Possible STD?

[JG27]

Hello and thank you in advance for your help. Here's my situation:
I'm a male heterosexual in my early 40's. 13 days ago I had sex with a 25 year old female friend, which consisted of giving and receiving oral sex, along with vaginal intercourse. I used a condom for intercourse with the exception of approximately one or at most two minutes when I did not (realized this was stupid and put another condom on). Prior to sex we discussed STDs and she said that she didn't have any (I think this means she doesn't have any symptoms). I do know that she's had other partners recently. I believe that she practices safe sex, but based on our experience, she did deviate from that.

The last day or two, I've noticed increased urination (although my work environment has changed and I may be drinking more fluids, but not entirely sure). Additionally, I think I feel a bit of an itch right inside my urethra. I'm not sure if this is just from the increased urination. Some websites state that an increase in urination is a sign of chlamydia or gonorrhea. I haven't noticed any discharge, swelling, redness or pain with urination (I'm assuming that the pain would be obvious). This morning I went to a clinic and provided a urine sample for a chlamydia/gonorrhea test. I should have the results back early next week.

Here's the tough part, I'm dating someone (for a year now) and we have unprotected sex. We haven't been in the same town the past few weeks, so we haven't had sex since my mistake. I feel bad about what I've done, but now realize how much she means to me and how stupid I was. I don't want to hurt her, but rather put this behind me and not make the same mistake ever again.

Here are my questions:
1. What's the likelihood that I've got something?
2. If the test comes back negative, can I rely on it and move on?
3. Could this be anything else besides chlamydia or gonorrhea?
4. Is there anything else that I'm missing/not providing you?

Thank you.

[Edward W Hook, MD]

Thanks for the followup.  I'm pleased my commnets were helpful.  EWH

[JG27]

I just wanted to conclude and say that my results were negative for gonorrhea and chlamydia. Additionally, I no longer have a frequent urge to urinate (I know this isn't a symptom, but I initially had thought it was) and my urethra is no longer irritated. Not sure what was going on, but I'm going to assume that it wasn't STD/STI related.

I wanted to say thank you and that both you and Dr. HHH provide a great service and are always caring and professional.

I learned a valuable lesson and will not be making the same mistake twice.

[Edward W Hook, MD]

Thanks for the follow-up. Calling her was a good idea and I agree that her reply makes to possiblity that you were infected still less likely.  EWH

[JG27]

Doctor, thank you for your response.  The "itch" has gone away and it seems to just be frequent urination. A bit of urethra irritation, but not necessarily out of the norm (considering it feels more like pressure from the frequent urination).

I decided to call the girl and just address it head on. It was a good conversation. She was also worried, as she stated that she is "OCD" about STDs, so she gets tested and always uses condoms. She also called her doctor after realizing that she had unprotected sex. Her doctor did not seem concerned. I asked her directly if I should be concerned for my health or my girlfriend's and she said that based on her history and conversation with her doctor that I should not. I believe that she was honest and wouldn't knowingly lie to me. This is someone I have friends in common with so I don't think she'd lie about this. Between that conversation and your response I feel better. Will wait for the test results and go from there.

Thanks.

[Edward W Hook, MD]

Welcome to our Forum.  I'll try to help.  Undeniably, there is some risk of infection related to the events that you describe but that risk is most probably small.  Most women do not have STIs and annual screening for chlamydia, the most common STI is recommended for all women under age 25 as part of routine health care so, if she is having regular checkups, she should have been tested in the relatively recent past.  Further, most persons with STIs do not transmit them in a single episode of unprotected sex. Among your sex acts, your unprotected vaginal sex is the highest risk event that you participated in,  your receipt of oral sex is a bit lower and your performance of cunnilingus on her is the lowest risk of the activities you describe.  While your application of a condom after starting to have sex is better than nothing, it was still  unprotected sex and, is she had infection, the highest risk of the activities you describe.  

As for your symptoms, despite what the internet says, urinary frequency is not a symptoms of STI but the "itch" you note inside your penis may be.  Testing was a good idea.  

Regarding your specific questions:
1. What's the likelihood that I've got something?
Low.  If your symptoms increase this could be a sign of infection but the odds are that you are not infected.

2. If the test comes back negative, can I rely on it and move on?
I would. There is a long list of possible STIs but if your gonorrhea and chlamydia tests are negative you have eliminated the possibility of the most common ones.  Syphilis is very, very rare and testing for herpes is not productive- if you do not develop lesions within 14 days of the exposure at a site of exposure, you were not infected with HSV.

3. Could this be anything else besides chlamydia or gonorrhea?
Non-chlamydial NGU could cause the urethral itch. the doctor who saw you should have considered this and tested your urine for the possibility.

4. Is there anything else that I'm missing/not providing you?
I think you've done fine

I hope these comments are helpful. EWH