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STD Symptoms?
Hi Doctor(s),
I visited massage parlors several times about two months ago, and after the last encounter, my penis started to feel itchy. A while later, I also started to feel a tingling or burning sensation, and also a frequent need to urinate. A couple of weeks later, I think the symptoms stopped.
Foolishly, about 2 weeks ago, I visited massage parlors yet again, and after approximately 2 days, I started experiencing the same symptoms (mostly itchy penis). I still could not find any painful sores, lesions, or blisters, but I noticed probably more smegma than usual when I pulled my foreskin. Also, there are several white spots (or dots) kind of grouped together in some areas on my foreskins close to the head of my penis.
In all of my encounters, there was no anal or vaginal intercourse. I received a protected oral sex on one of the encounters (couldn't tell if the girl was having cold sores or not), but in others, it was at the most hand release (I did touch one of the girls' vagina, but I made sure to wash my hand right afterward).
Could the protected oral sex be the cause of the symptoms? Didn't these symptoms sound like Herpes symptoms? I heard that hand-to-genital transmission is possible for Herpes and HPV, could this be one of such cases? What could possibly be the case, and what kind of STD tests would you recommend?
Thank you in advance for your help.
I visited massage parlors several times about two months ago, and after the last encounter, my penis started to feel itchy. A while later, I also started to feel a tingling or burning sensation, and also a frequent need to urinate. A couple of weeks later, I think the symptoms stopped.
Foolishly, about 2 weeks ago, I visited massage parlors yet again, and after approximately 2 days, I started experiencing the same symptoms (mostly itchy penis). I still could not find any painful sores, lesions, or blisters, but I noticed probably more smegma than usual when I pulled my foreskin. Also, there are several white spots (or dots) kind of grouped together in some areas on my foreskins close to the head of my penis.
In all of my encounters, there was no anal or vaginal intercourse. I received a protected oral sex on one of the encounters (couldn't tell if the girl was having cold sores or not), but in others, it was at the most hand release (I did touch one of the girls' vagina, but I made sure to wash my hand right afterward).
Could the protected oral sex be the cause of the symptoms? Didn't these symptoms sound like Herpes symptoms? I heard that hand-to-genital transmission is possible for Herpes and HPV, could this be one of such cases? What could possibly be the case, and what kind of STD tests would you recommend?
Thank you in advance for your help.
MEDICAL PROFESSIONAL
Welcome to the forum.
I reviewed your thread on the STD community forum a few weeks ago. I'm glad to hear your symptoms cleared up and sorry to hear they are back.
There is no measurable STD risk from hand-genital contact, as you were informed on the other forum. It is theoretically true that HPV or HSV could be transmitted that way, but there are few if any actual known cases; in 30+ years in the STD business, I have certainly never seen or hear of such a case. It is also impossible to catch an STD from oral sex with an intact condom. (Even without condoms, oral sex is low risk for most STDs.)
Since it is not possible you caught an STD from your recent exposure, something else is the cause of your penile itching. On this forum we don't speculate about non-STD explanations for genital symptoms -- except that penile itching, without visible rash, is often simply a manifestation of genitally focused anxiety.
If the events described here and on the community forum are your only sexual exposures in the past several months, STD testing isn't necessary. However, I do suggest you see a health care provider in person. Despite the low risk, s/he might recommend STD testing for reassurance. But I recommend against an extensive (and expensive) battery of tests. A urine gonorrhea/chlamydia test and blood tests for syphilis and HIV are all that would normally be done in this situation. (Of course I don't remotely believe you have HIV. But an HIV test usually is routine whenever any STD testing is done.) You can expect negative results.
Good luck-- HHH, MD
I reviewed your thread on the STD community forum a few weeks ago. I'm glad to hear your symptoms cleared up and sorry to hear they are back.
There is no measurable STD risk from hand-genital contact, as you were informed on the other forum. It is theoretically true that HPV or HSV could be transmitted that way, but there are few if any actual known cases; in 30+ years in the STD business, I have certainly never seen or hear of such a case. It is also impossible to catch an STD from oral sex with an intact condom. (Even without condoms, oral sex is low risk for most STDs.)
Since it is not possible you caught an STD from your recent exposure, something else is the cause of your penile itching. On this forum we don't speculate about non-STD explanations for genital symptoms -- except that penile itching, without visible rash, is often simply a manifestation of genitally focused anxiety.
If the events described here and on the community forum are your only sexual exposures in the past several months, STD testing isn't necessary. However, I do suggest you see a health care provider in person. Despite the low risk, s/he might recommend STD testing for reassurance. But I recommend against an extensive (and expensive) battery of tests. A urine gonorrhea/chlamydia test and blood tests for syphilis and HIV are all that would normally be done in this situation. (Of course I don't remotely believe you have HIV. But an HIV test usually is routine whenever any STD testing is done.) You can expect negative results.
Good luck-- HHH, MD
A related discussion, STD Symptoms? was started.
MEDICAL PROFESSIONAL
There's a typo above; should read "Under age 25, closer to 20-25% have HSV-1", not HSV-2. Sorry for any confusion.
