By Carol and our special guest blogger Dr Frank Paloucek
Sex and death share a history together in the arts and in medicine probably as far back as both coexist. Normally, when you put the words ‘harmful’ and ‘sex’ in the same sentence, it would be one about sexually transmitted diseases (er, or maybe S & M). But, did you know that poisons can also be transmitted via intimate contact and exposure to bodily fluids? Reminds me of one of my favorite ‘statshots’ from the Onion®, on how ‘best to poison your adversary’: “poison self, then have unprotected sex with adversary”. Frank, who was my mentor in pharmacy school (and the man largely responsible for me being such a tox geek) happens to be an expert on sexually transmitted poisons (hey, everyone’s got to have a hobby) and he has graciously provided us with some of the strangest, most fascinating, but 100% true stories on how someone can be poisoned.
Frank says that he first became aware of (intrigued by?) sexually transmitted toxins in the 90’s when he was consulted on a case regarding a man who had developed significant peeling and shredding of the skin on his groin after unprotected intercourse with his wife. The wife had been exposed and subsequently hospitalized for ciguatera fish poisoning several weeks before. Symptoms of ciguatera poisoning include numbness, tingling and itching all over, light sensitivity and strangest of all–the reversal of hot/cold sensations (i.e. ice cube feels hot). This poison actually concentrates in the reproductive organs (as well as in the liver and intestines). Several reports of very painful ejaculation and intercourse due to this poison have been reported in the medical literature. Poisoning can occur after eating contaminated barracuda, red snapper and grouper. Not the ideal end to a romantic Valentine’s or anniversary dinner.
Other important types of medications can also concentrate in reproductive fluids such as hormones, steroids and antibiotics (including some very common ones: penicillins, cephalosporins, and sulfas). There are a lot of people with significant allergies to those antibiotics. It could be a serious risk for someone with life-threatening anaphylaxis to an antibiotic to have unprotected sex with a partner who is on that antibiotic.
Some of the more mundane (if we can call it that) sexually transmitted poisonings occur with simple skin-to-skin transfer of drugs or poisons from one partner directly to the other, or from contamination of bed linens.
- A couple went camping, and after answering the call of nature, the wife inadvertently wiped with a poison oak leaf. The couple was inspired by the beauty of the woods shortly thereafter and the wife unwittingly transferred the poison oak from her genital region to his.
- A woman developed significant hirsutism (excessive, abnormal growth of hair in strange places). Turns out her husband was using a testosterone gel medication which had been transferred to her during intimate contact.
- Dermal nitroglycerin cream can also be transferred to a partner. It works by dilating blood vessels and one of its side effects is a headache. Quite an ironic example, don’t you think? The true killer of passion!
- A woman developed vaginitis and was put on corticosteroids by her doctor for that condition. She continued to have sex with her husband. Turns out he had a fungal infection, and that was what caused HER symptoms. So the steroids from her were making his fungal infection worse, which then made her rash worse and so on.
- A woman developed significant skin irritation/dermatitis in her genital area courtesy of her husband, who worked with nickel dust and didn’t wash up or change his undies before bedtime.
Some of these examples may be amusing in this context but it can be very unpleasant for the people involved (as can be imagined!). Another issue is that a sexually transmitted poisoning is definitely not the first thing doctors think of when someone has genital issues. It can be hard to diagnose and result in lengthy pain and discomfort, or unnecessary treatments for the wrong condition.
So as Spring fills the air, remember there is yet another reason to practice safe sex!