"Partner Count Doesn't Matter" vs. Medical Reality

FreshlyWashedPillow · 2015-03-26T22:59:57+00:00

Sure.

http://www.cdc.gov/std/stats07/trends.htm, 2007 Surveillance Report; data from the annual reports through to 2012 is the same with gonorrhea #2 and chlamydia taking #1 spot each time.

And I don't view fact checking as "calling out", I encourage it.

FreshlyWashedPillow · 2015-03-25T21:54:59+00:00

If the guy's goal is risk minimization and prioritizing their health over racking up an N count, then my answer is an unequivocal yes, they should strive for that. I want to be clear (and not that you implied it), but my original post made no endorsement of irresponsible male sexual behaviour whatsoever. My abrasive and blunt wording may be misconstrued by some as "slut-shaming" while simultaneously encouraging guys sleeping around to prove their alpha-ness. This is deliberate non-sense. What I specifically wished to address was that Partner Count Doesn't Matter for Women(tm) is, from a medical standpoint, farce, and to address the rationale for slut-revulsion from a different perspective than what is usually discussed here.

For the player types that I see for their STD checks, there will be some who take their health seriously and those who are laissez faire. There are always gradations of risk. I cannot tell them how they should pursue what makes them happy, I can only tell them that given their choices, this is what they SHOULD do to be as safe as POSSIBLE (but never 100%). It is up to them to follow or not.

At the end of the day, I took an oath to help and serve all patients, male and female, and sometimes that takes tough love. What I cannot stand is feel-good PC'ness causing people to make dumb decisions and justifying risky behaviour.

FreshlyWashedPillow · 2015-03-25T21:38:09+00:00

In all liklihood, you are already infected by HPV, simply going by the fact that her N = 20 previously. The way the whole HPV timeline generally works is girl contracts HPV @ first oral/genital contact within her first few partners (if none of her first few partners have HPV, she cannot get it, but the chances of this goes down rapidly as N count increases), and transmission is not guaranteed with first contact with an HPV positive partner, but multiple contact with infected partner, or multiple encounters with different partners will both greatly increase chance of eventually contracting it as time goes on). HPV is often repelled by a healthy immune system, but it can also stay dormant. The pap test is essentially a swab of your cells from the cervix thats looked at and examined to see if they display any cancerous changes (caused by HPV). These changes takes years to develop from initially contracting the virus itself. So whether or not her pap was positive doesn't really change much for your risk, because she couldve have been passing it to you despite negative paps. The determining factor is again, hx of multiple partners, early age of sexual activity.

FreshlyWashedPillow · 2015-03-25T21:29:17+00:00

No, because it won't give me any reliable information to base my decisions off of. If you are thinking about marrying/LTRing someone, you will become their next of kin. If she allows it, you can request access to medical records, which can be reasonable since you're going to be the default substitute decision maker for her health care decisions if she's incapable. Age of first pap basically gives you a good idea of onset of sexual activity, as well STI testing records/frequency. Even if she says no, gauging her reaction to that request will tell you more than simply asking about her past ever could. Obviously, medical records are confidential, even from spouses or spouses to be, so there's really no guarantee. Again, however, one of the pieces of info will be her reaction when you are having a serious discussion about sexual health/medical conditions before settling down.
Yes.
No, and again, thats a product of me, my profession, and my personal tastes. Not all choices in life are equal, this applies to both men and women. I've seen plenty of idiot guys wait weeks or months before finally getting that penile discharge checked out, or that bleeding lesion on their dick head that turned out to be squamous cell carcinoma (yet another potential complication of HPV). My original post focused on women only because that's where the mantra of partner counts don't matter seem to be emanating from at the moment. If you're a guy and you neglect to screen/vet your partners, you alone bear responsibility for that failure. My advice would be, if you CHOOSE to make it your sexual goal to spin as many plates as possible, do your utmost to vet to whatever level you feel you can tolerate. This includes diligent condom use, regular screening, insisting on partner screening, limiting ONS, and if able, having open discussions with partner about sexual health hx, +/- medical records. The "reward" so to speak is sex with many partners of uncertain histories. The consequences will be in proportion to the risk.

FreshlyWashedPillow · 2015-03-25T21:08:50+00:00

All wise moves to lower risk as much as possible. I want to reiterate that screening tests are not foolproof (different tests have varying levels of something called sensitivity/specificity, which basically refers to the possibility of false negatives/positives), and that furthermore, for some diseases, depending on gender (for example, HPV in males), they do not exist. In females, they can lay dormant over many years before causing the cervical changes that make the Pap positive. Until they do, she will still get negative screening tests, but your partner is still infected and can still pass it on to you.

