Risk Assessment Please

[crdno2]

Dear Sir.  I had a one year affair.  I'm 40 y/o male, white.  Affair with another married white female, 36, who had previous affairs with married men (including one African American male) and she had an abnormal PAP during our affair. Affair consisted of unprotected vaginal and oral sex.  I don't think she had any other partners during our affair, other than her husband. Timeline as follows.

Affair from Sept 2012 -->Aug 2013.  I continued to have sex with wife during this period.
Oct 2013 -- Tested negative for chly. and gonn (twice--urethal and urine)

March 2014 -- Wife started having continual vaginal discomfort.  No discharge.  She tested negative for yeast, BV, and Trich. Discomfort continues.

March 2014 -- I again tested negative for chly. and gonn(two urine tests) (also negative for HIV, Hep B, C, syphilis)

I never had any symptoms and I'm rather 'genitally aware'.  I did not take any antibiotics during this period.  How likely is it that I infected my wife with chlamydia or a less-common STD, but cleared the infection myself, was not reinfected and therefore tested negative?    Could chlamydia or some other STD start causing symptoms 7+ months after a woman is infected?  How sensitive are chlamydia tests?  

Thank You

[H. Hunter Handsfield, M.D.]

The single most common symptom of chlamyda in women is vaginal discharge.  Other common ones include discomfort in urination, and minor vaginal bleeding, especially after intercourse.  However, many other conditions, mostly not STDs, cause the identical symptoms -- and the large majority of women with these symptoms have something other than chlamydia or any STD.  Abdominal pain due to PID does not come and go.

In other words, even if your wife has symptoms like these, you can rely on your test results -- plus the other evidence noted in my reply above -- and stop worrying that your wife has chlamydia or any other STD.  She does not.

[crdno_2]

Thank you for the detailed response.  If I may ask a few more follow-up questions please.

What would be the expected symptoms for chlamydia in a woman, assuming symptomatic chlamydia?  Some of yours and Dr. Hook previous post indicate discharge is more of a symptom than pain/discomfort.

Is the abdominal pain associated with PID a constant pain, or can it show up for a day or two per month (come and go)?

Thank you Doctor.

[H. Hunter Handsfield, M.D.]

Thanks for your question.

This is a very low-risk situation; you really didn't be worried at all. Your extra-marital partner is at lower risk of STD than you might think.  Among other things, new STDs are quite rather after age 25-30.  Their is nothing in here wife's symptoms that are particularly suggestive of STD, and her negative test results are reliable, and your own tests rule out gonorrhea and chlamydia.  (Her symptoms didn't suggest these STDs anyway.) Further, assuming your wife is somewhere near your own age, a non-STD problem is a far more likely explanation of the kind of symptoms she has had.

To your specific questions:

"How likely is it that I infected my wife with chlamydia or a less-common STD, but cleared the infection myself, was not reinfected and therefore tested negative?"  Extremely unlikely -- not a realistic possibility.

"Could chlamydia or some other STD start causing symptoms 7+ months after a woman is infected?'  Also very unlikely.  When chlamydia causes symptosm at all, they usually start within 3-4 weeks.  And by 7 months, most chlamydial infections or gonorrhea would have been cleared by the immune system, without treatment.

"How sensitive are chlamydia tests?"  Over 95%.  Same for gonorrhea.  You can rely on your negative results, especially since you were tested twice.

In summary, it is very unlikely that your wife's symptoms are connected in any way with your extramarital partnership. You really needn't worry about it, and I recommend against any further STD testing for either you or your wife.

I hope these comments are helpful. Best wishes– HHH, MD