Unprotected Oral

[jimmyjones222002]

On 9/24 I had protected vaginal sex and received unprotected oral sex from a sex worker while in Chicago on business. Two days after the encounter I began to experience pain in the shaft of the penis and sensitivity at the tip of my penis. The pain is mild and doesn't really feel like a burning sensation. During urination there is no additional pain and I have no discharge. 7 days (Tuesday) after the encounter I went to a Planned Parenthood and was urine tested for chlamydia and gonorrhea. Yesterday the test results came back negative.

I am still experiencing the same mild pain in my penis and sensitivity at the tip. For some strange reason the pain is almost gone when I wake up and slowly comes back during the day. I also have some mild pain/sensitivity in my testicles. I also have some mild lower back pain that comes and goes.

So on to my questions...

1. Am I 100% clear of gonnorhea and chlamydia or is a false negative possible with me testing so quickly after the exposure?
2. What else should I go get tested for and what possible STD's could be causing these issues?
3. I can get some doxycycline pills that I know treat some STD's. Should I begin to take them? (friend has them leftover from acne or something, so he says.) Of course, I know I would need to check the dose and take appropriately.
4. The Planned Parenthood clinic says I am in the clear. However, I was 100% fine before the encounter and now I am not. Something has to be wrong!

Lastly and to better explain my anxiety... I was with the same girlfriend in a monogamous relationship for almost 5 years. At the beginning of last month we split due to disagreeing on children. We are going to reconcile this week and give things another try. I really don't want to give her anything if we have unprotected sex. I care about her a lot and would prefer to keep my scare and encounter to myself. So back to my question #4 is when can I have sex with her again with no risk of giving her anything.

[Edward W Hook, MD]

Welcome to our Forum.  I'll try to help.  this risk for getting any STI from the encounter you describe is quite low.  Most commercial sex workers do not have STIs and the chance of acquiring infection if you have sex with an infected partner is low.  Further, your genital exposure was condom protected and thus safe sex.  As for oral sex, fewer STIs are acquired through oral sex than through genital exposures.  

1. Am I 100% clear of gonnorhea and chlamydia or is a false negative possible with me testing so quickly after the exposure?.  

Currently available tests for gonorrhea and chlamydia are quite accurate and the timing of your testing is not a problem.  You should believe these results.  You did not get gonorrhea or chlamydia from this exposure.

2. What else should I go get tested for and what possible STD's could be causing these issues?

Your symptoms are not typical of any STI.  Herpes would not cause discomfort inside your urethra unless there were also lesions on the outside of your penis.

3. I can get some doxycycline pills that I know treat some STD's. Should I begin to take them? (friend has them leftover from acne or something, so he says.) Of course, I know I would need to check the dose and take appropriately.

The infections that are treated by doxycycline are the infections you have already had ruled out with tests.  I would not recommend taking the medication.

4. The Planned Parenthood clinic says I am in the clear. However, I was 100% fine before the encounter and now I am not. Something has to be wrong!

I agree with the folks at Planned Parenthood.  Your symptoms are not typical of any STI, your exposure was low risk, and your tests are negative.  Sometimes following exposures that people wish they did not have, they notice normal sensations that are overlooked when they are not so focused on the possibility of an STI.  Perhaps this is what is going on.

I would not worry about STI at this time and see no reason for you to abstain from unprotected sex with your regular partner.  EWH

[Edward W Hook, MD]

Straight to your follow-up questions:

If my symptoms are not STI/STD related should I just wait for them to go away?
That would be my advice.  On the other hand, if they are getting worse and there are still no obvious abnormalities that can be seen you should discuss them with your doctor. They could be due to back problems or some other process.  It is possible the doctor would tell you to just not worry but I think you'd be better off being checked first, if they are getting worse.

Should I go see some other type of doctor?
See above. A general internist would be a good place to start.  

Could I have some sort of other infection, inflammation, or virus? \
See above. This is beyond the scope of this site.  

And I know you already answered this... but I AM safe to assume normal unprotected intercourse with my regular partner?
Yes

Take care. EWH

[jimmyjones222002]

Hello again Doc. I appreciate all of your comments and time you took to address my concerns.

I am hoping you can help me out a little further and help guide me in the right direction for my next steps.

It seems likely I am clear of any STI/STD issue from your comments. However, I am still experiencing the strange mild pain/tingling sensation in the shaft of my penis. (No extra pain while urinating). If I squeeze my shaft to try to see if it does anything positive or negative for the pain it has zero effect. My testicles are also a little sore/tender. The very tip of my penis is also still very sensitive to where I can feel it when I walk and it rubs against my underwear. These are all symptoms that were 100% not there before my encounter (9/24) but have had since 2 days after.

If my symptoms are not STI/STD related should I just wait for them to go away?

Should I go see some other type of doctor?

Could I have some sort of other infection, inflammation, or virus?

And I know you already answered this... but I AM safe to assume normal unprotected intercourse with my regular partner?

I do appreciate your time & comments. Just looking for some sort of answer to the problems I am having and if I need to possibly seek help from a specialist.

Thanks again.