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HSV-1, Syphilis or Nothing?
I am a 31 y.o. male. Yesterday I went to a massage parlor and received protected oral sex, but the woman also sucked my testicles, unprotected, for about 1-3 min. I couldn't tell if she had any sores because of her lipstick but there was nothing that looked overt on her lips. Today, mainly in my left testicle but also in my right, I have achiness that causes stomach discomfort, and some tingling, burning. I am concerned about acquiring either HSV-1 or syphilis on my scrotum but I don't know if my concerns are justified. About 8 yrs ago I had one cold sore on the lip and tested positive for HSV-1 igg 3 yrs ago so I do have the antibodies but I know for certain that my HSV-1 is only limited to the lips. Except for the cold sore 8 years ago I don't get overt cold sores but am concerned about spreading HSV-1 to a future girlfriend or wife. My questions are:
1) I've read where you've said if you have HSV-1 you cannot get it at a different site. Is this true even for those who have HSV-1 antibodies but do not have chronic, recurrent outbreaks? Would I have the same level of protection as someone who has chronic outbreaks?
2) I've read on this board anecdotal evidence from some posters who've said that they acquired HSV-1 genitally even though they had it orally. What should I make of that? Since I have antibodies and the unprotected area was the less susceptible scrotum can I safely discount these exceptions from applying to me?
3) Are my symptoms related to HSV-1 or syphilis? What should I be on the lookout for in my scrotal area and if I don't see anything thru 21 days can I safely rule out HSV-1 and not think it will show up later or that i acquired it w/o symptoms but will shed asymptomatically?
4) If I did get HSV-1 lesions on the scrotum is that considered a recurrent or primary outbreak?
5) Should I abstain giving oral sex to any HSV-1 negative future partner, even though I never get cold sores?
6) Will an HSV-1 IGM test show if I've had a recent infection?
1) I've read where you've said if you have HSV-1 you cannot get it at a different site. Is this true even for those who have HSV-1 antibodies but do not have chronic, recurrent outbreaks? Would I have the same level of protection as someone who has chronic outbreaks?
2) I've read on this board anecdotal evidence from some posters who've said that they acquired HSV-1 genitally even though they had it orally. What should I make of that? Since I have antibodies and the unprotected area was the less susceptible scrotum can I safely discount these exceptions from applying to me?
3) Are my symptoms related to HSV-1 or syphilis? What should I be on the lookout for in my scrotal area and if I don't see anything thru 21 days can I safely rule out HSV-1 and not think it will show up later or that i acquired it w/o symptoms but will shed asymptomatically?
4) If I did get HSV-1 lesions on the scrotum is that considered a recurrent or primary outbreak?
5) Should I abstain giving oral sex to any HSV-1 negative future partner, even though I never get cold sores?
6) Will an HSV-1 IGM test show if I've had a recent infection?
MEDICAL PROFESSIONAL
I wasn't sufficiently careful in that comment. I should have said low transmission risk, not zero. But anyway this is completely irrelevant to the sexual exposure, since you are immune and simply cannot catch a new HSV-1 infection. Please try to understand that and get beyond your concerns about it.
Hi Dr. Handsfield,
Thanks for your prompt reply. I had a question about your quote "Oral to skin contact carries no STD risk -- whether the skin of the scrotum or anywhere else. Intact skin is not susceptible to STDs." Don't some men get genital HSV-1 on their penis from receiving oral sex from a female that has oral HSV-1? Does that mean that the skin of the penis shaft is tearing or cutting from the oral contact? My impression of herpes was that it had to be massaged into the skin which could happen even if the skin is intact. Is my assumption wrong? Could you clarify on this? Thanks.