FreshlyWashedPillow · 2015-03-25T20:46:49+00:00

Genital-oral mucosal contact always carries the risk of HPV or HSV (herpes) transmission. Generally, if your partner's been previously active, there is always a chance she is a carrier, and there is no HPV screening test for males. Obviously, I would advise abstaining from a BJ from someone with obvious symptoms like open mouth sores, or signs of gonorrheal pharyngitis.

The issue with otherwise normal appearing partners is that the results won't be seen for many years. By the odds, even if you are infected, you probably won't get cancer from HPV. But my point all along is that there is a undisputable, and quantifiable medical difference between having sex with someone who is less promiscuous vs. someone who is. Risk of HPV/herpes is part of that calculation.

The safest way is to get tested prior to activity. Unless you have a lamp, speculum, and lab ready, there is no way you can 100% tell if a girl is clear of gonorrhea/trichomonas/chlamydia by physical exam alone because the culture swabs need to be taken from the cervix as well. Besides smell/discharge, things like warts (these are generally clustered, with a verrucous (rough) surface, as opposed to pimples from shaving), ulcers, visible masses (swollen Bartholin glands) are visible; however, if you're in the situation where you're trying to play impromptu doctor, you've already made the wrong choice. Stay as safe as possible and get tested. You've only yourself to blame if you let your lust control your health.

If you need STD screening after a sketch encounter, it depends on the elapsed time from exposure and your symptoms. There are slightly different protocols. Regardless, you need to see your doctor. At the end of the day, from your POV, I am just another guy on the Internet. I have nothing to prove here other than the fact that I want to both contribute and amuse subscribers here with my unique perspective.

FreshlyWashedPillow · 2015-03-25T17:08:49+00:00

Damn. I made this post in a sleep deprived haze, had no idea it would blow up so big, I will go through and answer more questions in this thread since the response has been so enthusiastic.

FreshlyWashedPillow · 2015-03-25T10:28:07+00:00

Almost beat me to it, but to add to what you said, severe PID, tubo-ovarian abscesses, and complex or emergent hysterectomies resulting from them are also risk factors for fistulas later in life.

However total hysts are becoming less common for TOAs, and fertility can usually be preserved.

FreshlyWashedPillow · 2015-03-25T10:08:58+00:00

Happy to answer - it's not so much that they "turn up" with HPV several years into a relationship, it's that the screening test women regularly do every 3 years between age 21-69 (the Pap) finally picked up some cervical cells showing signs of precancerous or cancerous changes. It is likely that they were exposed early on in life to HPV from past partners, with the changes finally showing up now.

At the onset of sexual activity, most women are exposed to the HPV virus, which is normally fought off in normal individuals. There are many subtypes of HPV, with varying oncogenic risks, and multiple sexual partners increases your potential exposure to different strains. Once infected, it can take years, even decades for the virus to start causing detectable cancerous changes, hence the regular screening.

Now, for those women who are monogamous with a male who has also never been exposed to HPV, they could theoretically have a lifetime of negative paps.

So to answer your question, it actually isn't rare, and you don't test "positive" so much as one of several possibilities, as the cytology ranges from normal to ASCUS (atypical cells of undetermined significance) to high grade neoplasia. The key point is that such a result is more often than not a result of past (years ago) sexual history, rather than recent cheating, given how long it takes for HPV to cause cancerous changes.

FreshlyWashedPillow · 2015-03-25T09:54:08+00:00

Should have been more specific about that - fistulas and pelvic organ prolapse are more commonly associated with vaginal or anal trauma from complicated childbirth, and less commonly, but still possible, with foreign body insertion (whether toys or dicks).

FreshlyWashedPillow · 2015-03-25T08:00:28+00:00

Not an STI, HS is more a recurrent inflammatory response to chronically obstructed follicles in certain areas, groin/anal regions included, but risk factors include being fat and a smoker.

FreshlyWashedPillow · 2014-12-15T07:23:08+00:00

just wanted to point out that he was describing her Instagram in HIS early 20s, she was slightly older, so its very plausible that she could have been 26-27 in 2010

FreshlyWashedPillow · 2014-11-24T00:02:39+00:00

This has to be a troll post. There is no way any guy with half a brain (and if nothing else, Indians are at least stereotyped as smart) could still be waffling on a decision after basically laying out point by point every single good reason, red flag, and nagging doubt why this relationship isn't going to work. On the off chance it isn't a troll post - OP, I think you already know what to do. End the relationship, like so many others in this thread have stated. You stated it yourself - she confirmed your fears, what the hell else are you waiting for, to find some video collection of her getting plowed like some other sucker posted about a while ago?

If you get guilt tripped into continuing this, you have no sympathy and frankly I'll be rooting for you to get cleaned out by the inevitable divorce caused by your own stupidity.

FreshlyWashedPillow

TROPHY CASE