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Somatic symptom disorder (SSD) often leads to frequent doctor visit not only to psychiatrists but also to various kinds of physicians. We encountered four cases of SSD, particularly associated with sexual intercourse and fear of sexually transmitted diseases (STDs). To best of our knowledge, there is no independent clinical entity assigned to this phenomenon. Here, we propose a variation of SSD called four STD as an independent clinical entity since the presentation of this disorder is very distinctive, and lack of awareness of it may lead to unnecessary laboratory workup and antimicrobial prescription as well as augmented anxiety of the patients with potential "doctor shopping." Further studies are needed to elucidate the pathophysiology, diagnosis, and treatment of this disorder.

Somatic symptoms after sexual behavior with fear of four sexually transmitted diseases: A proposal of novel disorder