Std symptoms. But protected sex

[unicorn78]

Dear Expert

9 days ago I had a sexual encounter with a CSW. Who admitted to once a year testingting for stds.
During the encounter. Oral and penetrative vaginal sex was performed with condom use
for both acts, and condoms were swapped. It's unclear if there was any condom damage during
Oral sex as u felt strong friction from teeth. But during vaginal sex and after I kept an eye to ensure
that the condom was on. It appeared the integrity of the condom was maintained since the
ejaculate was inside the condom.

What is surprising is two days ago I developed some sharp burning meatal pain on urination. NOT through the whole stream
just at the very beginning before the urine is just about to come out and then it's painless for 99% of the urination.

There is no discharge. I can't understand it, as I thought I practiced safe sex. And noted that there was no breakage of the condom after vaginal sex. Could something have happened I didn't plan for?

Thank you

[Edward W Hook, MD]

Welcome back to the Forum.  I'll be happy to make some comments and suggestions.  Congratulations on your practice of condom protected sex.  As a generalization, condom protected sex is safe sex with virtually no meaningful risk for urethritis (i.e. gonorrhea, chlamydia or NGU) which is the problem that would lead to the sorts of symptoms you are experiencing. In addition, the symptom you mention, discomfort just at the beginning of urination is not typical of these STDs either.  For these reason, I am quite doubtful that your symptoms are due to an STD.  

There are other possibilities however.  Possibly your partner’s vigor could have led to some local irritation, even though the condom.  In addition, condom use itself can occasionally lead to irritation, either as a latex allergy, due to the introduction of condom lubricants into the urethra during sex to cause local irritation, or due to predisposing person to overgrowth of yeast (fungus) causing irritation and redness.  Any of these are possibilities. Of them, the first two should get better on their own over just a few days while the fungal infection may need treatment if that is the problem.  

My recommendation would be to give it a few days.  if the problem improves, then I would not worry and would the irritation run its course, being aware that it could recur the next time you have sex with a condom.  If it does not get better, you may wish to have your doctor take a look.  Finally, this may be coincidental and  totally unrelated to the encounter you ahve described.   Either way however, this is both unlikely to be anything serious and is unlikely to be an STD.

[Edward W Hook, MD]

The absence of fever does make the possiblity of ARS somewhat less likely, so does the absence of a rash and adenopathy.  EWH

[unicorn78]

Dear Dr Doctor

If you will indulge in me one last time. Is the presence of a fever as mentioned in this forum universal in ARS? If so perhaps the absence of a fever makes ARS less likely?

Thank you

[Edward W Hook, MD]

The symptoms you describe are consistent with the symptom of both influenza, which is common at this time, and with the ARS which is not.  As I mentioned to you above, your exposure was low risk.  I suspect this is far, far more likely to be coincidence than a consequence of the low risk exposure that you describe.  On the other hand, it you are nervous, you could seek evaluation which in my clinic would include both a test for the flu and testing for HIV.  Personally, IU would not pursue this but that is, of course, up to you and dependent on your level of concern.  EWH

[unicorn78]

Dear Dr Hook

Thank you for your reassurance.

For the past 4 days, starting about two weeks from exposure/intercourse with CSW. I developed widespread myalgia along with a mild sore throat. Temperature has not been elevated with 37.2 via aural measurements the highest. No rush or lymadenopathy had been noted.

I wonder if I should at all be worried about these symptoms, from the point of view of a mild seroconversion phenomenon.

Thank you

[Edward W Hook, MD]

Welcome back to the Forum.  I'll be happy to make some comments and suggestions.  Congratulations on your practice of condom protected sex.  As a generalization, condom protected sex is safe sex with virtually no meaningful risk for urethritis (i.e. gonorrhea, chlamydia or NGU) which is the problem that would lead to the sorts of symptoms you are experiencing. In addition, the symptom you mention, discomfort just at the beginning of urination is not typical of these STDs either.  For these reason, I am quite doubtful that your symptoms are due to an STD.  

There are other possibilities however.  Possibly your partner’s vigor could have led to some local irritation, even though the condom.  In addition, condom use itself can occasionally lead to irritation, either as a latex allergy, due to the introduction of condom lubricants into the urethra during sex to cause local irritation, or due to predisposing person to overgrowth of yeast (fungus) causing irritation and redness.  Any of these are possibilities. Of them, the first two should get better on their own over just a few days while the fungal infection may need treatment if that is the problem.  

My recommendation would be to give it a few days.  if the problem improves, then I would not worry and would the irritation run its course, being aware that it could recur the next time you have sex with a condom.  If it does not get better, you may wish to have your doctor take a look.  Finally, this may be coincidental and  totally unrelated to the encounter you ahve described.   Either way however, this is both unlikely to be anything serious and is unlikely to be an STD.


I hope my comments are helpful. EWH