Sexually Transmitted Diseases/Penis problem

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Penis head
Penis head  
Penis shaft
Penis shaft  
QUESTION: I recently found out that my penis has a lot of white spots and was wondering if it could be a STD. I sometimes get a tingling sensation on my scrotum area and penis shaft area (sort of like the feeling of goose bumps) and it gets a bit itchy, but not extremely itchy. Also the tip of my penis head looks a bit swollen and sometimes itch too. Also my penis shaft also sometimes itch. I'm a male Chinese, 24 this year, height of 173cm and weigh 65 kg. The white spots could be there for a long time and I just recently looked at my penis. I just had sex with a commercial sex worker 3 days ago, where I received an unprotected blow job and protected intercourse.

ANSWER: Hello Zee,
The photos you've included look like normal variations of the skin. The tingling sensations you've noticed are also normal physiological events that need not cause worry! These statements don't mean  you don't have an STD (sorry for the double negative!), just that the symptoms you've described and signs shown in the photos appear normal.

Good luck!
--mark


---------- FOLLOW-UP ----------

QUESTION: I do experience a dull ache in my right pelvic area, nearer to my right hip area, is that a cause for concern? I have also frequent urination, could it be due to anxiety? And could diarrhoea be part of it too?

Answer
Hello Again, Zee,
You are bringing up issues that support the need for you to see a primary care provider  (doctor) to pull together all of your concerns and issues into one or a few cogent conclusions.

Diarrhea can be caused by lots of things, from diet to viruses and bacteria, certain chronic conditions (like diabetes), and stress. These may contribute to aching or pain in the pelvic area, as can your prostate, which may or may not be related to STDs. Same thing for urinary frequency!!

It is inappropriate for me to suggest certain things, and then for you to throw a bunch of other things into the mix!! See someone in person!

Good luck!
--mark  

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Mark P. Behar

Expertise

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!

Experience

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.

Organizations
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)

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

Education/Credentials
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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