Problem Child

[introuble]

1. I am a 39 year old male.  
2. I had a girlfriend, named M., aged 26, for over almost 2 years.  I have not been in bed with ANYONE else (or even kissed anyone) for almost two and a half years (3 years since unprotected sex).
3. Had unprotected oral and vaginal sex for the last time in July.  That night she admitted to me she had had sex with someone since we last had.  A roadie for bands!  
4. Three to four days later I developed burning in my urethra on urination.
5. At the same time, she told me that she was having heavy intermittent bleeding between periods.  She had also told me that at one point she had had such discomfort in her lower regions and felt sick enough that she had thought that she was pregnant.  She was not.
6. 8 weeks after our last contact, my pain had spread to my prostate my ejaculate was yellowish with a little blood in it, and I could barely sit.  Went to the hospital.  Positive for Chlamydia.  Negative for all else. Treated. Worked my butt off to get her to the doctor and treated.  She was very slow in responding.  
7. 2 to 3 months had elapsed since her first contact with her new boyfriend when she was tested.  Was SURE she would be positive.  3 weeks later, she told me that she had been to the doctor, was tested, and had-- NOTHING.  She is certainly convinced that I cheated on her and got it somewhere else, during a time period in which I SWORE I was 100% faithful to her. Or that I made the whole story up to destroy her new relationship!  At first she had me thinking I was crazy.  I thought I might have caught it from a toilet, but THIS IS IMPOSSIBLE.  And, for me, it had been more than TWO AND A HALF YEARS since contact with another person.

Questions:
1. I have read elsewhere on your Website that MOST female Chlamydia infections clear up within several months ON THEIR OWN.  Is there any other possibility here?  Other than a the obvious false negative?  Could you PLEASE refer me to the research study on the rate with which women recover spontaneously?
2. Should she still be treated with antibiotics?  
3. Is it possible that she already suffered damage from the infection before fighting it off? Is all damage visible to her doctor? I am worried about her. She seems to be incapable of taking care of herself.
5. Since I have met her, she has often told me about a history of

[monkeyflower]

I agree that we have the responsibility to be kind to others, and to do what we can to make the world a better place. But that's not what you're describing at all. You can't save someone who doesn't want to be saved. You can't MAKE people do what you want, even if you think it's for their own good.

The forum you're looking for is under Sexuality and Relationships, but I'll warn you she doesn't respond very often. Honestly, though, I really think you'd benefit from talking to someone in person instead. Do consider seeing a therapist. I think there's more here than meets the eye.

[introuble]

Where is the relationship counselling site?  I think it would help.

Unfortunately, I thought that we had an ethical obligation to help people who could not help themselves.  And make sure this world stays a healthy place.  If M., through my inaction, makes other people sick and then sends them home to create havoc in their lives... and I have the information at my disposal to prevent disease transmission from happening in the future and she just needs the information herself to make this decision... then I felt it was my responsibility to prevent this kind of thing from happening in the future.  Maybe it is my Catholic upbringing and 10 years of college, but this sounds like a sin of omission.  But I MAY be wrong.

M. is not stupid.  She is just complicated, had a horrible childhood, is head strong, is saddled with genes which predispose her to alcoholism, and has a strong sex drive.  I do not fault her for this.  She just lacks information.  I believe I was the first person to ever tell her about something called chlamydia.  She claimed she would try to keep herself healthy after that.  Strangely enough I warned her about it after she started seeing this guy, but before I had a clue as to what I had.  With the proper information at her disposal, she usually comes to the right decision on her own.  Thank you for your help.  I am sure she will come to the proper conclusion with the information you have provided me.

(If I have misspelled anything here, you will have to pardon me, I have been living in Germany for five years).

[H. Hunter Handsfield, M.D.]

I'm sorry. I told you before this is not a counseling site.  I deleted your new thread.  Since your relationship is over, your partner is responsible for her own health.  It is not your problem whether or not she acts on the information she has, whether she has her current partner get treated, or anything else.

Please no follow-up questions.  I will have no further responses.

HHH, MD

[introuble]

Dear Dr. Handsfeld,

Thanks.  You are right.  If she wants to stay sick, make other people sick, and put her fertility on the line, this is her right, and up to her.  I am sick of it myself.  Fact is she needs to be treated.  And whether she believes me or not is up to her.  I DO know I will not be getting in bed with her again anytime!  ;D

Have a nice day.  And whether or not this is a counseling site, it has helped me realize how difficult this person was.

Thanks!

Sincerely,

C.

[introuble]

No.  She is not my girlfriend anymore.  We are both with other people now.  But she is still someone who helped me through some very difficult times, and I feel I owe her something.  So in spite of the fact that she keeps crapping on me, I feel I need to figure out what is going on here.  

She has had so many problems in her life, she doesn't need another one.  The last thing I want is for her to have problems getting pregnant one day.  But you may be right.  It may be time to let her go out and get herself sick.

I would not call what we had an "optimal relationship".  She and I had enough problems I was happy to see her try other relationships to see what would make her happy.  It is not my job to turn a woman into a slave.  But I was always ready to take her back in case she couldn't find someone to treat her with respect.  And while she was out screwing around, I kept my penis in my pants because I knew one day we might end up in bed together and I didn't want to get her sick.

The last boyfriend she dumped me for raped her, killed her cats, threatened to kill me, and stole a thousand dollars out of her purse before the cops caught him.  Now she must think every guy is like this.

