Testing Window

[jb3443]

I went to a massage parlor 3 months ago today.  The encounter consisted of her using her breasts to masturbate me.  I believe she may have also used her mouth, which is why I'm concerned. I was not sober - so the memory is hazy.

I initially didn't think much about it.  I did have intercourse with my wife on two occasions in early/mid August and nothing since.

I never noticed a discharge, or painful urination.  I did on a few mornings occasions notice stains in my underwear - which I had assumed to be being aroused in my sleep.  

If there were a discharge, how frequent/noticeable would it be?  

3 weeks back, the tip of my penis started itching, And the past week or so my left testicle is sore.

I'm going to my regular doctor tomorrow and requesting STD testing.  

My concern is that I've seen posted here that gonorrhea may subside on it's own.  If I were infected 3 months ago would I still be in a window where I would get a reliable result?


Bottom line, I guess I want to make sure that when I'm tested tomorrow - if the results come back negative - I don't have anything to worry about and can put this behind me.  

I know this was a one time thing - and am hoping that I don't need to discuss with my wife

Thanks Very Much

Jay

[H. Hunter Handsfield, M.D.]

Epididymitis does not cause the mild sort of testicular pain you describe, and you cannot have epididymitis from gonorrhea without having a positive urethral test.  And disseminated gonococcal infection causes obvious, painful arthritis and a chacteristic skin rash.  There is no chance you have either one, and as I said, even without testing it is exceedingly unlikely you had gonorrhea.  I suggest you stop searching the web about it; continued online searching is likely to turn up yet other issues that, out of context and given your anxieties, won't be helpful.  So re-read my reply above, continue normal relations with your wife, and put this event behind you.  All is well.

[jb3443]

Thank you for the detail response.  I do just have a follow-up question.  The CDC information site mentions that left untreated gonorrhea could cause, epididymitis as well as spread to the blood or joints if left untreated.

If the soreness I'm experiencing is epididymitis caused by my exposure 3 months back - would a test at 3 months post exposure come back positive?

Also, if it moved to the blood or joints - how would that be identified/caught?

I just want to make sure that if the tests come back negative - I'm in the clear and that I may not have given something to my wife back in August, since there are long lasting effects like PID for a woman also.

Once again thank you very much

[H. Hunter Handsfield, M.D.]

Welcome. Thanks for your question.

You had a very low risk sexual exposure.  It was zero risk from penile-skin contact, with breasts or any other body part.  If there was oral-penile exposure, then there was slight STD risk -- but unprotected oral sex is pretty safe, and the overall risk is low.  Gonorrhea is one of the STDs transmissible by oral to penile transmission, but almost all urethral infections with gonorrhea cause obvious and unmistakable symptoms (pus dripping from the penis, paniful urination).  Chlamydia is rarely transmitted by oral sex, and anything else that would have been a significant issue would have caused symptoms.

My guess is your urethral or penile itching and mild testicular pain don't reflect any STD.  (They may be simply increased awareness due to anxiety over a sexual decision you regret.)  Therefore, I expect your STD tests to be negative.  As for "window period", assuming your urethral (or urine) tests for gonorrhea and chlamydia are negative, it will prove conclusively you were not infected at the time of specimen collection.  It is impossible to know whether you had been infected, might have had positive test results earlier, but the infection had now cleared on its own -- i.e. there are no tests for past infection.  However, these infections are unlikely to have cleared spontaneously in as short as 3 months.

Blood tests for syphilis and HIV will be reliable -- and for sure I expect them to be negative.  Neither of these is remotely likely based on the exposure you have described.  I wouldn't have recommended any other STD testing, but if your panel includes herpes and/or hepatitis, they'll also be negative (or if positive, still would not be explained by the massage parlor events).

So all things considered, I'm confident you have no STD, and I expect your tests to be negative.  Assuming they are, I see no need for you to mention any of this to your wife.

I hope this has helped.  Best wishes--  HHH, MD