STDs Expert Forum
Protected sex, unprotected oral. STD risks?
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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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Protected sex, unprotected oral. STD risks?

I have had a few indiscretions with high-risk women.  Five or so very quick, protected vaginal penetrations. During these, I am fairly certain all of the penis shaft that was inserted remained covered and I had no noticeable open sores on my penis shaft. No rips or major slippage of condoms. I have also had a number of protected oral sex incidents performed on me.  The last penetration occurred a little over a week ago. During this incident, however, I did a very stupid thing.  I twice received unprotected oral from this high-risk woman, and performed unprotected oral on her.  After the incident, she swore she was clean, both face to face and over the phone, and asked if I wanted to see her papers.  At of the end of last week, I started getting lower back pain and some lower abdominal discomfort.  I have also had some testicular discomfort.  Just a general soreness, mainly in the right testicle. I don't believe I've had any discharge.  None that I can notice.  How noticeable would it be?  I keep checking during/after urination and everything seems like urine.  I dab the tip and never find wetness except for a few minutes after urination. There was a slight bit of general ache a couple times in what felt like inside the shaft, but only a couple of times. I also must admit that I doused my genitals and penis with hand sanitizer after each encounter. The urine is yellow, not discolored.  No fever, but general achyness, muscle soreness, tiredness.  I also do have IBS, and I have had some bowel irregularity and discomfort this past week too.

Do I have anything to worry about because of the unprotected oral?  The protected vaginal penetration?  About HIV?  Syphilis?  Chlamydia?  Gonorrhea?  Should I get a full STD panel?  Or am I worrying for nothing? I don't want to ruin my life, or the life of my wife or child.  I don't want to give my wife anything.  We had unprotected sex two days ago on her insistence (it was unexpected), and now I am worrying like crazy.
239123_tn?1267651214
Welcome to the forum.  Thanks for your question.

You had succinct but accurate replies to the same question on the HIV and STD community forums.  From an STD prevention standpoint, the most important information is that you used condoms for vaginal sex.  A little slippage of condoms is normal and generally doesn't elevate STD risk; the important thing is that the head of the penis and urethral opening remain covered.  Oral sex is low risk for STDs, although not zero risk -- but most STDs acquired that way cause symptoms that you would hav enoticed -- i.e. absence of abnormal urethral discharge, painful urination, or penile sores is good evidence you weren't infected.  Hand-genital contact is very low risk and probably entirely risk free, even when genital secretions are used as lubricant.

As for your other symptoms, rather vague testicular/genital or abdominal pain, or back pain, are not STD symptoms.  Testicular or penile discomfort in this situation is usually just the result of genitally focused anxiety, which is common after a regretted sexual decision.  And of course back pain is part of the human condition -- we all have it some of the time, some people more than others.

So I am confident you have no STD from the events described, and that your wife is not at risk.  (And of course your kids couldn't be at risk at all.  STDs aren't transmitted to children by personal or household contact, only by sexual abuse.)  However, if you want still more reassurance, you could visit your PMD, or a public STD clinic, or a Planned Parenthood clinic for confidential evaluation and testing.  If you do so, you can expect negative results.

I hope this has been helpful.  Best wishes--  HHH, MD
9 Comments
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Avatar_m_tn
Thank you doctor.  This is a new question.  It looks similar to old questions, but I have had a couple more incidents since the last questions. Mainly, however, I am most concerned about the unprotected oral that I gave and received.  She took my penis all the way into her throat, and I ejaculated at that point.  Plus I performed unprotected cunnilingus on her.  That is what I am most concerned about.

That still poses little to no risk for STDs?  This is my question.  Do I need testing because of these incidents?  Would have I noticed a noticeable discharge/sore a little over a week after this encounter?  Or do I need to wait longer to be sure?  How noticeable is "noticeable"?  
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239123_tn?1267651214
Penile discharge due to STD usually shows up in a week, sometimes up to 2 weeks.  Urethral testing (for gonorrhea and chlamydia) is valid any time more than 2-3 days after exposure.

However, this information changes my advice somewhat:  regardless of symptoms, you should visit a doctor or clinic for standard STD testing (gonorrhea, chlamydia, syphilis, HIV).  All people who are sexually active outside mutually monogamous relationships should have routine STD/HIV testing from time to time, like once a year, even if all exposures were apparently safe.  Since these are new exposures since November, it is apparent this sort of activity isn't unusual for you.  You can expect negative test results, but better safe than sorry.
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Avatar_m_tn
This activity will be unusual for me. It is not to occur again, and there has only been 2 incidents since November.  Like I said: 5 or so protected vaginal total (2 since November); 10 or so protected oral total (2 since November).  One incident of unprotected oral, both giving and receiving, which was a little over a week ago.

Are these considered "safe" exposures?  If no symptoms, can I assume that I have not acquired any STDs?
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Avatar_m_tn
And can I assume I have not given my wife anything? Safe to continue unprotected sex with her?
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Avatar_m_tn
I also forgot to mention that during this latest encounter, with the unprotected giving/receiving oral, I was on 500 mg clarithromycin, twice daily.  I had been on it for about 4 days, and was still on it when I had my encounter with my wife.  I was on it for a sinus infection.  

I was also on antibiotics for the same thing (sinus) either during or immediately after my other encounter I have had since November, and that was augmentin.
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Avatar_m_tn
Please, doctor...answer these questions, and I'll ask no more.  
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239123_tn?1267651214
Patience, patience! The moderators are not on call 24/7.

We don't expect much of questioners, but we do expect them to read our replies! I already answered your question about the chance you might be infected: the chance is low, but testing is the only way to know for sure.  The clarithromycin would have prevented chlamydia and probably gonorrhea and syphilis, but not for certain. It would have had no effect on herpes, HPV, or HIV.

If I were in your situation, I would consider the risk low enough that I would not be tested and I would continue unprotected sex with my wife.  But I'm not you. If you want 100% assurance, you'll have to visit a doctor or clinic for testing.

That's my last comment. Good luck.
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Avatar_m_tn
Thank you Dr. Handsfield.
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