Sexually Transmitted Diseases/Urethritis and herpes?


Hello, I'm a 22 years old man from South America.
Unfortunately, I've had unprotected anal intercourse with another guy about 3 weeks ago, where I was the one penetrating. After 1 or 2 days I started feeling a pain when urinating, not a severe pain, but more like a burning sensation. This sensation lasted for only one week. I went to the urologist and he noted that there was also a fungal infection. He told me to use a clotrimazole cream to treat the infection. Some days later, after analyzing the results of my urine test, he told me I had urethritis and prescribed me an antibiotic medicine to treat it.
The problem is: a couple of day after I went to the doctor for the last time I notice that my foreskin have become red, itchy, and it's been difficult to retract the prepuce (as if I had phimosis). In addition, I started to have a burning sensation every time water touched the head of my penis and I noticed a small blister on the frenulum and a few sores on the inner foreskin ( where the burning sensation was coming from I guess). I was very worried about this, but couldn't go the doctor because I was traveling. Few days later, all these sensations started to disappear gradually, except for today when I noticed blood coming out of my urethra. I'm going to the doctor tomorrow, but I'd like your advise as well. I'm worried this could be herpes. Are all of these symptoms caused by urethritis or can it be herpes? I didn't have a cluster of blisters, but as far as I noticed only one. But I had painful sensations and the blister is gone by now, so it may be herpes too. I'm confused and feeling guilty. Please, help me to understand it.

Hi Daniel,
Nothing to feel guilty about. It could be urethritis from chlamydia and/or gonorrhea, plus a phimosis due to balanitis (inflammation of the foreskin) from a skin fungus, such as yeast. And, unfortunately, it could also be due to herpes. One, two, three, or four things. Hopefully the doctor visit will help identify exactly what the problem is and the best treatment.

Good luck!

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Mark P. Behar


Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!


Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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