STD - risk of exposure?

[Cardynal]

On Friday I engaged in sexual acts with an acquaintance. She has stated since that she tested negativity on a panel test as of June and engaged in sexual acts with one girl before she was with me (I am male).

We kissed a lot, she performed oral on me for about a minute (some deepthroating), and I performed oral on her, for less than 30 seconds. I put a condom on and we began to have vaginal intercourse but we stopped after less than 30 seconds. No ejaculation occurred by either party.

Monday morning, after worrying about it all weekend, I got myself tested, even though I'm sure you will tell me it is too early for such a test to be determinative. I am still waiting on those results.

Is there any probability that I contracted an std, specifically gonorrhea, chlamydia, or herpes? I will be getting myself tested again in 2 weeks and then 3 months, but am looking for some answers in the interim.

I can feel a slight discomfort/tingling near the very top of my penis, almost as though it would be more pleasurable to urinate. I have no other noticeable side effects--no discharge (would I notice it? I haven't seen anything), no burning/pain during urination, besides the normal feeling I get if I drink too much coffee and no other fluids. I have had a bit of a cold; I had a sore throat yesterday and I've been slightly congested but no fever or headaches.

My girlfriend (I know, I know) will want to engage in intercourse soon (within a week or so), and I'd rather above all else avoid infecting her with whatever I may have.

Do I have something, if so what, and is there any other guidance you could give? This has been a very stressful 3 days. Thanks.

[Edward W Hook, MD]

No change in my assessment or advice.  Small amounts of blood in the semen occur from time to timeas blood vessels break and is not associated with STI.  

This will be the final response to yoru questions.  It is time to move forward.  EWH

[Cardynal]

Dr. Hook,

Pardon the additional message; I seriously would have held off on responding to this thread, but I have a somewhat alarming development. I masturbated tonight, more to make sure there wasn't pain or anything like that. After ejaculating, I noticed that there was a very small (probably the size of the apostrophe sign as it appears on a keyboard) amount of blood in my semen, which I have never seen before. My urethra felt sore after ejaculation, though felt fine during.

Does your analysis change at all? Part of me is wondering if I didn't get some bacteria from the girl's throat and that's causing my problems, but I am obviously not an expert at this. I'm 26 years old and previously in excellent health, so many suggested causes of this are kind of out of the window.

Thanks again

[Edward W Hook, MD]

No, this is not suggestive of herpes. There is much incorrect information "out there" about herpes.  When herpes causes urethritis, there are also typically visible external lesions as well. Further, HSV discomfort does not come and go with time. EWH

[Cardynal]

Doctor,

Thanks for your previous responses. I will hold off on replying to this again until I have retested (everything was negative, as expected).

Is it possible that this is urethritis caused by herpes? I've checked around and while not improbable it's looks possible.

The penis discomfort comes and goes in terms of severity, but hasn't gotten "excruciating" yet. I have not developed any sores or lesions (would I notice them?) and no part of my penis specifically feels raw on the outside, but from what I've read, the "initial outbreak period" can have a window as long as a month, which is why I'm above ruling out herpes at this point.

I am trusting in your judgment and the results that this is not chlamydia or gonorrhea, mainly because the symptoms don't align.

Your thoughts on this would be appreciated, thanks.

[Edward W Hook, MD]

Yes, if you feel the need to re-test at two weeks to be sure you are negative, after you get your negative test results it will certainly be OK to resume unprotected sex with your regular partner.  I suspect all os OK at this time.  EWH

[Cardynal]

Dr. Hook,

Thanks for your response. After a subsequent retest (in 2 weeks), if everything is negative and symptoms persist, am I alright to resume sexual relations with my partner, even if it's unprotected? (we have dated for 4 years monogamously, last friday night was a serious aberration in behavior).

[Edward W Hook, MD]

No change in my opinion or advice. In fact, your additional information makes me even more confident that you do not have an STI.  There are no STIs that causes symptoms which come and go as you describe.  On the other hand when persons are nervous and worried, they tend to "look" for sympotms and in doing so, become aware of normal sensations that they would not normally notice.  I suspect this is what you are expereincing.  EWH

[Cardynal]

Furthermore, is it possible that this is NGU or something? My rectum is also itching a little bit (again, more like tingling).

This is miserable.

[Cardynal]

Thanks Doctor

The discomfort comes and goes. If I'm walking or standing I can't feel it, but if I'm sitting, and especially if I'm not preoccupied, I can feel it, almost like something is blocking the tip and i should go to the men's room. Part of me is worrying because for a couple seconds during the fellatio I could feel her teeth, which is making me wonder whether there is a micro tear or something. A small portion (we're talking a pinhead) of my penis's head is a little red.

I admittedly masturbated last night--the last "sensation" felt a little off, but I couldn't figure out why.

I received a panel test for stis--blood and urine (gonorrhea and chlamydia). So no throat swab was performed.

Could the tingling be a uti or something? I'm seriously considering going to a cvs and getting antibiotics or something but I wouldn't even know where to begin.

You say it's anxiety--how would anxiety be the cause? Furthermore, if it is anxiety, how long will the anxiety take to stop manifesting itself? You see where I'm going here--if you're right, there are symptoms because of anxiety, which in turn causes symptoms, which in turn...keeps this vicious cycle going.

Thanks for your help

[Edward W Hook, MD]

Welcome to our Forum.  I'll be pleased to comment. The risk of acquiring an STI from any single exposure is low.  Most persons do not have STIs and most exposures to infected partners do not lead to infection.  Further, some sex acts are higher risk for acquisition of infection, if your partner is infected, than others.  Further, condom protected sex make exposures safe.  

In your case, it sounds as though your partner is not particularly likely to be infected.  Testing is always a reasonable thing to do if you are concerned and I presume that the testing you did was for gonorrhea and chlamydia.  If so, this rules out the possibility of those infections which are the most common problems which occur following exposure of the sort you describe.  There is no need for further testing for gonorrhea and chlamydia, provided you were tested at both of your sites of exposure- your throat and penis.  The risk for other STIs is low and testing will be of little help in determining if you were infected. Rather, for HSV, if you do not develop lesions of HSV within 14 days of your exposure, you can be confident you were not infected.  Should you develop lesions, I suggest you see a clinician who can do appropriate tests (i.e. a swab test for herpes if there are sores).  today in the U.S. syphilis is simply not a likely possibility.  

The tingling that you describe is more likely to be a manifestation of your anxiety than anything else.  While tingling can precede an outbreak, if your tingling were indicative of herpes, you would have developed lesions within a few (less than 8-12) hours.  Testing at three months, except perhaps for HIV is really not needed and the likelihood that you got HIV from this event is quite low.  

An alternate way to make sure you are not at risk is to see if your partner would be willing to get checked,  If she is negative for STIs, you are not at risk.

I hope that these comments are helpful. My overall sense is that your risk for infection is quite low.  Try not to worry.  EWH