There are 8 sexually transmitted infections that we can have without realizing it. Below you can read the infections we see in each type of sex and a comment on HPV (human papillomavirus), another silent infection.
Oral sex is THE MAIN ROUTE of transmission for gonorrhea, chlamydia, and syphilis.
We sometimes see a few cases of Mycoplasma genitalium in oral, but penetrations are its preferred route of transmission.
Transmission is most effective from throat to penis and vice versa, but we also see these infections moving from vagina to mouth and vice versa, and also from ass to mouth and vice versa.
In the throat it is very common to have NO SYMPTOMS of these bacteria, and only tests will reveal their presence.
There are also many silent cases in the penis.
However, there have hardly ever been described any cases of HIV in oral sex, with the risk being mostly theoretical.
In my satellite laboratories we have highly advanced technology to detect these infections, with an PCR test for HIV that allows detection just 10 days after a sexual contact.
If you would like to do a check-up specifically designed for oral sex contacts, please visit our shop now.
Gonorrhea, chlamydia and syphilis are also perfectly transmitted in vaginal sex. Just like in oral sex, it is very common to have these infections and not know about it.
But we also see hepatitis B, Mycoplasma genitalium, HIV and HPV (papillomavirus) transmitted in this way. All these infections you can have without symptoms and that’s why it’s important to do check-ups after unprotected vaginal sex because they can do harm or put the health of your sexual contacts at risk.
In vaginal sex we also see 4 other infections that you can have without knowing it, but there is an important difference between these infections and the ones I mentioned above – if they do not produce symptoms they are doing no harm. In fact, they are so common that it’s estimated that 30% of the population have these infections in their vagina (in women) or their urethra (in men) without significant consequences. They are Mycoplasma hominis, the Ureaplasmas, Gardnerella and trichomonas.
But of course, you may develope symptoms of these infections we see in vaginal sex and you can read more in the next section.
If you would like to do a complete check-up of all these infections please visit our shop.
Gonorrhea, chlamydia and syphilis are also perfectly transmitted in anal sex. Just like oral sex, you can have these infections and not know it. They are the most common infections in this type of sex.
But anal sex is a powerful route of transmission of hepatitis B, Mycoplasma genitalium, HIV, and HPV (papillomavirus). We also see cases of hepatitis C in anal sex, especially in the person receiving (being passive/bottom).
The vast majority of these infections in the ass DO NOT PRODUCE SYMPTOMS, which is why check-ups are of great importance if you have unprotected anal sex.
If you would like to do a complete check-up of all these infections please visit our shop.
What these two practices have in common is that an infection can pass from vagina to vagina, ass to ass, vagina to ass, and vice versa.
The infections we see are the same as in vaginal and anal sex (see above), that is to say, syphilis, gonorrhea, chlamydia, hepatitis B, Mycoplasma genitalium, and HIV, but in the case of shared anal dildos the risk of hepatitis C is greater.
If you have doubts about whether your own situation is of risk, we can always discuss this in a consultation, email or by WhatsApp.
The main risk here is if there is fisting contact with more than one ass, because hepatitis C can be passed in microbleeding from one ass to another. We also cases of the so-called “superchlamydia”, lynphogranuloma venereum in fisiting in groups.
Often there can also be anal penetration in this type of sex, and the infections that we see would be those mentioned in the above section. If you have doubts about the risk in your own situation, we can always discuss this in a consultation, by email or WhatsApp.
Hepatitis C almost never causes symptoms.
When we share rolled up tubes we expose ourselves to the possibility of traces of blood from the previous user’s nose.
Cases of HIV transmission have never been described in this way, but hepatitis C is well described. There are no other silent or symptomatic sexually transmitted infections that we see in this kind of practice except if there has also been sex.
Hepatitis C almost never causes symptoms.
If you need advice about tests specific to this situation, please write to me.
There are some studies that have described that deep kissing can transmit gonorrhea (from throat to throat), but, for reasons that we do not understand very well, it was only described BETWEEN MEN and with a very reduced risk compared to other routes of transmission (for example oral sex).
We don’t see other sexually transmitted infections in kissing.
The only sexually transmitted infection that is normal to have.
That is to say, in the VAST MAJORITY of cases we get infected and IT DOESN’T DO HARM. Of course, it is linked to certain cancers, but between regular check-ups of people at risk (especially women and people with HIV) and vaccination programs that are spreading around the world more and more, we do not usually include HPV in routine tests after a risk contact.
