Issues in mouth after oral sex

[blues246]

I would like some advice, please. I am a gay man who has sex with men.

Gave oral sex to a male 9 weeks ago

Within 30 minutes tip of tongue started burning and mouth was dry

Next morning my tongue was coated white

3 days after this the roof of my mouth behind front teeth was sore and looked irritated.

Consulted an online pharmacy who advised it could be oral thrush and prescribed Nyastin oral suspension liquid. Used this for 3 days and saw no improvement, made burning worse.

Tongue still coated white and sometimes appears bright yellow with red spots over it
Small, painful ulcer on tip of tongue, right side  

Some ulcers that come and go on inner cheeks causing burning pain, notice more when eating and drinking

Small, single red sore within right cheek - worried this could be Syphilis. This was initially a red area which turned into a sore, then blistered, turned yellow and went away.

Grey, painful patch on inner cheeks, both sides.

Large raised red lesion on inner right cheek - very painful. Observed 21st January, cleared within 3 days.

Redness on palate, tonsils and uvula

Sore throat which comes and goes.

Generally feeling unwell

Contacted sexual health clinic before Christmas and asked for an appointment. They would not see me in person as my symptoms were oral and advised me to see GP.

Did an at home STI test for
Clamydia
Gonorrhoea
Syphilis
HIV
HEP B and C at 7 weeks post sex
Came back negative.

May need to test again at 12 weeks to confirm negative result.

Visited doctor in January 2022

Advised that tongue looks normal and suggested symptoms are not as a result of an infection (sexual or otherwise) I have picked up or could pass on to anyone else. Doctor did not look inside my mouth, just my tongue.

Ulceration could be due to feeling run down and anxious. Suggested issues in mouth may be burning mouth syndrome for which there is limited treatment available.

Advised to make an appointment for blood tests to rule out any other diagnosis. If blood tests come back negative will look at other options.

Bloods taken for Chronhs Disease, colitis  - came back negative.

Fear that I could be experiencing symptoms for years with no diagnosis. Impacting my mental health and overall quality of life.

Saw a dentist who also said that my mouth and tongue looked normal. The ulcers I had have gone away now so he could not see anything of concern. He said I could be experiencing burning mouth syndrome which can sometimes stem from anxiety.

I am considering paying for private health care as I am in the UK. Please advise what my condition could be and what tests I should ask for. I read online that a lady was diagnosed with burning mouth syndrome, but when her saliva was tested, it was found to contain huge quantities of the herpes virus, which explained her burning tongue. Couls this be possible for me? Should I test again for STIs at 12 weeks post possible exposure? I am really worried about this and becoming depressed. I just can't see an end to it. Please help. Any advice would be greatly appreciated.

Thanks.

[Sillymistake87]

Hi there,

I agree with AJ and the GP that this is not related to the encounter.

You are obviously very worried by this and you will probably find it is a circle and making these symptoms worse. Try meditation or relaxation techniques before you decide to spend in private care. The UK MaxFax teams are very good (I used to work with one before I went into orthopaedics) so have a chat with them. There is a bit of a wait though. It isnt a bad idea to speak to the GUM clinic again and speak your concerns. They may do a swab. If that comes back negative, and im sure it will, try to move on and relax. Oral sex alone carries reduced risk than penetrative sex.

In the UK we can get free sti tests from...

https://sh24.org.uk

I know its easier said than done but try not to look at the "what ifs" but instead say to yourself "Its NOT This....".

[blues246]

Thank you very much. I am an incredibly anxious person, anyway. I'm also dealing with the fact that the guy this happened with is no longer interested in me (probably never was) so I no longer hear from him. That really hurts, i liked him a lot and it was not just a casual hook up. The encounter itself was not a pleasurable experience for me. I keep getting flashbacks in my head and go over it again and again. I just can't forget about it.

I think the guy has many sexual partners, which is fuelling my anxiety. As well as these physical symptoms that are just not clearing up. I am constantly looking inside my mouth and checking my body for symptoms elsewhere. I feel so guilty and just can't believe I have gotten myself in this situation. I was happy before all  this, and now I just have no quality of life. I'm not sure I will ever get over it.

I will call GUM clinic tomorrow whist waiting for MaxFax appointment. Its so hard dealing with this on my own. I wish I could take it all back.

[Sillymistake87]

Its these things which build us :) Try to look at facts:

Oral sex is a lot less risker than penetration.
Experts do not believe a single exposure is worth testing for with symptoms.
Your symptoms are not classical of any STI.
Your test a 7 weeks is conclusive so rules out everyone of them.
Anxiety mimics symptoms. Also causing you to check and touch which causes those areas to hurt.
Herpes sores in the mouth usually last for around 10 days.

I have been in the same boat and so have millions of people. We are humans. Emotions get away from us and we are stuck in a circle of self-doubt, constant checking and googling. Statically, and from a logical standpoint you are most likely fine.

[auntiejessi]

Please, get some counseling. Maybe SillyMistake can help you with where to go in the UK for that.

