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I'm currently away from home on overseas deployment. Three weeks ago I went to a bar, picked up a prostitute, and we had protected vaginal sex. The next morning, my penis really hurt. I figured it was down to being a little drunk and not fully hard whilst having sex, so that and the condom friction did some nerve ending damage. Anyway, three weeks later, it's still sore. I have no discharge, it doesn't hurt when I pee, there are no sores there, so I'm writing off an STD. I've taken 1g Azithromycin and 400mg Cefixme as a precaution anyway. Any clue what this could be causing the problem?

Hi,

Thanks for writing.

Without doing an assessment in person it’s hard to give you a specific answer, but I can give you some general information.

If you used a condom (and there wasn’t any penetration before the condom went on, and it was still intact when you withdrew) then we would say the chance of getting an STI is very low.

Did you receive unprotected oral the same night? It’s possible to get an STI from the back of someone’s throat… Or, did you have any unprotected sex in the last 3-6 months? Sometimes it can take a while for STIs to show up but we only notice it after new encounter…

If you had unprotected oral or other recent unprotected sex, then there’s still a possibility your symptoms are caused by an STI. Not all STIs cause discharge or pain when we pee.

If you haven’t had any unprotected oral or other recent sex, I would say the chance you have some soft tissue/ nerve damage seems likely. Friction injuries are quiet common, and usually resolve on their own. Our doctor says to compare it to an ankle sprain—for some people it can take 6 weeks for things to feel normal again.

It’s not a bad idea to have taken the Azithromycin and Cefixime, and I’m glad you were able to access that. Did the medication help with the pain? If you feel better after the meds we can assume there was an STI component to your symptoms.

If your pain is persisting after taking the meds, I would continue to monitor it. Likely it will resolve on its own in a few more weeks. However, if your pain worsens, or you notice new swelling, or pain in your scrotum (testes), then I would recommend going to see a health care professional right away.

Please let us know if this answers your question or if you need any additional information.

Health Nurse

This answer was posted on October 4, 2017

Community comments

billyboy1965 says:

Thanks for the reply.

Just to clarify, the sex, oral and vaginal was with a condom on, and as far as I can remember it didn't split.

The pain comes and goes, but is mostly subsiding.

One thing that has developed though is a little red sore on my penis shaft. It's about 3mm wide in diameter, and flat. Cropped up about 5 days ago, and it's now been 5 weeks since the sex.

I'm concerned it could be syphilis, as I think that point would have been outside the condom coverage.

However, it's not raised like a syphilis chancre. It's neither full of pus like herpes.

Aside from posting up a picture of it, any idea what something like that could be?

Health Nurse says:

Hi again. Its not possible to tell what this is by email or even by a posted photo. It sounds like you had protected sex for all the sex that you had so there is not a concern re syphilis transmission. There are lots of reasons that a small re sore can appear on the shaft including an infected hair follicle, oil gland or shaving nick. Skin issues are best assessed in person by a health care provider and if it doesnt clear, gets larger and painful, then please consider getting an opinion in person. 

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