Sex w/ Massage Worker

[worried8989]

Hello Doctor,

       I visited an asian massage parlor one week ago today.  I meant to only go in for a massage & possibly a happy ending.  I recently broke up w/ my girlfriend & have been feeling down lately.  Somehow I ended up having sex w/ the massage worker when she asked.  It didn't last very long (maybe a couple of minutes) missionary position.  She put a condom on me before it started.  Directly after I noticed the condom did not cover the bottom half of my shaft.  I became instantly scared that I may have contracted something.  Herpes being my number one fear.  I asked her if she had anything.  But she couldn't speak english very well & I didn't get a direct answer.  I then washed up w/ a warm cloth, went home & had a shower immediately.  I'm been feeling very guilty & ashamed of myself.  But I'm even more afraid that I could have contracted Herpes or HPV from this instance.  I've been inspecting my genitals daily & am having some itching sensations near the top of the shaft of my penis.  I have terrible anxiety issues & am worried sick that I might have contracted herpes.  I just wanted to know if this is a possibility & how easily herpes can be caught.  & in what time frame would I know if I have it.  I did wear a condom, but have read several different views on-line about the effectiveness of condoms w/ regards to herpes.  I'm finding it difficult to concentrate on anything else & work is becoming very difficult.  Please let me know your knowledge on the disease & if you think I might have caught it from this encounter.  

[worried8989]

Thank you very much Dr. you have been very helpful.  

[H. Hunter Handsfield, M.D.]

Getting genital HPV is a normal and expected part of being sexually active, and over 80% of people catch genital HPV at least once.  But only a minority of infected persons get warts. Most HPV infections cause no symptoms and go away on their own, without ever being known.  As for most sexually active persons, probably you're never going to be sure whether or when you had genital HPV.  And when HPV is diagnosed, it rarely is possible to know for sure when and from whom the infection was acquired.  Unless you are the only person your former partner ever had sex with, most likely she has no way to know whether you were the source of her HPV infection.

Search the threads for more information about HPV, where you can find recommendations for websites with reliable information.  Also consider visiting the MedHelp HPV/warts community forum for lots of discussion.  

Tha't all for this thread.  Please move on.

[worried8989]

Sorry, I actually have one other question as well.  If you say that I've probably slept with someone (or already have) hpv...wouldn't I have warts show up?  A girl I dated 3 years ago actually contacted me this summer & told me she had them & was wondering if I was the cause.  But I've never had genital warts.  She then told me she found out it was most likely her new husband that had given them to her.  Is there anyway to protect against this?  Or can you have HPV and never show any signs, & how would I ever know if I have it or not?  I'm not really as concerned about this as herpes, as I know herpes is  more extreme & there is no cure.  So if you can only answer one of the questions, that the one from my second message is more important.  Thanks again for your help.

[H. Hunter Handsfield, M.D.]

Most herpes shows up in 3-10 days, but sometimes up to 3 weeks.  If you have no symptoms by then, you can be sure you weren't infected.  I recommend against testing for it.

It's up to you whether to discuss this event with your OCD provider, but I recommend that you do so.  I see nothing to be embarrassed about, and obviously the sexual event is interacting rather seriously with the underlying OCD.

[worried8989]

Thank you so much Doctor Handsfield.  I do suffer from ocd & am on medication for it currently.  You helped relieve some stress & anxiety that I was having over the matter & that I didn't want to speak to my therapist about, being that I'm quite ashamed of the incident.  I appreciate the depth of the response, the only other question I was wondering was that I've heard that if you were to get herpes, it would present itself within 2-10 days on average.  I believe you when you say that the likelyhood of having it is extremely small, but when will I be sure that I'm out of the woods & do you think I should get tested?  That's my last question & I won't take up any more of your time.  I think that this site is a wonderful place for those misinformed to seek professional advice & I just want to thank you for your knowledge & compassion.  Reading your response, I could feel my anxiety & stress levels level out.  Thank you.

[H. Hunter Handsfield, M.D.]

I'll try to help.  Most important, you can be reassured; you are overreacting.  The chance you caught anything is very low, certainly too low to worry about.  Condoms always cover only about the first two thirds of the penis; that's how condoms work.  There is always some skin-to-skin contact, yet people rarely get any STD -- even those that are transmitted skin-to-skin, like herpes and HPV.  It is impossible to calculate the exact risk for those infections without knowing whether or not your massage partner is infected.  But the odds you caught herpes probably are under chance in several thousand.  It's higher for genital HPV, but everybody gets genital HPV anyway; you probably have been infected already, perhaps more than once.  Anyway, there is nothing to be done about HPV exposures, so it isn't worth worrying about.

As you seem to realize, your emotional state is the main problem here, and that is almost certainly the origin of the itchy sensation, not an STD.  Any mental state that makes it "difficult to concentrate on anything else & work...becoming very difficult" requires professional attention.  Your worry about STD outcomes is mostly a symptom of that problem, not the main problem itself.  I suggest you visit your primary health care provider for his or her advice, which might include referral for professional counseling.  I suggest it out compassion, not criticim.  In the meantime, you can go forward knowing that no STD is likely to result from the encounter you describe.

Best wishes--  HHH, MD