Gonorrhea

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Hello

I have a question about Gonorrhea. I understand that is the most common infection one can acquire from oral sex. well I only found out about this readin this site I always assumed you cannot get any serious infection from oral sex.

My exposure was in Aug of 2009 (a year ago) and I received a CONDOM protected oral sex from a CSW. and I have recently been beating myself up trying to remember if I had any symptoms. As you can imagine this is tough to do and many of my memories are vague at best. Some days I am convinced I remember certain symptoms such as morning discharge, waking up with an erection and the tip of my penis being stuck to my underwear but I do not know if that was abnormal. One thing I know for certain is I never had any pain. I am generally very in tune with sensations on my genitals and i would have certainly noticed some pain.

I guess my question is, why do people miss to recognize a gonorrhea infection? If the symptoms are always obvious? How could have I missed my symptoms? can they be so mild as to go unnoticed?

Another question, a nurse at a local clinic has informed me that condoms are not effective for oral sex. She said that chemicals in saliva erodes a condoms layers damaging it. Is this true? How effective are condoms for oral sex? Is there another protective measure I could have used?

I am worried about all of this because I have a significant other whom I have unprotected sex with.

[Edward W Hook, MD]

Condom protected sex, oral or otherwise IS safe sex - you should not be worrying about STDs if you used a condom.  No, to my knowledge there is no such thing as improper condom use.  EWH

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I thought I was being 100% safe by practicing condom protected oral sex but now I realize I put myself and more importantly my girlfriend at risk of health complications such as infertility.  

Last question, in your experience what are some of the most common causes of infection despite condom use (assuming no breakage or contact before condom use). My condom did not break nor did I have any contact before the condom was put on. Does improper condom removal pose a risk? Maybe surface contamination outside condom?

[Edward W Hook, MD]

If you were tested you are not ifected. If you had been infected and it cleared itself, you are still not infected.  Believe the tests.

Condoms are safe sex.  The risk of infection, if exposed to an infected partner is a small fraction of 1% as long as the condom does not break (and when condoms fail they break wide open- condoms do not just "leak).  You did not get infected- believe it.  EWH

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Thank you very much for your response. This site is a great resource

I have tested recently and it was negative and I understand that means nothing since gonorrhea always clears itself up in men.

In your estimate what is the likelihood of being infected through my exposure? that is a Condom protected Oral sex? 10% or more like 1%?

[Edward W Hook, MD]

Welcome to our Forum.  I'm pleased that you find the information here useful, that's a big part of why we do what we do.  Let's work through your comments, they are good ones.

Actually, gonorrhea is not the most common STD one can get form oral sex, nongonococcal urethritis (NGU) is with gonorrhea coming in second.  Indeed, gonorrhea, as your question implies can be completely asymptomatic and in other people the symptoms can be mild ( I cannot tell you how many patients over the years have told me, that they thought their symptoms would be more severe if they had an STD)..  it is for this reason that we suggest that persons with multiple partners or new partners during the past year get "screening" (that is tested in the absence of symptoms) about once a year.  The tests are very good and reliable (and one screening test is enough).  Many women get screened yearly when they go for their annual PAP smears, even though their doctors may not mention it, but there is little automatic screening for men and we think it is a good practice.  

Don't beat yourself up trying to recall symptoms, just get screened and then if your tests are negative as is usually the case, move forward with confidence.

Finally, this nurse who you spoke with is incorrect.  Condoms are safe sex and they work well irrespective ot he site of contact- oral genital or rectal.

I hope these comments are helpful to you. EWH