Oral sex - treatment

[Lyndon511]

Dear Doctors. I am a Scandianavian Male who received about one minute of insertive fellatio from a woman with experience from the swingers lifestyle. I had decided to go for tests, as I have a regular partner. However, as a recurring sinusitis flared up again, I was put on doxycycline 5 days after this event. After having taken doxy for six days (7 day cure, 2x100mgx7), I started having sex with my regular partner again, assuming that the doxy would make tests irrelevant. I know that chlamydia is almost never transferred by oral, and that doxy takes care of this. Moreover, I guess this dose of doxy would take care of incubating syphilis as well. However, I am curious about your thoughts on the chances of gonorrhea (which is rare in my country from the outset). I had no symptoms at all during the 5 days before I started taking doxy, and have not developed any symptoms during the six days I have taken doxy (which might be likely in the case of doxy-resistant gonorrhea?).

[Edward W Hook, MD]

Welcome to our Forum. To address your question I must retreat to the probabilities.  Indeed, gonorrhea is occasionally transmitted by oral sex and when it occurs it is asymptomatic less than 10% of the time.  Furthermore, over 60% of gonorrhea remains sensitive to doxycycline in the doses you were taking.  Thus, when you put these facts together with the facts that gonorrhea is rare in Scandinavian nations, that it is unlikely that your partner had oral gonorrhea, and that if she did it is unlikely that you were infected, your risk of infection is very, very low.  

Having outlined things as I have above, the question then becomes are these facts and the cumulative weight of the evidence is that you did not get gonorrhea enough for you to feel confident.  I would but if not, you should get tested. That is a decision only you can make.  I hope my comments are helpful to you in your decision making process.  Personally, I would not worry. EWH

[Edward W Hook, MD]

Glad to help. EWH

[Edward W Hook, MD]

In theory the doxycycline could inhibit but not cure gonorrhea.  If you feel you must test for gonorrhea (I would not feel the need) I suggest you wait until you have been off the doxy for at least 4-5 days.  EWH

[Edward W Hook, MD]

Yes, this does sound overly paranoid.  Chlamydia is just not transmitted through oral sex often enough to be a concern and even if you had gotten chalmydial infection or NGU, the doxy would have both cured it and prevented transmission to your GF.  Your prostatitis issues are a far more likely cause.  EWH

[Edward W Hook, MD]

I agree.  Glad we could help.  EWH

[Lyndon511]

A related discussion, Hi again.... was started.

[Lyndon511]

Thank you so much again. Given the bewildering chaos of info and advice related to STDs from various internet sources, the research based knowledge provided by you and doctor Handsfield is really essential.

[Lyndon511]

Hi again. I apologize for contributing to irritating endless threads. After having experienced very moderate dysuria 2-3 mornings over the last week (no discharge, no reddening of meatus), I have started to fear that I might after all having been unlucky enough to have been infected by chlamydia by the oral experience referred to in the initial question (receptive fellatio). In theory, I might then have infected my partner during my doxy cure (7x200mg) as we resumed sex between my 6th and 7th day of treatment and subsequently been reinfected by her. Does this sound like a overly paranoid scenario to you? I have - by the way - had many problems with prostatitis over the last years, but rarely with any kind of dysuria.

[Lyndon511]

I would just like to say thank you for excellent advice. Because I started to develop some prostatitis-like pains before being finished with the doxy, I went to a STD specialist. She applied the same logic as you when reassuring me, and checked an urethral sample (Löffler?) which was completely normal without any leukocytes. She perceived this as even stronger proof that I had no infection.

[Lyndon511]

Thank you so much, Dr. Hook. It seems like we can agree on the tiny risks involved here. There are still no symptoms. Would being tested for gonorrhea while on doxy create any problems for diagnosis?