Sore Throat after Oral Sex

[GoingHome]

Hey Doc,

I've looked around a bit on the forum and found a few cases that were similar to mine, but I wanted to start one so I could get some peace of mind and maybe help anyone else going through the same thing.

Approx. 3 weeks ago, I gave unprotected oral sex to a female, focusing entirely on the clitoris (no penetration) with no other activitiy.  Afterwards, I noticed a somewhat strange taste at the back of my throat (which, granted, could have been from the oral and not from anything else), but it made me sort of paranoid.  Over the next few days, I would occasionally go to the mirror and make sure I didn't have herpes or anything.  No symptoms emerged except I noticed a few random bumps on my inner lower lip that were probably there before.

About a week and some days after the event, I woke up having to constantly clear my sore throat and was having some issues talking (hoarse voice).  There were no other symptoms.  I went to an immediate care facility and they did a rapid strep and throat swab, although I didn't mention to them about the unprotected oral as I was embarassed.  The strep came back negative and they put me on Z-Pack (which I took to finish) anyway.  The throat culture came back negative a few days later, and they said that checks for any bacteria so I'm guessing that may or may not clear me of the bacterial STDs like Gonorrhea.

It's been almost 2 weeks now and the sore throat is still lingering (although it was at its worst a week ago) and this morning I noticed that my tongue is a bit cracked and has developed a white coating (not spotted, it's like a layer) that doesn't easily come off using a tongue scraper.  My talking is fairly normal, although sometimes i do have to clear my throat.

Should I still be concerned about STDs?  If it's not an STD and it is a viral or fungal infection, what infection is it and how long will it linger around?  What are my next steps?  I've tried to lay off worrying about it, but I need some clarity.  Thanks!

[Edward W Hook, MD]

Oral sex is an inefficient way to acquire STDs.  Even if your partner had an STD (any STD and it is likely she did not), most exposures do not lead to infection.  In your case,  I would urge you not to worry.

While the throat culture you took would not diagnose gonorrhea ( a culture using special medium is required), the chances that you are infected at this time, even in the unlikely situation that your partner had gonorrhea is miniscule.  The only STD for which there is any meaningful concern for you from the activity you describe is for gonorrhea and gonorrhea of the throat is almost always asymptomatic.  In addition, if you had gonorrhea, chances are that the azithromycin you took, while not the standard does for gonorrhea, would have cured the infection.

Try not to worry.  I am confident that you do not have an STD and the your sore throat did not result from performance of oral sex on your partner.  EWH

[Edward W Hook, MD]

The impression of many clinicians is that sore throats following oral sex with a new partner are often a manifestion of anxiety and concern regarding their recent activities.  Of course, in some it is likely that there is a coincidental, community acquired sore throat.  EWH

[GoingHome]

Dr. Hook,

I really appreciate you taking your time to answer my question in detail, it gives me a lot of comfort.  I hope you don't mind that I ask one quick followup question that might benefit me or even someone looking at this post in the future.

Some other posts I've read on this site also involve males giving oral sex to women, and while oral is an inefficient way to transmit STDs, it seems like guys end up with sore throats soon after!  Is there a known cause behind this - perhaps irritation from fluids?  Is there some type of typical virus that gets passed to the mouth from oral sex that's not an STD?  Or is it simply a coincidence and involves some sort of anxiety?

Again, I really appreciate your time.