STD symptoms

I had unprotected oral sex(gave and received) with a women 27 days.  There were no visible sores on the women’s mouth.   I’ve been beating myself up about it – I’m married and been completely faithful up until this lapse in judgment (married 5 years).  I got tested at a local clinic 5 days after the experience.  Chlamydia , Gonorrhea, Syphilis, and HIV all negative.

Couples questions:

1. Was 5 days too soon to test for Chlamydia and Gonorrhea?  The reason I ask is I’ve had a sensation in the tip of my penis for some time now.  No sores.  It’s not constant, but I usually feel it more when sitting.  It feels similar to the way it felt shortly after I had Q-tip type tested performed at the STD clinic.  I haven’t had any discharge or painful urination.  I have noticed that after urinating I have been experiencing droplets of urine coming out shortly thereafter.  I’ve also had periods of frequent urination.
2. Some other symptoms I’ve been experiencing:  night sweats and canker sores (inner mouth area – nothing on outer lip or face).   Would you chalk them up to anxiety?
3. Should I go for further testing?  
4. What could be causing the sensation in my penis?

[Edward W Hook, MD]

Fewer STDs are transmitted by oral sex than genital or rectal sex.  This is true in terms of the types of STDs and how likely infection is to occur.  This is because the mouth is a relatively hostile environment for microorganisms.  Thus, we consider oral sex relatively low risk.  From giving oral sex your risk is for getting gonorrhea and possibly herpes or syphilis although in the absence of seeing lesions or sores, this almost never occurs.  From getting oral sex, you could again get gonorrhea as well as possibly nongonococcal urethritis (NGU).  Once again herpes could occur if there were sores or lesions but otherwise this is unlikely as well. Chlamydia in not tranmitted through oral sex so this is not a concern and the odds of HIV transmission, while quoted at less than 1 in 10,00 are actually probably far lower than that (and therefore not a concern).  As for your questions:

1.  No the timing was good and the tests are good.  Believe them, you do not have gonorrhea or chlamydia.  With these tests for gonorrhea and chlamydia, tests are routinely performed for NGU as well so this is also ruled out.  (Was your throat checked?  It should have been.  If not, you might request it.)
2.  Night sweats and canker sores- no relation to the exposure.  Anxiety- yes, see below
3.  Throat testing for GC if not done.  this is the only testing I really recommend.  If your anxiety will be improved with a negative HIV test, get one at six weeks, not before - it will be negative.  No herpes testing unless you have symptoms (i.e. sores)
4.  Sensation in your penis.  Let's now talk about anxiety.  You strayed and feel bad and anxious about it.  As a result, you  have focused your attention on your genitals which happen to be one of the most sensitive parts of your body.  This focus leads you to note sensations that have likely always been there but were overlooked and/or discounted.  This happens all the time.  You need to believe you tests, appreciate that the risk of this exposure was low and move on.  You will be fine.  EWH

[knucklehead789]

Thanks for the quick responses!

Quick follow-up -
1.You mentioned a throat test for GC - is that for gonorrhea?  What symptoms, if any, would I expect to have with an STI in the throat?
2.Worse case scenario.  I don't get the throat test, but I'm infected with the throat infection (GC test you referenced).  What would typically happen?  How long would I be able to infect my wife?  Can I infect by kissing?  When would I be in the clear?    

[Edward W Hook, MD]

1,  sorry, yes  GC = gonorrhea
2.  Not much.  Potential (low risk) of infection your partner if you perform oral sex on her
No risk from kissing.  EWH

[boatboy78]

i had the same sort of experiance, im happily married for 4 years and had unprotected sex with a old gf. symtoms (symptoms) are the same as yours, i had all the tests done and everything came back negative.
i think it was Anxiety, i had the sweats from the guilt that i might have passed on something to my wife but its been 2 days since the results and the stinging is going away,
i hope you learned your lesson like i did and worship you wife

[OneStupidNight32]

The Mind is a VERY powerful thing and most of it is unexplored. Budha says, "If you loose something, do not loose the lesson". In this case, you loose the vow you made (as i did)...for what its worth, you'll look at women differently (with more respect, not just to mount every single one of them) and...worship your wife. Have a good life

[knucklehead789]

Thanks again for the responses.

I woke up this morning with a small amount of discharge.  It wasn't a lot...it was white and gooey.  I have made an appointment today at the clinic to get it checked.  

Based on negative tests for gonorrhea and chlamydia, I'm guessing it's NGU.  When I was initially tested (5 days after exposure) it may have been too soon to detect NGU.  Please correct me if I'm wrong.  My other current symptoms are redness on the tip of my penis,  the sensation of holding in urination(especially when sitting), lower stomach pain(feels like gas), and drips of urine surfacing after urinating.

I do not have any bumps, sores or painful urination.

To be honest, I was somewhat relieved when I discovered the discharge.  I've spent every free second worrying about STDs and looking for bumps, sores, etc....  It is my understanding that the discharge is a typical symtom of something curible with antibiotics.  If my assumption is correct, then there is a light at the end of the tunnel and I can eventually put this behind me.  Without the discharge, I could have continued to let this eat me up - wondering if/when something may surface.  Crazy I know.

1.  Was it too soon to detect NGU?
2.  Can Herpes cause discharge?  
3.  Other than NGU, what other infection can cause my symptoms?

Thanks again and I hope this is my last post....forever.

[Edward W Hook, MD]

I suspect your AM discharge is normal.  The way to get this sorted out is to have another swab test although the first one, particularly if it was taken at least two hours after you last voided, should have detected NGU at the time you were tested.  Herpes can casues discharge but it should be accompanied by lesions.  You do not have lesions- this is not herpes.

Please let us know the outcome of your evaluation.  EWH

[knucklehead789]

The physician gave me the same diagnosis.  I was tested for Chlamydia , Gonorrhea, NGU, and HIV all negative.  She told me that my worries are getting the best of me, but just to be sure she gave me Metronidazole (4 pills) for Trich because they can't test for that and 2 weeks worth of Doxy to wipe out any chance of NGU or Syphilis.  She told me, as YOU did, that herpes was not a possibility without lesions - especially being 32 days post exposure; she told lesions typically surface within 14 days.

Dr. Hook thank you!  The service you provde is priceless!  

[knucklehead789]

Quick follow-up......At 32 days post exposure, how reliable was the negative HIV test?  

[Edward W Hook, MD]

At four week 85-90% of all HIV test that are going to be positive will be.  Given that your exposure was low risk, that should be all the reassurance you need that you do not have HIV. EWH