Problem is.  Too many of them are.

Disgusting.

This new guy made her, and me, sick, and he is always on the road (she is already worried she will cheat on him...perhaps with good reason since 42% of ALL men have cheated on their partners according to a recent German study--men on the road are certainly MUCH worse than average).  Another guy who she decided on going to bed with was her drug dealer who was happy to provide her with so much dope so he could sexually harass her and screw her once in a while. Another one of her boyfriends beat her for two years, drove her to attmept suicide, put her in the hospital twice.  Me?  My problem was that I have chronic pain and was occassionally suicidal.  Otherwise a drug free, alcohol free decent guy who was happy to see her perhaps find someone who could provide her with a stable life and income.  She and I met in a mental hospital for depressive people.  M. also has severe problems with alcohol dependency.  Living with her in my life was like living on a rollercoaster.  I have never been with someone so complicated.

But she deserved someone who thought she was worth the effort.

I tried to give her someone who would treat her with respect.  But she just shits on it.  It really is too much.  I don't know why I try.  I see your point.

[monkeyflower]

I know this isn't the appropriate venue for this kind of discussion, but I can't help wondering what you're getting out of this relationship. You admit the relationship has been less than optimal (seems like quite an understatement), that she treats you horribly, yet you continue to be there for her to abuse whenever she wants. You say you don't know why you continue in this relationship. Therapy could help you figure it out.

[monkeyflower]

"She seems to be incapable of taking care of herself."

"Yet, for all of my effort to keep her healthy, I have gotten nothing but trouble."

You didn't ask this, but I'll volunteer anyway ;-) You sound like a really sweet, caring guy and a good friend. I'm touched and impressed by your concern and your efforts to help your gf (or is it your ex?).

However, she's certainly perfectly capable of taking care of herself. She sounds like she might be self-destructive, but that's not the same thing. She's an adult, and she's *choosing* to live this way. And as much as you might try, you can't help someone who doesn't want to be helped. And continuing to try is unhealthy for both of you: it only strips her power, increases her dependency, and makes YOU miserable. It's fine to be concerned and to worry about her. But you've told her what's wrong and how important it is to take care of any potential problem, and she's choosing not to do anything about it. That's her right. If she suffers consequences from her inaction, they are her own.

So, I don't know if this kind of relationship is a pattern for you. Some people are really drawn to relationships where they can be caretakers. If this describes you, you might want to consider a few sessions with a therapist.

[H. Hunter Handsfield, M.D.]

Nobody ever got chlamydia from a toilet seat.  Consider printing out my reply above and having her take it to her gynecologist.  That doc in turn can google me (or search my name on Medline) if he doesn't trust my expertise.

HHH, MD

[introuble]

She claimed that she used a condom with her new friend before our last contact.  What are the odds against this?  Oh yes...She would probably like to believe that it is more likely that I got it from a toilet than her having gotten it from her roadie friend in unprotected sex and having passed it on to me, then testing negative for it herself two or three months later.  I tried to convince her what a serious illness this can be, and that it can come and go quickly.  I warned her that she needed to get into a doctor QUICKLY after I put it all together, including her obvious symptoms.  Yet, for all of my effort to keep her healthy, I have gotten nothing but trouble.  I care for her deeply, and our friendship was moving along well and now am simply exhasperated.  Yet I can understand her skepticism if her (small town, with 25 year old information in his head) gynecologist is telling her she doesn't have anything.  I do not know at this point if her symptoms have continued.

[H. Hunter Handsfield, M.D.]

I won't mediate he-said, she-said debates about who got infected when and by whom.  But if your facts are correct--you had no sex with anyone else for 2 years, then developed symptoms the symptoms you describe and had a positive test for chlamdia--then the only possibility is that you acquired it from the one person with whom you are sexually active.  Indeed it is true that chlamydia resolves on its own without treatment; it can clear up as soon as a few weeks and rarely persists more than a few months.  Also, tests can miss an active infection, although this depends a bit on exactly what test was done.

In summary, if your facts are correct, you acquired your infecton from your girlfriend M; her negative test doesn't change anything.  As to where and when she was infected, I haven't a clue and won't speculate.  On to your questions:

1) Go to any standard textbook, such as the Holmes text on Sexually Transmitted Diseases.  This is standard, basic, well known knowledge. (Almost all bacterial infections clear up on their own, without treatment.  People recovered from pneumonia, gonorrhea, bacterial dystentery, and a thousand other things long before antibiotics were invented.  Chlamydia is typical.)

2) Absolutely yes, your partner needs to be treated, both to protect your health and to prevent you (and others?) from getting reinfected.

3) Most likely she doesn't have fallopian tube damage, but it can happen with no symptoms.  There is no easy way to tell until/unless a woman has difficulting conceiving a child.

5) If her "mysterious pain" indeed orginates in her fallopian tubes, that could be a sign she had pelvic inflammatory disease (PID); and yes, that could have been due to a past chlamydial infection.  But it is unlikely she has carried an infection over the years and that you only were infected recently.  It is far more likely that she acquried a new infection recently.

6) A blood test for chlamydia won't tell anything.  Such tests miss many infections and can be false positive as well.

This isn't a relationship counseling forum.  But it certainly sounds like you guys have an important trust issue between you.  Think about whether couples counseling would be a good idea.

Regards--  HHH, MD