Oral Sex Concerns

[RickyVilla]

Hi Doctor,

I am a married man but almost ten days ago I had unprotected oral sex from a sex worker. She told me that she was clean and she showered me before the event. I haven't had any discharge at all and no pain whilst urinating. What I am is extremely anxious to the point that it has completely consumed me. I am constantly focused on my genital area. It feels that I have a continuous dull ache in my bladder and a slight burning on the underneath of my penis (below the opening of my urethra). Sometimes it feels like I have warmth/tingling/annoyance in other areas. This I'm aware could be due to the copious amounts of water I'm drinking and constant focus on the area. Does NGU and Gonorrhoea always manifest itself with discharge? Do these symptoms seem like an STD?
Thanks very much for your help.

[RickyVilla]

Thanks very much for all your help doctor.

[H. Hunter Handsfield, M.D.]

This symptom also is suggestive of anxiety and it doesn't change my advice.  The main STD symptoms in men are discharge of pus or mucus from the penis, sometimes along with painful urination; or penile blisters or sores.  But these sometimes are absent.  So as I said, the chance you were infected is low, especially if such symptoms don't show up. But if you want 100% assurance you caught no STD, you'll need to be professionally evaluated in person.

[RickyVilla]

Hi doctor,

a final question on my part. I am getting some burning after urination and it seems persistent for a while after. Can this also be symptoms of anxiety?
I am indeed waiting for it to occur.
Thanks

[RickyVilla]

Thanks very much doctor. That has helped greatly to ease my concern. I also have a burning/soreness sensation within my penis on the underside. At least that's my best guess to the location. Again is this a sign of my general anxiety? It's not particularly prominent before, during or after urination but just seems to be "there". What would be typical symptoms to look out for?

[H. Hunter Handsfield, M.D.]

Welcome back to the forum.  Thanks for your question.

While I understand your concern, you are overreacting to a low risk situation.  Oral sex is safe sex, with a low chance for most STDs and zero for some of them.  You can see more details in the threads linked below:

http://www.medhelp.org/posts/STDs/Simple-question/show/1723730
http://www.medhelp.org/posts/HIV---Prevention/Need-Education-Regarding-Oral-Sex-HIV-STD-Infection-Chances/show/1721189

Your symptoms are not typical for any STD.  They are, however, quite typical for the physical manifestations of genitally focused anxiety; such symptoms are common when someone comes to regret a sexual decision, as you obviously do.  (Your symptoms are so typical, in fact, that I could use it to teach medical students and residents about GFA -- and I might do so!)  As you imply yourself, gonorrhea and NGU almost always cause discharge and do not cause the sorts of symptoms you describe.

Since you're worried, you might want to vist your local STD clinic (or a NHS GUM clinic, if I correctly interpret "whilst" as a Britishism -- it's rarely used in the US and I believe uncommonly in Canada) for their advice and testing.  But I suggest purely for reassurance, not because I think you are at high risk for infection.  But if I were in your circumstance, I would not get tested (unless more typical symptoms appeared) and I would continue unprotected sex with my wife without worry.

Best wishes--  HHH, MD