I'm sorry the guy didn't work out. Don't spend another minute mourning his loss. He treated you poorly, and you deserve better. You have nothing to be ashamed of.

[blues246]

Thank you, both. You have been really helpful. Managed to get an appointment at the GUM clinic for Tuesday morning so I can be tested again for piece of mind. I hope it will get easier.

[auntiejessi]

Good luck!

[Sillymistake87]

Nice one :)

A tip is to write everything down as when you get there you may suddenly forget something!

[blues246]

UPDATE:

Results from 2nd STI testing all negative for Clamydia, Gonorrhea, Syphilis, HIV, HEP B and C. So at least I know for sure that the issues in my mouth are not caused by an STI. Symptoms still persisting and as they began so soon after the encounter with this guy, I am still convinced they are related.

I don't know what to do now. Had no referral letter for Oral Maxillofacial Specialist yet from my GP. I really don't think all of these symptoms are just down to anxiety because I am a lot calmer now about the whole thing and have been gradually coming to terns with it, but the symptoms are still there. I think I will pay privately and get swabs of my tongue and inner cheeks done, as these areas are where the discomfort is mostly coming from. My tongue is still coated and the tip is burning. I'd like to try a broad spectrum antibiotic or something to see if that would help. I just want things to go back to normal now so I can move on, but if these symptoms persist I really don't think I will be able to. Its so hard.

I've also tested positive for COVID this week as members of my household have it which doesn't help.

[AnnieBrooke]

It sounds a little like Covid tongue. https://covid.joinzoe.com/post/covid-tongue  

If that is what it is, you would have to have had Covid before having the sex, and you don't mention that you did. The article I linked here suggests that it is rarer to have Covid tongue with only a mild case of Covid.

[Sillymistake87]

Again look at fact. You no NOT have an STI. We know this.

Try to move on from the anxiety and everything may get better.

[auntiejessi]

Agree with Annie and SM here - it has to be something else.

Do NOT take an antibiotic. If you have a fungal infection, an antibiotic will only make that worse.

Call your GP and follow up on the referral. Get counseling. Talk to your GP about all of this.

It is NOT an STD.

[blues246]

Further update:

I decided to pay privately to see an Oral Maxillofacial Specialist. He diagnosed me with Geographic Tongue with altered sensation in the mouth. He advised that I probably would have gotten this condition at some point in my life, but the oral encounter triggered it. The friction of the oral sex damaged the protective lining in my mouth. He described it like a snake shedding its skin. Some patches on my tongue shed the skin too early leaving red, sore patches and other areas shed the skin too late leaving white patches. The red patches are thin and raw which causes the pain.

My tongue is mostly white which he said is the bad areas. I need to watch what I eat as certain foods can make it worse. I've changed my toothpaste so it is gentler with less harsh ingredients. I may have this condition for many years or it could go into remission for periods of time. But it is a lifelong condition so it is something I will always have so need to learn to live with it. There is no cure so it is more about managing symptoms. Most people with the condition do not experience pain, but unfortunately I have the type that is painful, more or less continuously.

It was a lot to take in. I am glad I have a diagnosis but upset to think I could have this for life, living in pain with little relief. It is difficult coming to terms with it as this is something I did to myself, and it could have been prevented. I am working on accepting it but it will take a long time. I just wish it had never happened.

[auntiejessi]

I'm glad you have some answers.

I'm not that familiar with this, but please do some research on it. Find some support groups, especially online ones where patients are from all over so you can get advice and info from all around the world. As someone living with a few chronic conditions, I've learned more from other patients than I have from doctors. It looks like there are 2 on FB.

Try to remember that if it wasn't this, it would have been something else.

Having a chronic condition and chronic pain can affect everything. Counseling, in my opinion as someone who has both, is a must. Give it some thought.

[Sillymistake87]

Glad its sorted. I spent a little bit of time doing ENT and MaxFax in my early years and it is surprisingly common (to a degree) yet little is known about it. Now you know what it is you can relax. It is not dangerous and it wont kill you, it is just an annoyance! This should relax your anxiety and other symptoms can start to simmer down :)

Like AJ said, if you seed help then see a counsellor, they can help you see it from a different perspective :)

[auntiejessi]

Can you get a herpes test? Even if you get the test to rule it out, it would be helpful.

You wouldn't get symptoms that fast if you got it from that encounter, but that's not to say that you didn't have it before.

Burning mouth syndrome can be caused by anxiety. Were/are you feeling anxious about this encounter for some reason? Was cheating involved? Or some other reason why you might have some anxiety about this?

Food allergies are a big cause of burning mouth.

Maybe it's time to see an ear, nose and throat specialist or a dermatologist, or even an oral surgeon. You need some further testing done if it's not anxiety.

https://www.nidcr.nih.gov/health-info/burning-mouth

[blues246]

Thank you for your response. I would like a herpes test, but I read that test is only done if there are ulcers or sores present, which they are not at the moment. I've had cold sores before, so the test may show as positive even if I did not get herpes from this encounter. All of these symptoms began from this encounter, beginning with the burning tongue half an hour later which has never gone away.

