the top of the google hit list.)
Of course the other possibility is that you really do have NGU or chlamydia, but that would require that your wife caught it first -- which I assume is unlikely, although you don't say anything about her sexual lifestyle. I'm sorry your doctor apparently treated you with clarithromycin without testing your for STDs -- probably it wouldn't have made any difference, but it makes it impossible to ever know for sure, unless and until your wife also is tested.
Another slim possibility is that you had NGU due to normal oral bacteria, if your wife performs oral sex on you. Because of the normal bacteria aspect, NGU sometimes can appear in monogamous settings. However, that usually would have caused a definitely abnormal urethral discharge; and in any case would be unusual to pop up many years into a relationship. But if that's the problem, the clarithromycin will clear it up.
Those comments cover questions 1-3 and 6. Question 4 also partly addressed above: 2 weeks of clarithromycin will clear up chlamydia and probably gonorrhea, but gonorrhea is a virtual impossibility for the reasons above. Question 5: syphilis is not a consideration here. Having had sex with another man, it wouldn't be a bad idea for you have a syphilis blood test somewhere along the line, but the chance you were infected by a single episode of oral sex is extremely low -- and if positive, it would not explain your symptoms.
Bottom line: Read up on CPPS, and discuss that and the prostate issue with your provider. If you are convinced your wife couldn't have picked up an STD, then you can put traditional STDs aside; this has nothing to do with the event of 2 years ago.
Best wishes-- HHH, MD
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I appreciate the input. I will check up on chronic prostatitis, maybe that's more the issue here. Do you know if that affects fertility? I assume it might, but I'm not sure.
My wife has never had sex outside of the marriage, so that's definitely not an issue. I got tested for syphilis about 6 months after the encounter and the antibody test was negative. I assume that test is extremely accurate for diagnosing syphilis.
When I got the swab test to check for gonorrhea/chlamydia they were able to culture Staphylococcus epidermidis. Is this something I need to be concerned about or is it just normal bacteria?
Just out of curiosity, on the average without treatment how long does it take for gonorrhea to resolve itself within a couple where both people are infected? The constant re-exposure from the other person won't perpetuate the infection?
Thanks for the help.
Without treatment, gonorrhea usually clears up in men within 2-3 months and in women within 6 months. Reexposure makes no difference; the same immune response that clears the infection prevents it from being bounced back and forth within couples.
Also is chancroid transmitted through oral sex too? I've noticed a sore recently at the base of the penis--not well defined or big, but it hurts a bit.
Disregard chancroid. It is almost the rarest of all STDs in the US, probably fewer than 100 cases per year in the entire country. Even in most developing countries, where chancroid used to be common, it is disappearing.
It is time to drop your obsession with STD as a potential explanation for your symptoms.
That's all for this thread.