Irritation to tip of penis immediately after oral sex (and still present 4 days later)

[a bit concerned]

I have had slight irritation, some redness and minor swelling at the tip of the penis since immediately after receiving oral sex from a woman early on Sunday morning.  She was the friend of a friend and I would think that she would have informed me of any STDs if she had them.  I don't have health insurance, and I can't find any free clinics in my part of the country.

Since there was no delayed onset and the irritation was noticeable as soon as a few hours later, I'm hoping that gonorrhea isn't a possibility.  Actually she was quite gentle and I don't think the penis hit the back of her throat.  One post I read said that there can be minor trauma or irritation to the tip of the penis, resulting from normal mouth bacteria.

There is still some minor irritation and swelling/redness, although perhaps slightly less today (4 days later).  There isn't a discharge, just a minor drip after urination which isn't completely atypical for me from time to time.

I was wondering where I could find Doxycycline, just to take it as a precautionary measure (if you think this is a necessary/good preventive route to take).  I have scoured this site and spoken with someone at Planned Parenthood, and the only STD that I could possibly have would be gonorrhea - and you had mentioned in other posts that Doxycycline would take care of that condition as well.

Thanks so much.

[careless0581]

A related discussion, how soon after sex was started.

[HIM74]

A related discussion, What type of medicine is needed? was started.

[im concern]

Hi what happen to the redness? what medication did you drink? thx

[im concern]

Sir I have similar situation, what medication i can u give. im really scared right now..

[H. Hunter Handsfield, M.D.]

Certainly if any other symptoms appear, such as a definitely abnormal discharge of mucus or pus from the penis, even if the pain resolves; or if current symptoms persist a week.  But be aware that resolution of symptoms doesn't guarantee an infection is not persisting.  One theoretical possibility, if you have otherwise been sexually active in the past month, is that you have something actually acquired 1-4 weeks ago, with symptoms trigger but not directly caused by the more recent oral sex event.

[a bit concerned]

Thanks doctor -

I guess my one follow up question then is: At what point in time would it be essential for me to attend a clinic....if there is continued improvement over the next few days, should I assume that the reaction was physical or chemical, in other words "normal minor trauma" (non-STD), and that no further action is necessary?

I promise this is my only follow up question.  I really appreciate this service.

[H. Hunter Handsfield, M.D.]

If onset of symptoms was literally immediate (right after sex or within a day or so), the initial symptom had to be due to a physical or chemical irritation.  With ongoing symptoms, it is possible there also is an infection, but it could be an oral virus.  Your advice from Planned Parenthood was wrong:  s/he was right that chlamydia isn't an issue and that gonorrhea is possible.  But normal oral bacteria and certain oral viruses (especially adenovirus) can cause some cases.

I recommend against taking doxycycline unless and until a definite infection is diagnosed.  Doxycycline is not reliable against gonorrhea, and wouldn't do anything for a virus.  You need to see a health care provider in person and not try to deal with this yourself or with indirect advice, such as online sources.  Your local health department would be a good option, or you could go to Planned Parenthood (most PP clinics serve men with STD problems as well as women).  Wherever you go, the ideal approach would be for you and your partner to go together so she can be tested for oral gonorrhea and perhaps other STDs.

Good luck--  HHH, MD