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Low back pain after unprotected sex
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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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Low back pain after unprotected sex

I recently (a month or so ago) had both unprotected oral (gave and received) and unprotected vaginal intercourse.  I have the "cold sore" herpes, but have never had any breakouts other than near my mouth.  I did not have any open sores while engaged in sexual activities.  A couple of weeks after having unprotected sex, I noticed a very slight discomfort near the tip of my penis.  There was no discharge and no apparent sores.  I did seem to have to urinate more, however.

I did come down with a slight cold with a mild sore throat, fatigue, fever, etc during this period.  I now have low back pain, particularly on my left side, which seems to be spreading some to my right side.  I called my brother, who is in the medical field, but lives too far away to visit face to face, and he indicated I may have a bladder infection which has spread to my kidneys.  He said it was important not to ignore it and see a doctor immediately, but I'm worried about another issue.

My g/f is hitting her early 40's, and has been showing some menopausal signs.  She just went back to her specialist, who ran tests that confirm her perimenopausal status, but also found some blood in her urine.

Any thoughts?
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I doubt your back pain is due to herpes or any other STD.  To my knowledge, in 30+ years in the STD business, I have never had a patient whose first STD symptoms was back pain.  And although "mild sore throat, fatigue, fever" could theoretically be due to an STD, it's very unlikely that any STD would cause only those symptoms.  However, discomfort at the urinary tip could be due to an STD like nongonococcal urethritis (NGU) or chlamydia -- or, theoretically gonorrhea, but that's much less likely.

With respect to urinary tract infection (UTI, bladder infection possibly involving a kidney).  UTIs are rare in healthy younger men.  If you are under 40, UTI is unlikely, but they become increasingly common with aging, especially beyond age 50 -- when a naturally enlarging prostate gland can predispose to infection.  However, it is unusual to have a kidney infection without fever.  If your temperature is normal, most likley something else is going on.

I don't see any possible connection to your sex partner's menopausal status, and probably no relationship to traces of blood in her urine.  She could have a UTI herself (much more common in women than men), but that's not sexually transmitted; and STDs don't usually show up with urinary blood as the main symptom.

Bottom line:  I cannot put all this together under a single diagnosis.  Most likely not an STD, and I doubt you have anything related to the sexual encounter a month ago.  I definitely agree with your family member's advice about seeing your doctor right away.  Probably you have nothing serious, but you should not take chances about it and should see your primary care provider as soon as possible.  If you do in fact have a kidney infection, it is urgent that it be diagnosed and properly treated immediately; such infections can get very dangerous very fast.

I hope this helps.  Good luck--- HHH, MD
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H. Hunter Handsfield, M.D.Blank
University of Washington
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