STD Worry

[scared805]

I am an engaged woman who had a one time unprotected exposure on this past Friday with an ex boyfriend.  The guilt and worry of an std is killing me.  He is a high risk partner who has had many partners in his past.  He is also married, and swares to me that he has always used protection with his partners and is tested for STD's every 6 months.  Even with that said I can't eat or sleep thinking I caught something from him.  I haven't had any symptoms and we are on day 4, however I know most take a longer time to show symptoms.  My main worries are Chlaymdia, Gonn., and Trich.  On saturday I did notice a little more one time occurence of discharge, but looked more to me like normal discharge that comes before ovulation.  Kind of thick, clear and stringy stretched easily.  no odor.

I went to urgent care on Saturday (day after exposure) and was given zpak, and Flagyl.  

Questions are:
1. Is 4 days after exposure enough time to test for Chlamydia, gonn. and trich?

2. I took 500/mg of zpack on Saturday, then took my second dose on Sunday 250/mg.  I then read online that chlaymida should be treated by taking a one time dose of 1gram.  So thirty minutes after taking the 250/mg I took another 750/mg to total 1 gram.  Would that still be considered a one time dose of 1 gram even though there was a 30-40 minute time span from taking the first with the other three?  Would it cure chlamydia?

3. Would that dose also cure gonnorreah?  

4. Does gonnoreah usually cause symptoms? If so what is the most reported discharge or pain with urination?

How long would your recommend avoiding intercourse with my fiance after taking the meds of flagyl and the one time dose of zithromycin I took on Sunday?

Thanks so much!

[Edward W Hook, MD]

Before I comment on your questions, a brief comment on your risk. It is low.  If your ex tells the truth ( and his answer was really rather detailed to be made up), your risk is very low. Furthermore, even if he was infected,  not all exposures to infected partners lead to infection, in fact the majority do not.

Now to your questions:

1.  Testing for gonorrhea, chlamydia and trich at four days will give reliable results.  

2 and 3.  The 1 gram dose of azithromycin you took on Saturday, even divided the way you did will reliably cure chlamydia and about 70-80% of gonorrhea infections, if you had it.  The metronidazole will cure trich if that was present.  

4.  Many but not all women with gonorrhea will have symptoms.  the most common symptoms are an increased or changed vaginal discharge and discomfort on urination, similar to when a person has a urinary tract infection.

5.  Following the treatment you have had, you are currently safe to have sex with your fiancé.

Hope this helps.  Take care.  EWH

[scared805]

Thanks so much for your insight.  This sight is very helpful, and your expert opinions are helpful to many!  

You said an increased or changed vaginal discharge is a sign of gonorrhea.  What type of discharge does it usually cause.  I did notice an increased occurence on Saturday like I said very thick clear and stringy (stretched easily).  Seemed like it had a few white streaks in it.  But it could have very well been discharge that comes with ovulation.  I am on day 11 of my menstrual cycle.  Is burning with urination almost always a symptom? or is discharge alone enough for worry.

Also I just took the zithromycin on Sunday, and am on day 3 of Flagyl, last day will be Friday.  Is it still safe in terms of trich?  or should I wait until finishing those antibiotics.

Lastly I was going to visit dr. for a test for those three std's this morning, would you say I am pretty safe and don't need the testing?

[Edward W Hook, MD]

The discharge of gonorrhea is quite variable and buring is not always present.  As I said, if you had an abnormal discharge you should be evalauted.

the flagyl you have already taken woul dhave cured trich if present.  EWH

[scared805]

I went yesterday for urine test of chlamydia & gonn.  Dr. said it would be back in two days.  My question now is would the azithromycin I took on Sunday & the flagyl I have been taking cause a flase negative?  Or would the results still be accurate?

[Edward W Hook, MD]

Taking the antibiotics may cure chlamydia or trich if you had it, givng you a false negative test.  That is part of the reason we urge peole not to take medications before they know what they have.  You're stuck. EWH

[scared805]

Thanks so much for your help, this site is amazing and you dr.'s are more help than my treating physicians.  Very helpful.

Anyhow, follow up.  My test that was taken four days post exposore for chlam. gon. came back negative.  The did a urine sample test.  However I am still have more discharge, than normal.  Discharge is white, normal colored but more than I normally have.  So went back to dr.  and he said he "thinks" I have bacterial vaginosis (after observing under the microscope) which I find hard to believe being I just finished my flagyl medication.  So he started me on Clendomcyin 3X a day for 7 days. He also wants to do a vaginal culture but said he has to wait until i finish antibiotics because they can "mask" test results.