Thanks for your prompt reply. I had a question about your quote "Oral to skin contact carries no STD risk -- whether the skin of the scrotum or anywhere else. Intact skin is not susceptible to STDs." Don't some men get genital HSV-1 on their penis from receiving oral sex from a female that has oral HSV-1? Does that mean that the skin of the penis shaft is tearing or cutting from the oral contact? My impression of herpes was that it had to be massaged into the skin which could happen even if the skin is intact. Is my assumption wrong? Could you clarify on this? Thanks.
MEDICAL PROFESSIONAL
Welcome back to the STD forum.
Oral to skin contact carries no STD risk -- whether the skin of the scrotum or anywhere else. Intact skin is not susceptible to STDs. Testicular discomfort like you describe is not suggestive of any STD. And in any case, STDs that involve the testicles get there by traveling up the urethra, and your penile exposure was condom protected, so STD from this exposure isn't a possible explanation for that symptom.
1) You read correctly. Your history of oral herpes and your positive test for HSV-1 mean you are immune, or at least very highly resistant, to a new HSV-1 infection anywhere on your body.
2) What you should "make of that" is in the opening part of this question: "anecdotally". For the reason just discussed, such stories are rarely reliable, if ever.
3) As already discussed, not herpes. And syphilis does not cause symptoms like this -- not a chance. The first symptom of syphilis is always a sore, which cannot start sooner than ~2 weeks (usually 3-6 weeks) after exposure.
4) Irrelevant -- not possible. But primary herpes (or a primary outbreak), by definition, is a person's first infection with HSV, anywhere on the body.
5) There is a very small risk of transmission of oral HSV-1 by oral sex, even without an overt cold sore. But it's very tiny and not worth worrying about.
6) HSV IgM testing is never useful and certainly would be a waste of money in your case.
The most common explanation of the sort of testicular discomfort you describe, especially when it also radiates into the lower abdomen, is the chronic pelvic pain syndrome (CPPS). It used to be considered a form of prostatitis, but the prostate might not be involved at all. CPPS is often (usually? always?) a manifestation of genitally focused anxiety. For more information, google the term (spell it out) and start your reading with the excellent Wikipedia article and the information you can find from the Stanford University dept of urology. Last time I looked, both were near the top of the google hit list.
But you can forget herpes, syphilis, and any STD from the event you describe.
Regards-- HHH, MD
Oral to skin contact carries no STD risk -- whether the skin of the scrotum or anywhere else. Intact skin is not susceptible to STDs. Testicular discomfort like you describe is not suggestive of any STD. And in any case, STDs that involve the testicles get there by traveling up the urethra, and your penile exposure was condom protected, so STD from this exposure isn't a possible explanation for that symptom.
1) You read correctly. Your history of oral herpes and your positive test for HSV-1 mean you are immune, or at least very highly resistant, to a new HSV-1 infection anywhere on your body.
2) What you should "make of that" is in the opening part of this question: "anecdotally". For the reason just discussed, such stories are rarely reliable, if ever.
3) As already discussed, not herpes. And syphilis does not cause symptoms like this -- not a chance. The first symptom of syphilis is always a sore, which cannot start sooner than ~2 weeks (usually 3-6 weeks) after exposure.
4) Irrelevant -- not possible. But primary herpes (or a primary outbreak), by definition, is a person's first infection with HSV, anywhere on the body.
5) There is a very small risk of transmission of oral HSV-1 by oral sex, even without an overt cold sore. But it's very tiny and not worth worrying about.
6) HSV IgM testing is never useful and certainly would be a waste of money in your case.
The most common explanation of the sort of testicular discomfort you describe, especially when it also radiates into the lower abdomen, is the chronic pelvic pain syndrome (CPPS). It used to be considered a form of prostatitis, but the prostate might not be involved at all. CPPS is often (usually? always?) a manifestation of genitally focused anxiety. For more information, google the term (spell it out) and start your reading with the excellent Wikipedia article and the information you can find from the Stanford University dept of urology. Last time I looked, both were near the top of the google hit list.
But you can forget herpes, syphilis, and any STD from the event you describe.
Regards-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