If I can help you with questions about the papillomavirus, I am at your disposal.
Here I review the symptoms I commonly see and the sexually transmitted infections that may be underlying.
If the relevant contact has been oral sex, we think of gonorrhea and chlamydia.
If there has been anal penetration, you should also consider a third bacteria, Mycoplasma genitalium.
In vaginal sex, all these infections are relevant and also Mycoplasma hominis, trichomonas and Ureaplasmas.
These symptoms can also exist as part of an inflammation of the urethra not due to these infections or as part of prostatitis, a very common diagnosis in sexually active men.
I can help you reach a diagnosis because I have seen thousands of cases of urethritis and prostatitis.
Please visit my shop to book a consultation or choose relevant tests.
Herpes produces painful sores (ulcers) and has a very short incubation of just a few days.
Syphilis produces other sores that are usually not painful, and it is much more common between men.
Many ulcers that I see are not related to these two infections and are from trauma or other infections that have occurred in sex.
I have many years of experience in how these cases should be handled if you would like a consultation with me
Please visit my shop to book a consultation or choose relevant tests.
It is very common to develop a sore throat after sexual contact, but in more than 95% of these cases I do not diagnose an STI.
Of course, in the same contact there wasprobably kissing and then viruses of the cold-type family got exchanged.
We occasionally diagnose gonorrhea, chlamydia and Mycoplasma genitalium in these patients. Treating this throat infection requires a lot of care and follow-up tests because it can turn into a resistant infection. I usethe most updated treatment protocols to avoid this situation.
You can book an appointment with me if your symptoms concern you.
Please visit my shop to book a consultation or choose relevant tests.
If you have had anal sex without a condom, you may develop symptoms in the anus or rectum. The most striking symptom of STI infection is tenesmus (the urge to keep passing stools but there is nothing left).
We also see these infections if someone has licked your ass, or sometimes even in protected penetrations (the bacteria were on the outside skin and got inside with the penetration).
These four infections require a lot of attention if we detect them in the ass, because they can be resistant to normal treatment with antibiotics. I work according to the most up-to-date protocols to avoid this situation.
If you have worrying symptoms, please do book an appointment with me.
Please visit my shop to book a consultation or choose relevan
Genital symptoms in women that are mainly located in the vulva and / or vagina are not usually due to an STI. We think more of Candida (fungal infection), a bacteria called Gardnerella or trichomonas, but it is true that sometimes the cause is gonorrhea, chlamydia, etc.
However, the symptoms that indicate a “deeper” problem (of the cervix), such as pain during sex, bleeding that cannot be explained, pelvic pain etc, DO make us think mainly of STIs such as gonorrhea, chlamydia and Mycoplasma genitalium.
These three infections can also produce symptoms similar to a urine infection.
If you need guidance on any symptoms you are experiencing I can always help.
Please visit my shop to book a consultation or choose relevant tests.
We have all read about the symptoms of HIV primary infection (the symptoms of so-called seroconversion), fever, malaise, headache, flu-like symptoms, etc. But in my experience, people with these symptoms following a sexual contact have another type of virus (such as cold viruses).
If you really think you might have HIV because you are experiencing these symptoms, it requires special HIV tests, not just an antibody test.
I remind you that we usually see HIV in cases of anal sex without a condom, and it is much less likely in vaginal sex. If you want to know more about the risk of HIV in the type of sex that you do, do not hesitate to get in touch.
We sometimes see these symptoms as part of secondary syphilis (widespread infection). Syphilis is perfectly transmissible in oral, vaginal and anal sex.
Don’t forget that I offer an HIV tests by PCR detection that you can do just 10 days after a sexual contact of concern. Or if you prefer, you can book an appointment with me if you would like to discuss your case.
Please visit my shop to book a consultation or choose relevant tests.
The vast majority of these cases have to do with fungal infections (Candida). Sometimes this is due to changes in the bacterial flora, having taken antibiotics etc. rather than a direct transmission of the yeast from person to person.
I also see cases of redness due to trauma in sex. Very occasionally we see a red penis due to syphilis, or because of skin eruptions that have decided to appear in the genital area by chance.
You can always book an appointment with me before deciding which tests are best for your situation.
Please visit my shop to book a consultation or choose relevant tests.
