Worrying about an unprotected oral sex, need help!

[Harris198]

Hi Doctor,

Thanks a lot for your attention, I need your help!

Last Sunday (Mar-24-2013) afternoon, I had a sex with a bar girl which health status is unknown during my business trip in Greece. She gave me an oral sex without condom for 2 or 3 minutes then we had vaginal sex with a condom (she at first use hand to put the condom on my penis, pushed it down about 2 or 3 centimeters then used her mouth to complete that procedure). After all I washed myself immediately with shower gel.

In the next day I don't know if it because of anxiety and regret, I got frequency of sensation with urination also sometimes with burning sensation. I did drunk lot of water during these days and also took 500mg amoxicillin caps 3 times per day. But those uncomfortable feelings didn't go.

After three days, I stopped taking amoxicillin caps and the sensation of frequency of urination remitted a little.

Btw, I found that on my penis near the urethral orifice there are a few small rashes or spots. The same color as skin, neither painful nor itching. I don't know if it is balanoposthitis symptoms?

I'm worrying about if I could get STDs or other disease from that activity? What should I do if I want to have a testing and how many days should I wait for?

Thanks so much for your reply and best regards!

[Edward W Hook, MD]

Welcome to the Forum. I will try to help.  The exposures you describe were low risk, both because most commercial sex workers do not have STDs and because even if she did, there is very little risk for STD both from condom protected vaginal sex, from receipt of unprotected oral sex, or because she touched you with her hands and finished applying the condom with her mouth.

Oral sex is an inefficient way to transmit STDs.  Even among persons with many sex partners, oral infections are uncommon and for a number of biological factors too complex to go into here, the efficiency of transmission of infections through oral sex is lower than for penetrative genital-vaginal or –anal sex.  Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are transmitted through oral sex; for all practical purposes, chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny.  There is also currently a large amount of overstatement of the risk of HPV and its very rare consequence, oral cancer, related to HPV infections is excessive and should not be a concern either.  If you had gotten gonorrhea or NGU you would have most likely developed symptoms of urethritis (penile infection).  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, your exposure was brief; I would urge you not to worry. If you must, you could go to your local STD clinic or health care provider to be tested at this time.  If you choose to do this, tests fro gonorrhea and NGU are the most appropriate tests at this time.  The tests will be negative and in my opinion, you do not need testing at all.  

Blood tests for syphilis and HIV are easily done but this is too early for such tests to be accurate and your risk for these infections is very, very low.  In the absence of symptoms, we recommend against blood tests for herpes- your risk for a false positive result is far higher than the likelihood that you got herpes from this exposure.

I hope my comments are helpful.  Your symptoms are not suggestive of an STD acquired from the exposure you describe and are more suggestive or anxiety or guilt than anything else.  EWH

[Edward W Hook, MD]

Yes, it is time for you to move forward and stop worrying.  EWH

[Harris198]

Very appreciate to your patience and kindness Doctor, I had testings about Syphilis, Hepatitis and HIV after 4 weeks since the unprotected oral sex, all results show negative. And also I do not find any developing symptons since I released my anxiety. Can we say that Im alright now?

Thanks for your help.

Kind regards.

[Edward W Hook, MD]

No, this is not reasonable and the Dr. who told you this was mis-informed.  Some gonorrhea and NGU and most chlamydial infection in men are asymptomatic. Even so, your overall risk for any STD from the exposures you describe are quite low.  I would not be worried if I was you.

This will complete this thread. EWH

[Harris198]

Dear Doctor, before ending this thread, may I ask the last question because today I went to a hospital for applying a testing about Gonorrhea and NGU.

I told the doctor in that hospital what happened to me and ask him to give me a testing. But he told me that they will give a testing only if I have some symptoms like discharging pus from the penis then they will take a sample to test. And he told me if I don't have, I don't need do a testing. Is that reasonable?

12 days passed, I don't have any similar problem like discharging pus, as it means I'm almost ok?

Really appreciate your help!!! Please reply me.

[Matlow_1987]

Thanks for answering that, Take Care

[Edward W Hook, MD]

Oral chlamydial infections have been found to be so rare in studies which looked for them that the CDC does not even recommend testing. Those are the data.

Time for the thread to end.  Take care.  EWH

[Matlow_1987]

How come chlamydia is not passed via oral sex? I always thought it was a method of transmission.

[Edward W Hook, MD]

I have not examined you however the small dots that you describe are not suggestive of any STD.  My guess is that becasue you are looking more closely, you have noticed spots that were present before.  If you are really concerned, you could ask a dermatologist to take a look but I really would not be worried.  EWH

[Harris198]

Dear Doctor, there are some questions following.
Your reply comforted my anxiety which is really helpful. I did felt that the sensation of  frequent urination is eased. But you didnt explain me why there are a few of small rashes or spots appeared around my urethral orifice. actually I dont konw if I got this before or after that unprotected oral sex.

Through my observation, there is no discharge or my penis nor other strange herpes come out. Does it means I didnt got infected?

Thanks a lot for your patience and help! All best!

[Edward W Hook, MD]

Glad I could help. EWH

[Harris198]

Thank you very much Dr. Hook!!! Your reply is professional and very helpful.
I will definitely take your advices.

Best regards!

[Edward W Hook, MD]

SOrry, this one works better.  EWH

http://www.medhelp.org/posts/STDs/Worrying-about-an-unprotected-oral-sex--need-help/show/1923553