unprotected oral - pain in legs, electric pain, varicose veins

[so_scared_help]

Hi Doctor,

I received unprotected oral sex from a prostitute 28 days ago. There was no other acts performed after this. I am a 22 year-old male. Since then I have experienced a wide variety of symptoms. I have listed them below based on timeline from exposure:

Week 1: itchiness, pain urinating and strong flu
Week 2: symptoms from week 1 subsided but I noticed inflammation of veins on my penis (two definitely new enlarged veins and some more prominent small purple veins - these are still slightly painful) and my hemorrhoids were far worse.
Week 3: first began to experience electric pain through groin area and noticed prominent varicose veins in right groin. also noticed numbness and tingling sensations throughout my body (pins and needles). the best I can describe it is short electric shock like pains. some muscle weakness, headaches as well as overall fatigue.
Week 4: the week 3 symptoms have worsened and now I feel similar pains in my left leg. In addition, there is muscle quivering in my groins and my biceps. some discomfort under my armpits. I sometimes feel numbness in certain body areas as well.

I am really confused as to what this can be as I can not match my symptoms against any common STDs. I have been under a high level of stress because of this encounter so is hypersensitivity to my body the cause? I have no cough or fever but have slight post-nasal drip. I have no visible sores or lesions on my body. The only visible symptoms are the enlarged veins on the penis and prominent varicose veins around my right knee and some prominent varicose behind my left knee (I think I have never had varicose problems prior to this). Is this all stress-related or a possible STD? I have been to see my doctor in week 3 and I am currently waiting on tests for Hep A, Hep B, Syphillis and HIV. The doctor did not feel the need to test for anything else after his examination. Please let me know if I should test for anything else (maybe an uncommon STD?).

[Edward W Hook, MD]

HIV is not transmitted by oral sex. Your doctor is being a bit conservative in his assessment.  Nothing you have reported suggests HIV.

NGU and gonorrhea can be asymptomatic.  You noted above that you had pain on urination.  Even if it had resolved, I would have tested you for gonorrhea and NGU.  EWH

[so_scared_help]

I have no discharge or pain in urination, so the doctor did not feel the need to test for gonorrhea or NGU. Can gonorrhea or NGU be asymptomatic? Also it has often been commented on this forum that HIV is no risk from oral sex. When I visited my doctor, he made it seem as if HIV was still a risk, however low, but still a risk. Can any of my symptoms be HIV related?

Thanks and this will be my last comment.

[Edward W Hook, MD]

Welcome to our Forum.  I'll try to help.  There are no STDs which cause prominent veins or the sorts of electric shock sensations you describe.  Further, since your only exposure was oral sex, your risk for infection is, in general, quite low.  Oral sex is an inefficient way to transmit STDs.  Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are transmitted through oral sex; chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny.   The pain on urination you mention could be a sign of urethritis and if you were my patient I would have checked for gonorrhea and NGU.  At the same time, I should point out that even if your partner had an STD (any STD and it is likely she did not), most exposures do not lead to infection.  In your case, your exposure was brief; I would urge you not to worry. If you must, you could go to your local STD clinic or health care provider to be tested at this time.

This really does not sound like an STD at all.  On the other han, stress/anxiety can play a role.  Sometimes after an exposure that, in retrospect, one wishes they had not had, persons tend to examine themselves and be far more attuned to genital sensations than in periods when they are not concerned.  This in turn leads to noticing what turn out to be normal sensations that might have been not noticed or ignored at other times.  Perhaps this was a contributor to your situation.  

I hope these comments are helpful.  EWH