STDs Expert Forum
Prodromal herpes?
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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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Prodromal herpes?

I am a male. Possible exposure 12 days ago; PROTECTED vaginal sex and UNPROTECTED mutual oral sex. She was menstruating; no visible blood. NOT my fiance. My only genital symptom is a tingling sensation in penis, specifically the urethral opening, since day 3. BUT, this feeling comes and goes. AND, I've been checking for issues at least twice daily. Otherwise, VERY mild sore throat after 5 days (gone now). I have had NONE of the following:

- discharge
- pain while urinating (above-mentioned tingling disappears during urination)
- sores, lesions, blisters

I acknowledge that I am a neurotic and my OCD is in overdrive. I have read through the archives looking for insight. I've found plenty, but still have the following questions:

1) Can I rule out genital chlamydia & gonorrhea (in the absence of the above traditional symptoms)?
2) Can I rule out throat infection caused by chlamydia or gonorrhea (very little information online)?
3) Could the tingling be prodromal herpes? Or, are prodromal symptoms limited to skin surface?
4) As a marathon runner, could physical condition inhibit symptoms?
5) I had sex (unprotected vaginal, performed oral) with fiance the morning after possible exposure. Is it possible I could have exposed her to anything so soon (no sexual contact since)? THIS is my biggest worry.

Thank you for what you do here. It is both insightful and noble.
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Thanks for the thanks about the forum.

From a transmission risk perspective, there is little chance you caught any STD.  Condom protection during vaginal is highly effective against all STDs--virtually 100% for gonorrhea and chlamydia, not quite as good for herpes, but still excellent.  And oral sex is inherently low risk for all STDs:  the risk of all infections is near zero for performing cunnilingus; for a male receiving fellatio, there are small risks of gonorrhea, nongonococcal urethritis (NGU), and genital herpes due to HSV-1, but none for chlamydia.  Although any of these can occur asymptomatically, most infected men would have the classical symptoms, which you do not.  Computing the combined odds--i.e. low transmission risk plus lack of symptoms--almost certainly you acquired no infection.

Herpes does not cause the sort of 'prodromal' symptoms you describe.  Herpes prodrome refers only to the numbness, tingling, or similar symptoms that occur in the area of an outbreak prior to development of overt herpes sores, and is a symptom only of recurrent herpes, not the initial infection.  And the prodromal symptoms only last for 1-2 days.

Of course I never guarantee someone isn't infected, whether from a particular exposure or because they might have been infected from another source.  But to answer your particular questions:

1, 2) There is no realistic risk of gonorrhea or chlamydia, either genital or throat.

3) You don't describe anything like a herpes prodrome or any other symptoms that suggest an HSV infection.

4) There are no data, but no reason to suppose that physical conditioning affects STD symptoms one way or the other.  Contrary to popular opinion, there is no evidence the 'strength' of the immune system, as supposedly influenced by exercise, diet, etc, has any effect--good or bad--on symptoms or recovery from STDs or other infections.

5) As I said, I never guarantee someone isn't infected.  But I see no significant risk to your fiance.  Of course if you remain concerned despite my judgment, you can always visit your personal health care provider or your local STD clinic for testing.

Good luck--  HHH, MD
Miraculously, I feel better already.

May you live to be 1,000 years old.
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H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
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