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Itching and aching, scared and frustrated
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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.

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Itching and aching, scared and frustrated

Thanks for your attention!

Male with slight redness around the urethra opening, and the itching/burning is just barely inside and outside on the bottom of the penis for > 1 month.

5 weeks ago I had unprotected vaginal/received oral.  About 3 days later the opening to my urethra started to itch and burn a little.  It has persisted since. No discharge or sores.  Itch varies in intensity but it's never crippling... it's never more than just enough to know things aren't right.  A little more intense after ejaculation, but again, not crazy.  Never burns/hurts when I ejaculate or pee.  Just an itchy tingly sometimes burning sensation just slightly inside the opening of the urethra and underneath.  2 weeks after the encounter, 3 weeks ago, I went to PP and had chlamydia and gonorrhea urine test.  They gave me a 1g Z-pack, which I took that night.  Both tests turned out negative.  For a couple days after the Z-pack, I felt ok... maybe a placebo effect?  I also had a physical exam.  Nothing unusual, no swelling (glands, lymph nodes, etc).  Went to 2nd doctor two days ago.  Another physical exam with no unusual findings.  Did a urine test for bacteria which was negative.  I asked about trich, he said it was too uncommon in men to worry about, and hard to test for without a discharge. I wasn't too concerned about syphilis, and the doctor didn't seem to be either, because there've been no sores. I also asked about a yeast/fungus infection - after the z-pack I almost immediately came down with case of jock itch which I treated successfully with OTC cream.  He did a swab culture of the inside of my urethra and I'm awaiting results.  I plan to go to a clinic this week to take more STD tests.  Am I worrying too much here?  What other possibilities are there?  From what I hear herpes can show up without sores but it shouldn't be itching/burning like this for a month+.  Yeast?  Trich?  Hopefully I'm way too worried about not a lot.
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Welcome to the STD forum.  I reviewed your threads on the STD and herpes community forums.  I'm happy to confirm the reassuring responses you received (as always -- the moderators are highly qualified professionals).

First, herpes:  Like a lot of people, you may have been misled by things you have read about genital herpes online or elsewhere.  Lists of herpes symptoms generally include genital itching, tingling, etc.  However, such symptoms by themselves almost never are due to herpes.  Herpes lesions may itch or tingle, and tingling or burning sensations sometimes precede recurrent (but not initial) herpes outbreaks.  But the symptoms you describe do not suggest herpes.

And they really don't other STDs either.  While urethritis (gonorrhea, chlamydia, NGU) could cause redness of the urethral opening and urethral itching, they are all unlikely in the absence of overt abnormal discharge.  Even more important, the standard lab tests are highly reliable; and azithromcin (Z-pak) would have aborted or cured almost all such infections.  Trichomonas is unlikely; it usually is asymptomatic in men, and in any case goes away on its own.  And on top of all this, you have been professionally evaluated by two health professionals.

In one or both of your other threads, you asked whether your symptoms could have a psychological basis.  The answer is yes, and in my experience that is the explanation in the large majority of men with similar symptoms plus repeatedly negative examinations and tests.

So for multiple reasons -- your initial symptoms, the negative tests, examinations, and treatment -- you can be very confident you caught no STD.  My advice is that you cease all medical evaluation for at least 2-3 weeks.  If and when you become convinced nothing is really wrong, most likely your symptoms will fade away.  In the meantime, you should resume sex with your regular partner (if you have one); no harm will result.

I hope this helps.  Best wishes--   HHH, MD
2 Comments
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Thanks, Doc.  I will follow the advice... possibly with a little cortizone for the itching.  :)
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H. Hunter Handsfield, M.D.Blank
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