STDs Expert Forum
Overlooked stds
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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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Overlooked stds

Dr. Hansfield-

I just want to say that even though you and Dr. Hook advise people online and not in person, easing a person's mind is without a doubt priceless.  

I will try and make this as brief as possible.  I am looking forward to proposing to my girlfriend of 3 years in the next few months.  She was tested for chyl/gonn, syph, hep, herp, and hiv... all negative.  I recently went to planned parenthood and tested negative for the same diseases.  I want to make sure that we are negative of what we can control so that we can live a life without unnecessary worry.  The problem is that we weren't tested for trich or ngu.

Question:

Is trich harmless for guys?
If my girlfriend got tested at a clinic for all std's (negative) but not necessarily trich should I be concerned?
Hypothetically, if she and I had ngu without symptoms would ngu go away without treatment and consequence?  I know that you can't guarantee things online but I would like to know that no symptoms is a good thing.
Are there any health risks for us, if neither of us have symptoms of any kind?  

Dr. Hansfield... You have said that symptomatic ngu clears on its own after weeks or months but does asymptomatic ngu?  Since I am negative of all the std's that my planned parenthood can provide, except ngu, I am tempted to take a zit for any chance of ngu so that I can feel completely std free... I just don't want to turn into a hypo std chondriac! :)  

P.S.  I apologize for yet another crazy-nuerotic-compulsive-paranoid post!  

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Welcome to our Forum.  As you probably know, Dr. Handsfield and I share the forum and we take questions based on our availability.  Clients are not able to direct their questions to one or the other of us.  You got me.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.

Your questions raise important issues as they relate to the topic of sexual health (as opposed to disease).  You do not say much about either your or your partners sexual histories but I'll presume that you have each had other partners in the past and that is the basis for your questions.  I will comment from this perspective.

I applaud the fact that you and your partner have now made commitments to one another and have sought to assure yourselves and each other that the possibility of STDs will not cloud your relationship going forward.  Your test results provide very strong, reliable evidence that neither of you has gonorrhea, chlamydia, syphilis, hepatitis, herpes and HIV.  Believe these results.  So, you ask, what about other STDs?  Several comments but the bottom line is that, based on your test results, you should go forward without concern.  Remember, most people do not have STDs.  With your test results you should not be living in fear:

1.  It is likely that your partner was checked at PPH for trich. That is typically part of the evaluation for women when microscopes are available to check.  The tests are not perfect, even in women abut a negative test is good evidence that she probably is not infected. As for you, trich is not associated with any complications or problems in men and the infection, when present, typically clears itself quickly.  If I were you, I would not worry about trich going forward.
2.  NGU.  There is honest debate about the topic of asymptomatic NGU and whether, in the presence of a negative chlamydial test it even needs to be looked for or treated when present.  NGU refers to the presence of increased white blood cells in male genital secretions and it is most important as surrogate for chlamydial infection.  Based on your and your partners results, I would urge you not to worry about asymptomatic NGU.  


Bottom line,. Based on the results you report for you and your partner, my advice is to go forward without concern. I do not recommend further testing and would not worry.  I hope you will find my comments helpful.  EWH
3 Comments
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Your comments were extremely helpful, as I stated earlier, all we want to do is move forward together in a healthy manner.  Just to be perfectly clear, I was tested at a planned parenthood, she was tested in a clinic but not a planned parenthood.  However, I am sure this clinic is just as reputable as pph.  Anyways, none of her test results she got in the mail said anything about trich.  Should we still not worry about trich? Also, you said not to worry about asymptomatic ngu.. does that go for the both of us?

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Personally, I would not be worried about trich.  ff there is a lingering concern she could call the clinic and ask if she was tested for trich. Since it is a microscopic test they may have looked but not mentioned it.  If not, there are trich tests available for women and she should be able to get one.  

As for NGU, women do not have this manifestation of infection, thus it is only men and, as I said above, I would not be worried.  EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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Edward W Hook, MDBlank
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