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Oral Sex, Molluscum
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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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Oral Sex, Molluscum

Dear Dr. H,

I first must say that I feel that this forum & system is a tremendous resource for people wanting to get real world information about medical situations!  I've been a long time reader & fan ... and now it's time to submit my own question.

THE SITUATION:

I'm a male. Received fellatio from my wife's girlfriend. The brief event lasted under 1 minute to completion.  She's single & has a quiet to below average sex life with like two boyfriends with whom she's had sex this year and has had no known STD issues.  We talk often and if anything like that came up, we'd know, but not sure if she tests for STD's often, but is far from high risk like a sex worker.

This was one of those dumb situations that shouldn't have happened, and I'm not too happy with myself - alchohol and lack of judgement can do that to you!  I feel bad enough about the event but then

THE COMPLICATION:

Exactly 5 days after this event, I noticed small flesh colored bumps on my penis.  They came about literally overnight. The lesions didn't hurt and were just "there". I went to my GP and he said "looks like herpes" but not sure.  He referred me to my Urologist who said without a doubht that it was Molluscum, quickly ruling out syphilis & warts). From my research and the lack of pain etc. I knew he was right. He Prescribed Aldera (ouch!) and to come back in 6 weeks to get "frozen off" if Aldera didn't work.

It's now 5 weeks past the event and still have MOST of the lesions so they are surely Molluscum and go in to get them removed in a few more weeks.

MY QUESTIONS:

(1) How readily is Molluscum transmitted by oral sex, mouth-to-penis?  Could my Molluscum have been caused by this event? From what I read & researched, I can't find a straight answer since the incubation period from exposure to outbreak seems to be longer than the five days from the event.

(2) LATELY (couple of weeks past event) I've noticed an occasional burning, tingling at the tip of my penis & what I think is an occasional "mild burning" with urination sometimes. I am attributing this almost 100 percent to STD Anxiety linked with guilt.  I find myself thinking about my penis all the time, consistent with the guilt complex and too much online research. I got worried about Chlamydia and Gonorreah but didn't notice any overt symptoms. Have had NO discharge or any severe pain on uriation etc. (Thanks to this forum, I understand that Chlamydia is not an issue).  My question, IF there was any exposure to oral gonorreah (which I consider unlikely), I assume that I would have had more pronounced symtpoms earlier on?  And, if so, how severe ARE symptoms if they show up in a male?

I feel, per this forum, that this event was not a "high risk" situation and that the worst thing I caught from this situation was a bad case of "guilt".  But I'm very curious about the two questions I asked and hope that you can answer them and help alleviate some of my concerns.  

I will check back and post with updates.





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The epidemiology of gential (genital) molluscum contagiosum has not been well studied.  But one thing clear is that the incubation period is at least several weeks, typically 2-3 months.  Almost certainly you did not acquire it 5 days before appearance of your lesions.

Acquisition of MC by oral sex has not been reported to occur.  It might happen, indeed makes sense, since exposure to infected saliva is presumed to be the main transmission route in young children.  But it's more likely that you acquired it by genital intercourse.

The infection has been reported to sometimes occur in the genital area by non-sexual routes, e.g. by towels or even, according to one report, to a swimming pool (suggesting contaminated water).  However, the quality of the science in those reports was poor.  Whether masturbation might have contributed to the distribution of your penile lesions also is not clear.  Based on the biology of the virus, it makes sense that lesions might appear preferentially at places of abrasion or friction--not because of autoinoculation (ie, from your own hands), but simply from massaging the virus into the skin.

Yes, you would almost certainly have more prominent symptoms if you had urethral gonorrhea.  As I have said many times, when a person suspects his or her symptoms might be related to stress or anxiety, s/he probably is usually right.

Sorry it's all so vague.  The good news is that the main reason there is so little information is that the infection is essentially a cosmetic issue, not a serious health risk--so there isn't a lot of stimulus for research.

Good luck--  HHH, MD
3 Comments
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Sorry, but forgot some details:

(1) Molluscum appeared primarily on top of shaft of penis, 7 small lesions in particular, in the area that grasp my circumsised penis during masturbation, something I do often.  Possible transmission by my hand from "something else" possible?

(2) The Molluscum is also located at base of penis and a few lesions on my lower abdomen.

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Avatar_n_tn
Dr. H,

Thank you for such a fascinating, enlightening and stress relieving reply!  That is why I think this forum, with people like you, is the best place for people to participate with questions like mine!

(1) My wife and I realize(d) that we've probably both been infected with MCV for MONTHS previous after our preliminary research and consultation with my urologist.  He said: "You both probably have it, don't worry about it, you've had it for months or even years from God knows where".  Neither of us have had any extramarital relations for a full 12 months prior to the outbreak guaranteed (long story, don't ask :-) ).  So, the timeframe you suggest and our history prove that the oral episode was NOT the cause.  And where I / we got it?  Who knows!  Not gonna worry about that!

BUT That was the reason for my question about oral transmission! The timing of my slip up and the sudden appearance of the lesions just threw me for a loop, and I got concerned that there WAS some kind of correlation.  LOGICALLY I knew what you restated here was TRUE, but a guilty mind gets you thinking all kinds of nasty things!

(2) Thanks for the info on the friction and abrasion issue regarding the virus.  That is really fascinating that the virus could have been sitting there and my actions could have exacerbated and helped the virus along!  Thinking back with a clear mind, it seems that I was masturbating heavily previous to the outbreak, and there was a little area that was kinda tender on my penis near where the lesions started.  Go figure!

(3) Thanks AGAIN for the clarification on gonorreah.  Look, we all know that I KNEW that I likely DIDN'T have it! Say THAT three times fast!  But, as you say, a guitly mind can create interesting physical symptoms when you think about them too much!  Like so many folks, I just wanted to hear it for myself! I am NOT going to worry about this or testing for it etc. since this was a low risk situaton (per your numerous posts) THANKS!

AND I hope that my story and information here helps other folks that may have questions or concerns like mine!

I will be getting these pesky buggers frozen off very soon and the wife is getting checked out too so we can avoid cross contamination!

Thanks for all that you do!

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