Questions are:
1.) Being I tested with urine for chlamydia & gon. 2 days after I took the 1 gram of zithromycin are the negative results not reliable?  Would the antibiotics "mask" and give me a false negative when in fact I was infected with those STD's?  I am wondering if I should go back and test now?  I know you said testing after taking antibiotics might turn the test negative because i had been cured and i would never know i had it.  My concern is just that if I did have it I don't now.  as long as I know I can count on the negative results.  the way my obgyn said they can "mask" results has me concerned.  

2.) Are there any other std's that might cause more discharge?  no odor. no lesions or anything like that and I am now at 12 days past exposure.

Again thank you so much for your help, your information is very helpful with these type of situations when our own dr.'s don't give much help.

[Edward W Hook, MD]

1.  Believe the tests you have.  the antibiotics you took might have  either cured gonorrhea and chalmydia ut would not mask it
2.  Bacterial vaginosis is a possibility but seems unlikely.  At this time, I think you need to work throught this with your OB/Gyn.

Probability of other STD, given all the therapy you have had is close to zero.  EWH

[scared805]

Maybe you can answer in place of Dr Hook?  I would possibly like to get get retested today.  if you can see above...
Thanks!

[Edward W Hook, MD]

Sorry, you will have to continue your converstaion with me.  I am not sure what you are referring to.  Retested for what?  I have no control over what you get tested for - that is up to you.  If you go get tested again for gonorrhea, chlamydia or trich the tests will be negative again.  EWH

[scared805]

Sorry i did not notice you had responded to my previous post before i submitted the question to dr. hansfield.  I think we both must have been posting at the same time.  

Anyhow, you answered my questions.  Retesting was in regards to testing for gon & chlamydia because at the time of the last test I had just finished the zithromycin, and I wasn't sure if i could in fact be infected when the test showed negative.

Again thanks for all your help.

[Edward W Hook, MD]

No problem.  Take care.  EWH

[scared805]

Just reread your post.  So you are saying that with me taking 750 mg of zithromycin then 30 minutes later taking another 250mg totalling 1 gram would have for sure cured chlamydia and 80-90% cured gonn correct?  

And the flagyl would have killed trich.

Based on your experience you would not worry about the other std's?  i know there is no treatment for herpes or hpv, but is what you are saying is the zithromycin would have cured syhpillis and canchroid?  So basically i don't have anything to worry about anymroe in terms of stds? (with expection of herpes, hep & hpv).

I just want to put this behind me and move on in life worry free without worrying I will infect my fiance.

[Edward W Hook, MD]

Please stop repeating your questions.  I will not repeat my answers.  Your statementss are correct.  EWH

[scared805]

I posted a few days ago, not sure if it got deleted?
Sorry to ask so many questions, however i rely on your information heavily.

I had a Obgyn follow up since last posting, had another gon, chlaym test done both negative.  That same day as test i also took another 1 g of zithro, and my fiance took 1.5g.  Two weeks later (no sexual contact) after us both taking...i am still having wierd symptoms.

Discharge a little heavier than normal.  Most of time white, sometimes very very light yellow colored.  Also still have pain feeling sometimes burning deep in vagina, near uterus or cervix.  Felt most when walking around or sitting for long periods. Some back pain as well.  My dr. did blood panel to check for infection, all normal.  vaginal culture all normal. urine culutre normal.  and ultrasound good also.

From your experience could these symtpms still be caused from STD?  Could I have had chlaym. gonn that was cured by zithro but before I took the antibiotics had already turned into pid, which is what i am now still suffering from?

Just not sure if I should get std out of my mind and focus on other causes like possibly endimetriosis....

PLEASE your thoughts are much appreciated.

[Edward W Hook, MD]

Your last post was deleted because it just repeated the same questions that had already been answered.  You do not have STD.  I am not trying to be unkind, but I can assure you that your symptoms are not due to STD - your tests are negative and you have been treated wtih antibiotics which would be effective if you had been infected.  Taking antibiotics without a good reason and perseverating on things will not help.  Really, believe your tests!  You do not have STD.  

If your symptoms persist, please work with your doctor to sort them out.  If there is no biological cause when can be discovered, consider that it may be your anxiety.

Further questions will be deleted.  EWH