vaginal irritation with hasv 2 and on 1 gm of valtrex

I  was diagnosed 3 yrs ago with hsv 2 and placed on 500mg for suppressive therapy after my initial outbreak.  After 6 months on suppressive therapy, I was having constant vaginal itching and redness.  My OB changed my valtrex to 1 gm and had vaginal itching decrease but did not go away.   I was prescribed a cream-triamcinolone acetonide 0.1% and it would help to relieve the itch, but it would come back a few days later.   I have used the cream for 2 years off and on, until recently due to becoming pregnant.  Is itching a side effect of the valtrex?  Now I am pregnant and my OB thought I had yeast infection and prescribed metronidazole vaginal gel .75% for 5 days. (no testing to confirm what type of infection-just visual examination) I got better then got worse with itching, pain and she prescribed monostat....but then I examined myself closer and realized it was my first re-outbreak of the HSV2.  I had minor spotting and went to see my OB and she confirmed what I already knew.  She told me to double my valtrex for 10 days.
A side note, my OB changed my prescription of valtrex back to 500mg when i asked for a refill-so for 4 months (october 2010-january 2011)  i had been taking a lower dose (i never checked the prescription strength) and i did notice a slight change in my vaginal itch.  Now , I think I know why I had a an outbreak-1)change in medication strength 2) being pregnancy and having my immunity lowered.  Do you believe that may be the cause.  But what I really want to know is why do I still have vaginal irritation?  Should I be taking more valtrex?  

[Mistakeguy789]

I don't know much about dosage on the medicine and will leave grace to answer it.

Herpes isn't going to keep lasting every day for so many months.  Your post makes it sound as this isn't letting up.  Your OB should be testing for bacterial / yeast infections.  She can also culture the area to see if this in fact your herpes acting up or not.

How were you diagnoised with HSV-2?

[gracefromHHP]

The metronidazole is for bv, not yeast. it's a shame your provider never did any proper testing to see what is going on and evidently just treated you for bv and then when that didn't work, treated you for yeast with the monistat. had you had any vaginitis testing done at all during the 2 years that you had itching issues?  

You only have to increase your valtrex to 500mg 2x/day for 3 days to treat ob's.  

At this point, if you continue to have itching, you need properly tested for yeast and bacterial infections vaginally.  the cream you were using was for eczema - if you have an eczema condition going on, not unusual for itching to be frequent. At this point you need to be getting properly tested for vaginitis and if that's not an issue, discussing with your obgyn what medications you can use for chronic itch.  

have you discussed with your obgyn going on the pregnancy doses of valtrex ( 500mg 2x/day ) for the last month of pregnancy too?

grace

[nasty1023]

I have had not testing done for vaginitis-what is the testing and how it is done?  Please describe.  

Where are the recommendations for obs prescription dosage?  

I am on 1 gm now as my daily therapy before and during pregnancy-is that too much?  Why do you recommend a different dosage the last month of pregnancy?

[gracefromHHP]

they get a sample of the discharge from inside your vagina and either look at it under the microscope, send it off to the lab or do some simple testing in the office to look for ph and a whiff test.  

pregnancy naturally makes you immunosuppressed. the 500 mg 2x/day dose is the suppressive therapy for the last month of pregnancy.

when you have a recurrence of herpes, you switch to either 500mg 2x/day for 3 days or you can even do 2gm 2x/day for 1 day even.