Asymptomatic Gonorrhea: Risks and Relationship Guidance

Q: Asymptomatic Gonorrhea: Risks and Relationship Guidance

Hello： The information provided here is for reference only and cannot replace a physician's examination, testing, or diagnosis. <br><br>1. <br>Is it possible that I did not actually transmit the infection to my new partner? -- It is possible, or could it be that the new partner i

Gonorrhea diagnosed, but boyfriend has no symptoms?

Hello, doctor.
On October 21, 2021, I had protected sexual intercourse with my ex-partner.
On October 22, I discovered that they were seeing someone else, which led to our breakup.
On October 25, I had protected intercourse with a new partner, but oral sex was performed without protection.
On November 1, my ex-partner informed me that they were diagnosed with gonorrhea.
On November 5, my test results also confirmed a gonorrhea diagnosis.
My ex-partner reported significant symptoms (pus discharge, inability to achieve an erection), while I have not experienced any noticeable symptoms (in fact, I feel that my discharge has decreased and is drier).
The new partner currently shows no symptoms.

1.
Is it possible that I did not actually transmit the infection to the new partner? Or could the new partner be infected but asymptomatic?
2.
Since the new partner is asymptomatic and tends to avoid testing, can we still engage in sexual activity after my treatment is completed? Alternatively, how long should we observe before concluding that they are not infected? Thank you.

R, 30~39 year old female. Ask Date: 2021/11/06

Dr. Du Shixi reply Urology

Hello: The information provided here is for reference only and cannot replace a physician's examination, testing, or diagnosis.

1.
Is it possible that I did not actually transmit the infection to my new partner? -- It is possible, or could it be that the new partner is infected but asymptomatic? -- That is also possible.

2.
If the new partner is asymptomatic and tends not to get tested, can we still engage in sexual activity after my treatment is completed? -- What constitutes safe sexual practices, and how long should we observe before we can conclude that they are not infected? -- It is not possible to confirm gonorrhea, as a small number of individuals may not show symptoms for several months.
For reference, please see: http://www.shutien.org.tw/dr_doc_detail.aspx?bookid=556 and https://www.cdc.gov.tw/Category/Page/oENrYytXCrwUl6SijsDFcw.

Reply Date: 2021/11/06

More Info

Asymptomatic gonorrhea presents a unique challenge in both diagnosis and treatment, particularly in the context of sexual relationships. Your situation raises important questions about transmission, testing, and the implications for future sexual activity.

1. Transmission to New Partner: It is indeed possible that you may not have transmitted gonorrhea to your new partner, especially if you used condoms during penetrative intercourse. Condoms significantly reduce the risk of transmission of sexually transmitted infections (STIs), including gonorrhea. However, it is important to note that gonorrhea can also be transmitted through oral sex, albeit at a lower rate compared to vaginal or anal intercourse. Since you engaged in oral sex without a condom, there is a possibility that your new partner could have been exposed to the infection, even if they are currently asymptomatic. Asymptomatic individuals can still carry and transmit the infection, which is why testing is crucial.

2. Testing and Future Sexual Activity: If your new partner is asymptomatic and is reluctant to get tested, it poses a risk for both of you. The Centers for Disease Control and Prevention (CDC) recommends that anyone who has been exposed to gonorrhea should get tested, regardless of whether they have symptoms. If you complete your treatment for gonorrhea, it is advisable to wait until your new partner has been tested and received a negative result before resuming sexual activity. This is to ensure that you do not risk reinfection or transmission.

In terms of the observation period, after treatment for gonorrhea, individuals are typically advised to abstain from sexual activity for at least seven days to allow the medication to take full effect and to prevent transmission. If your new partner chooses not to get tested, it is prudent to wait at least two weeks after your treatment before engaging in sexual activity, as this allows time for any potential infection to manifest if they were indeed infected.

In conclusion, while the use of condoms during intercourse reduces the risk of transmission, it does not eliminate it entirely, particularly with oral sex involved. Encouraging your new partner to get tested is the best course of action to ensure both of your sexual health. Open communication about STIs and testing is vital in any relationship, especially when there is a history of exposure. If your new partner remains unwilling to get tested, it may be wise to reconsider the risks involved in continuing the relationship without clarity on their health status.

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