Sexually Transmitted Diseases/Question.

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Hey mark. I don't have a picture to show you, but rather wanna get your take on my situation.
Recently I've had some vaginal discomfort which I attributed to a yeast infection and took monistat and was good. Then a week later, my urethra started to sting and shoot pain up into my bladder. Was treated for a UTI, and I'm good. EXCEPT: the two different nights I had way more than a few drinks while still on antibiotics for UTI, and the next day the burning urethra pain came back with the uncomfortableness in the bladder. Does this sound like STD symptoms? No weird odors or discharge. Just seems like the antibiotics they have for a UTI don't help anything when I drink. Is that weird? Also no weird bumps or leasions....I'm at a loss. Sometimes idk if it's my urethra that's stinging, or my vaginal entrance. Doesn't hurt to pee though. Do you think it's a bladder infection vs a UTI? Would they see all this from a urine sample? Please help

Answer
Hello Danielle,
Some antibiotics may not be as effective when ingesting alcohol, due to how both the alcohol and certain antibiotics may use similar liver (hepatic) enzyme systems to become biologically active against the germ they are designed to fight. There are lots of antibiotics used for treating UTIs, including but not limited to macrodantin, trimethoprim/sulfamethaxazole, ciprofloxacin, amoxicillin, etc. It also depends on whether you had one or two drinks or whether you got "shit-faced" drunk.  It also depends on other medications you may also be on, such as oral contraceptives, diabetic, cholesterol, or blood pressure  medications, etc.

Your symptoms may occur due to several reasons, including inflammation, infection, friction, etc.  A urine sample may provide some evidence, but is incomplete as a single test for exactly what you may have. Drink lots of liquids, complete all medications, and if symptoms continue, get it checked out.

Good luck!
--mark  

Sexually Transmitted Diseases

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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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