I am very anxious about this. No cheating or anything of that nature involved. This is the first person I have been intimate with since splitting up from my monogamous partner of 5 years. I got tested for STIs before meeting this new guy just for piece of mind, and everything was clear. The first time we do anything intimate, and this happens to me. I believe this guy has multiple sexual partners. I am very regretful and should have been more careful, especially as I knew he was not particularly interested in me beyond sex, and now I do not hear from him. I noticed after I had given him oral, that he had 2 small red spots on the head of his penis, which is really worrying. He also told me that he had not showered before seeing me. I really like the guy, it hurts knowing he does not care for me and now I have been left with these symptoms.

I am worried this is some kind of obscure infection that will not show up on routine tests and will take years to diagnose. I am a disabled person and am not able to keep going back and forth to the doctors for appointments. I just wish I could take this back. I am suicidal at the moment as it consumes my every thought.

If this is not something sexual, I just can't think what it could be. I'm doubtful that it is burning mouth syndrome as I've had ulcers within my mouth as well as the white, burning tongue. I understood that BMS was only diagnosed if there were no other symptoms present? I am constantly googling my symptoms. It is making me mentally as well as physically ill. I just don't think I will ever recover from this.

[auntiejessi]

So there is a herpes blood test that you can get - a type specific IgG blood test. It's not done a lot in the UK, but maybe you could persuade your doctor to give it to you.

The issue with it is that it misses 30% of hsv1 infections, so if it's negative, it doesn't help you much.

In the case you were referring to, it looks like they did PCR swabs of her saliva to detect herpes. They could certainly do that for you. Show this to your doctor - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4401976/ Even if it's not BMS, it shows that you can PCR swab saliva, or the tongue or cheeks.

There is no STD that gives you symptoms within minutes or hours. The absolute minimum is 2 days.

I don't know if your issues are with transportation, or it being hard physically to get out, but you are suicidal. You need to find a way to make this happen. I'm sorry it's so hard for you, but there is a doctor out there who can help you.

Suicide is not the answer.

In the US, there are reputable places online where you can get acyclovir and valtrex online without a doctor's prescription. Are those available in the UK? If they are, maybe you can try that and see if it helps, if you can safely take meds that are metabolized through the kidneys. It really doesn't sound like herpes, though.

I wish someone would swab you or biopsy it. I'm sorry it's not been easier.

[blues246]

Thank you. I will look into getting a herpes test and a tongue / cheek swab to look for infection. I'm so tired of feeling like this. It just feels like I have sought medical help, but doors are being slammed in my face and they are writing me off.

[blues246]

Hi,

I've been trying for a few days to get a doctors appointment. I  will try again tomorrow and ask for an emergency appointment. I going to ask for a tongue and cheek swab, (PCR) as well as asking to be tested for STIs again, especially some of the more obscure ones. Is there anything else I should ask for? I am so desperate to find a solution to this. Any advice before my appointment would be greatly appreciated. I just can't think what could be causing my symptoms. I'm sure it is not burning mouth syndrome as the doctor suggested. I am at a loss.

[auntiejessi]

Are you still experiencing symptoms with no relief? That wouldn't be a herpes outbreak if you are. A herpes outbreak would be at least getting much better by now, if not healed.

The only STIs that you are at risk for from giving oral sex are oral gonorrhea, chlamydia and syphilis, possibly herpes, but that's very rare.

None of them would give you symptoms within 30 minutes. No STI would.

Another member told me about https://www.thesticlinic.com/.  You can get a type specific IgG herpes blood test here, but you'll have to self-pay.

https://www.thesticlinic.com/herpes-blood-test.aspx

It says index values are available on request. If you test positive, get the index values.

They also offer a PCR swab test that you can use to see if it detects herpes in your mouth. If you decide to do this, I would swab the areas that have the most symptoms. They have a swab test if you have a lesion, too.

https://www.thesticlinic.com/symptomatic-lesion-test.aspx

It will test it for herpes and syphilis.

I can't vouch for their reliability, but if you can afford it, it might be worth a try.


Also, have you seen your dentist?

[blues246]

Thank you again for your detailed response. Doctors phone call this morning was a complete waste of time. She will not see me in person as the last time I went in a month ago she saw nothing inside my mouth which was of concern. She just kept reiterating that my symptoms were akin to burning mouth syndrome. I don't know how she can be so definite in this diagnosis as so far all I have done is a home test kit for STIs at 6 weeks post encounter which was not the full range and some blood tests for vitamin defincies etc. No one has swabbed my tongue to check for infection. I really feel a lot more could have been done to assist me, if only to put my mind at rest.

She is going to make a referral to an Oral Maxillofacial Specialist so they can examine me, but that will take weeks and I doubt they will find anything. She also suggested calling the STI clinic again and stressing that I am very worried about this so I can be tested again. I doubt they will see me in person as my symptoms are oral and not presenting in a private area, as they advised the last time I tried referring myself.

Yes, I've seen my dentist who said everything looked normal and suggested burning mouth syndrome also, although no one is doing conclusive testing to confirm this diagnosis for me. Its hopeless.