MEDICAL PROFESSIONAL
No STD is likely to cause "white spots" on the penis; conceivably warts, but warts cannot show up sooner than 1-2 months after exposure and the average is 6 months or more. For most people with such complaints, nothing is wrong; it's likely you're just examining yourself too closely and noticing normal features of your penile skin, such as prominent sebaceous or sweat glands. But if in doubt, see a health care provider. You'll never get a clear answer otherwise.
If you insist on HIV testing despite lack of risk, wait until 6-8 weeks after the event.
Your herpes questions are irrelevant, if the exposure above is your only one. If you are otherwise sexually active, however, you could be tested if you want. But be aware that the chance of a confusing result (e.g. false positive) may be higher than the chance you are infected. The proportion of the US population with a positve HSV-1 or 2 test is indeed around 60%, although lower in young people, and of course HSV-2 is absent in people who have not been sexually active, or who have had only the sort of exposure you described above. Under age 25, closer to 20-25% have HSV-2. Either way, most infected people indeed have no symptoms. However, virtually all HSV-2 infection are genital. Most HSV-1 infections are oral but there is no way to know for sure unless there are localized outbreaks. And no blood test accurately says how long someone has been infected.
For all these reasons, it would be a mistake for you to have an HSV test on account of this exposure; please don't do it. But if you decide to do it anyway, you need to wait until 3-4 months have passed. Also, make sure you do NOT request an HSV IgM test; a type specific IgG test is the only kind that should be done.
That will end this thread. There is no need to return to post negative test results.
If you insist on HIV testing despite lack of risk, wait until 6-8 weeks after the event.
Your herpes questions are irrelevant, if the exposure above is your only one. If you are otherwise sexually active, however, you could be tested if you want. But be aware that the chance of a confusing result (e.g. false positive) may be higher than the chance you are infected. The proportion of the US population with a positve HSV-1 or 2 test is indeed around 60%, although lower in young people, and of course HSV-2 is absent in people who have not been sexually active, or who have had only the sort of exposure you described above. Under age 25, closer to 20-25% have HSV-2. Either way, most infected people indeed have no symptoms. However, virtually all HSV-2 infection are genital. Most HSV-1 infections are oral but there is no way to know for sure unless there are localized outbreaks. And no blood test accurately says how long someone has been infected.
For all these reasons, it would be a mistake for you to have an HSV test on account of this exposure; please don't do it. But if you decide to do it anyway, you need to wait until 3-4 months have passed. Also, make sure you do NOT request an HSV IgM test; a type specific IgG test is the only kind that should be done.
That will end this thread. There is no need to return to post negative test results.
So I take it, whatever it is that's causing my penis to itch, I can assume it's not STD-related?
And what about white spots on the foreskin? There are areas on my foreskin close to the top of my penis with white spots that appear in groups. Does this sound like STD or warts? They probably look the closest to pearly penile papilus, but not exactly the same (I could not find pictures of pearly penile papilus on the exterior of foreskin). They're not painful or anything, but the fact that they are there freaks me out.
And about performing STD test, should I wait until the HIV and HSV testing window period is over? How long is this? The last exposure was about 3 weeks ago, so is this enough time already for any sort of antibody to start showing up if I really did catch anything?
I also heard that it is impossible to determine if somebody has a genital or oral herpes, and HSV positive in blood test doesn't really mean one or the other. I never recall having a cold sore, but then again, people mistake canker sore for cold sore and vice versa, so I could never really tell.
Because 60 odd % of the US population carry the virus, is it likely for one to have been infected, but not showing much cold sore symptoms if at all? I'm wondering because I never had herpes specific test done before, so if it shows up positive, is there any way to determine if the infection has happenned for long or recently and whether orally or genitally?
Thank you very much for your reply, Doctor. You have been extremely helpful and it is really appreciated. If I do decide to take the STD test, I'll keep this forum informed of the results. Once again, thank you very much :)
And what about white spots on the foreskin? There are areas on my foreskin close to the top of my penis with white spots that appear in groups. Does this sound like STD or warts? They probably look the closest to pearly penile papilus, but not exactly the same (I could not find pictures of pearly penile papilus on the exterior of foreskin). They're not painful or anything, but the fact that they are there freaks me out.
And about performing STD test, should I wait until the HIV and HSV testing window period is over? How long is this? The last exposure was about 3 weeks ago, so is this enough time already for any sort of antibody to start showing up if I really did catch anything?
I also heard that it is impossible to determine if somebody has a genital or oral herpes, and HSV positive in blood test doesn't really mean one or the other. I never recall having a cold sore, but then again, people mistake canker sore for cold sore and vice versa, so I could never really tell.
Because 60 odd % of the US population carry the virus, is it likely for one to have been infected, but not showing much cold sore symptoms if at all? I'm wondering because I never had herpes specific test done before, so if it shows up positive, is there any way to determine if the infection has happenned for long or recently and whether orally or genitally?
Thank you very much for your reply, Doctor. You have been extremely helpful and it is really appreciated. If I do decide to take the STD test, I'll keep this forum informed of the results. Once again, thank you very much :)
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
