Symptoms after 2 days?

[Karl81]

Hello doctor,

I am a gay male in a relationship.  Last week, I received rimming from another guy and gave fellatio (I did not receive); there was no kissing.  The next day, I had intercourse (oral and anal) with my partner.  On day three, I started feeling a discomfort in the anal region as well as an urge to pee and stinging in the urethra.  No discharge whatsover, even after 7 days.  

What is the risk that I got an STD (Chlamydia?) either from getting rimmed or performing fellatio, and is it possible that this was then transferred either from my mouth or my anus to my penis by my partner (the next day)?  The symptoms started on day three and have not disappeared one week later.  As my partner was absent for a week, I did masturbate a lot, could this be a cause as well?

Many thanks.
Karl

[H. Hunter Handsfield, M.D.]

Infections of the mouth or throat from performing fellatio, or anal infections from whatever source, cannot cause urethral/urinary symptoms.  It is possible, of course, to acquire oral/throat STDs (primarily gonorrhea, low risks for syphilis, herpes, and HIV, no risk for chlamydia) by performing fellatio.  Receiving oral-anal contact is zero to low risk for all STDs; I'm not sure there has ever been a documented case, although I imagine that herpes and syphilis sometimes are transmitted that way. Further, 2 days is too quick for symptoms of most STDs, with the uncommon exceptions for gonorrhea and perhaps herpes.  Chlamydia symptoms rarely if ever start sooner than 7-10 days after exposure. As for anal "discomfort", I'm not sure exactly what it means, but it seems unlikely to be related to receiving analingus.

Accordingly, I doubt any STD explains your symptoms. But if it does, most likely it was acquired from your regular partner.  I am not in a position to know whether he might have other partners -- but when one member of a partnership is stepping out, frequently the other member is doing so as well.

As a sexually active gay man, and as a person who obviously is sexually active outside a mutually monogamous relationship, periodic STD/HIV testing makes sense.  So regardless of your symptoms, I suggest you visit your health care provider -- or perhaps your local health department STD clinic -- for professional examination and testing for common STDs.

I hope this helps.  Best wishes--  HHH, MD