Prostatitis and new girlfriend

[seamus187]

Hello doc,

Here is my breakdown.  Diagnosed & treated for Chlamydia last fall (azithro).  Symptoms went away.  Went to Mexico for the winter.  During masturbation saw blood in my ejaculate two or three times a month after treatment and then no more.  Symptoms came back a little but were different (discomfort while urinating like before, but pain at tip of penis and during ejaculation were new) and then receded.  After 2 months symptoms returned.  Got STD check -treated me presumptively for chlamydia & gonorrhea while we waited for the test.  Results negative.  Referred to a urologist.  Told me I have Prostatitis and gave me Bactrim (still taking).  He said it is not an STD.  I have not had unprotected sex since about a month before being diagnosed with Chlamydia.

My issue:  I have a relationship that has grown from friendship to more sexual.  I travel for work a lot and we have discussed that we would like to be sexually involved but not monogamous as I am gone for months at a time.  I am worried about this prostatitis and if it is transmittable.  I care about this girl deeply as a friend and potential long-term partner and do not want to pass it to her (not that I'd want to pass anything on to anyone).  And even if it doesn't affect her I worry that she could potential pass it on to another partner.

My questions are:

Was this caused by chlamydia?

Can I transmit this?  If so, is a condom effective protection.

Can I transmit it via her to someone else? (i.e. it wont affect her as she is a woman but she could carry it and pass it on without knowing)

How can I explain this to her?  This is the real hard part - 'hey honey, I have prostatitis, all the symptoms are similar to an STD but its not an STD, I swear.'  That, plus I am on antibiotics, so if it isn't an STD why am I on antibiotics?  
It feels like I have an STD and the doctors tell me I don't.  How can I explain this to someone so that it makes sense.

Thanks Doc.  I look forward to your reply

[Edward W Hook, MD]

Welcome to our Forum.  Your questions are good ones.  prostatitis is a mis-understood problem and it sounds as though you are getting good, accurate information from your urologist.  Indeed, as he has told you, prostatitis is not an STD or if it ever occurs, it is the exception. There have been many studies of this and is appears that prostatitis occurs when the sort of bacteria that cause urinary tract infections move up to reach the prostate.  It is difficult to treat because not all antibiotics get to the prostate well.  Bactrim does however.  In addition, prolonged treatment for prostatitis is typically needed, again because of problems getting antibiotics to the prostate.  With that as background, let's address your questions:

1.  No, chlamydia does not cause prostatitis.  The prostatitis issue is coincidental and not related.
2.  No, prostatitis is your problem and does not put sexual partners at risk.
3.  Nope.
4.  I think that what you have just said, plus perhaps some of what I have just told you may be helpful.  The analogy is that when women have vaginal discharge it may be an STD but many times is not, instead representing yeast infections, bacterial vaginosis or urinary tact infections, none of which are STDs.

Hope this is helpful.  EWH

[seamus187]

Thanks for the quick reply Doc, I really appreciate it.

[Edward W Hook, MD]

1.  Your chlamydial infection is history.  No reason to share this with your GF.

2.  Prostatitis take a long time to respond and does so slowly.  Somethimes people even need a repeat treatment after a month of therapy.  If you are improving you are going in the right direction.  EWH

[seamus187]

Thank you doctor.

Quickly a follow up:

I have not told her that I tested positive for Chlamydia in the fall and would prefer to keep that private as it is somewhat embarrassing.  In your opinion, am I wrong in not disclosing this?

Also, I have been on the Bactrim for 13 days with 17 left to go.  I felt some improvement of symptoms followed by a regression - it is better than at the beginning but there is definitely still some pain/discomfort.  Is this normal?  How long does the Bactim take to reach the prostate?

Thanks again.