Almost all sexually transmitted infections are treatable, with antibiotics or other medications.
Read some reflections of mine on an immense problem that we are experiencing – the resistance to antibiotics of certain STIs:
Many patients of mine have taken the antibiotic azithromycin thinking it will help. In its day it was a very useful antibiotic in the treatment of several STIs…. and now?
– it fails in almost all cases of syphilis
– it induces changes in the gonorrhea genome that can cause resistant strains
– it induces multi-resistant strains of Mycoplasma genitalium, leaving it susceptible to one single antibiotic. This is a disaster and very difficult to solve.
– the indiscriminate use of antibiotics induces intestinal bacterial flora with resistant strains
– never take antibiotics without having a relevant test result. I am at your disposal to give you advice and organise tests.
It has evolved to be increasingly resistant: Gonorrhea has become very resistant to antibiotics. In the last 13 years I have had to change the antibiotic regimen for this infection 4 times. I currently follow the UK protocol, the most radical to combat this problem. Where it develops resistance this occurs most commonly in the throat and rectum, which is highly problematical, because gonorrhea in these two places does not usually produce symptoms, so you have no easy way to know if the treatment has worked or not based on just symptoms.
I no longer have symptoms so I am cured, right ?: When gonorrhea becomes resistant to treatment, many times the symptoms improve and the patient thinks that they are better. But it may simply be “suppressed” and not eradicated.
Second test for everyone: For these reasons, if we diagnose you with gonorrhea it is ESSENTIAL to do a follow-up test afterwards. I can give you advice on what is the best time to do it after the treatment and organise this test in my shop for you.
Very resistant: Due to the indiscriminate use of azithromycin to treat STIs, this bacterium has become resistant to practically all antibiotics. In 2013 I used the standard treatment regimen that was successful in 75% of the patients with this infection, and in the other 25% I had to use an alternative antibiotic. But these figures were changing, and between 2018 and 2023 the first line of treatment only worked in 40% of Mycoplasma genitalium infections, the second line another 40%, but in 20% of the cases I had to request the import of an antibiotic not marketed in Spain to eradicate the infection. There were no cases resistant to all drugs, but this situation is described in publications in countries around the world.
Mycoplasma genitalium is an STI with a very long incubation (several months). It is very common that people testing positive in this test do not remember who was the source of infection contact. It is not transmitted in oral sex, that is, we see it in the cervix, the urethra (the tube from which pee comes out) and the rectum after vaginal or anal sex, but 70% of infections do not present with symptoms, and therefore that should be included in post-contact checks.
In Spain we sometimes see cases of superclamydia, lymphogranuloma venereum. It requires a special antibiotic treatment.
Ass to ass: This infection passes (in Spain, almost exclusively) from ass to ass, that is, it is a rectal infection. Chlamydiae need some force to enter cells, and so this bacterium is seen in more “harsh” situations, for example sharing rectal toys, or fisting in groups.
Symptoms of LGV: It has an incubation of several weeks and then produces a picture in the rectum similar to normal chlamydia, that is, mucus, bleeding, the desire to continue expelling stools when there is no more left etc.
LGV testing : Routine chlamydia tests (taking a sample from the rectum or anus and looking for its DNA) are also positive for LGV but many of the machines cannot discriminate between normal chlamydia and LGV. Therefore, we often do not know if it is a normal strain or superchlamydia. LGV does much more internal damage so it is preferable to know which strain the patient has.
So, do I need treatment for Chlamydia or LGV? : If you have been diagnosed with chlamydia, the treatment does not last more than a week, but in these cases I can make a recommendation on how to proceed if there is any suspicion of LGV. This second infection requires several weeks of treatment and then we do not start it if we can avoid it. I am at your disposal if you need help.
Many of the STIs harm the body while you have the infection. We can kill the infection with antibiotics but often it is ESSENTIAL to follow other recommendations. I give you an example – 15% of men with gonorrhea or chlamydia inside the urethra (with discharge from the penis or itching) contact me again because they follow their symptoms. At the time of diagnosis I advise you to drink a lot of water, avoid tobacco, not traumatize the penis with masturbation, because the damage caused by the bacteria also has to be rectified. In these 15% it is almost never due to a failure of the antibiotic but rather that they did not follow these instructions strictly. If you have persistent symptoms after a sexually transmitted infection, I can help you take the right steps.
