diagnosis

[jill730]

I just began a new relationship and my partner and I agreed to get tested for STDs, but we had sex several times before we got the results.  My results were negative, but his doctor told him that he had exposure to HSV-2 and that he has to have additional tests.  We probably have had sex 10-20 times (including oral sex) with and without a condom before we received this news.  This is my first time being sexually active in a long time.  I do have some vaginal dryness and some mild irritation, but I don't know if this is from being sexually active or whether I have the HSV-2 virus also.  Please provide any guidance that you can. thanks.

[auntiejessi]

I'd have another blood test.  The cultures can give a lot of false negatives.

Aj

[jill730]

The doctor took a vaginal culture and had it tested for HSV and HPV and both tests came back negative.  She suspects that what I have is an "external" yeast infection and gave me some cream for it.  Are the results of the vaginal culture conclusive or do I have to have other blood tests still? Thanks.

[jill730]

I will and thanks.  The bumps that I have don't look like the photos that I saw of HPV (the cluter like bumps), but I will tell the doctor everything.  This certainly doesn't seem indicative of herpes either.  Based on your response I'm wondering whether the stress of the situation has my hormones out of wack.  I can't thank you enough for your assistance on this - truly.  

[auntiejessi]

I have no idea what is going on - its not a common group of symptoms.

One thing that does come to mind is a hormone issue - hormone fluctuations can cause variations in levels of lubrication in the vagina, something like bacterial vaginosis, etc.  You could have the bumps from irritation from either of those.

HPV can cause itching.

Good luck at your appt, and let me know what happens.  Be sure and tell your doctor that you are experiencing other symptoms.

Aj

[jill730]

thanks.  i did google fordyce spots and saw some photos, as well as photos of hpv.  the itching has subsided considerably, but i now have some more severe vaginal dryness, even when aroused.  the small fleshy bumps are still there as well.  i have an appointment for the doctor to get the bumps examined.  have you heard of this conglomeration of symptoms before? what does it sound like to you?  the research that i did on fordyce spots did not connect the spots to vaginal dryness or itching or to menstruation (i notice the spots on the day that my period began . . .).  any guidance on these facts would help a lot.  thanks again very much.

[auntiejessi]

Everyone has oil glands- google fordyce spots.

If you are having symptoms, then you should get checked out.

Aj

[jill730]

it wasn't over herpes; it was over lying.  i was willing to live with this, but now am very concerned that i have contracted it.  i have had a yeast infection before and this doesn't seem like yeast i've had before.  i've never had bumps in connection with yeast. is hpv an std? i'm unfamiliar with that?  what do you mean by oil glands?

[auntiejessi]

Bumps under the skin aren't herpes.  In a row might be hpv, but they can also be oil glands.

Since you are having some itching, you should get checked for yeast, bv, etc.  You should also test for herpes again in a few months.

I'm sorry you ended the relationship if it was over herpes.

Aj

[jill730]

in addition, the bumps are all under the skin and not above.  so i can't pop them and they are close together and kind of clustered.  they don't hurt when i touch them and appear most in the pubic hair area

[jill730]

also i read that the virus is associated with blisters and not small bumps.  i haven't seen any blisters.  is this true? if not, what could be causing small bumps like this?

[jill730]

I have been having itching.  I looked in the mirror and notice rows of very, very small bumps.  You would not notice the bumps unless you looked for them closely with a mirror.  Some are in the pubic hair area.  I am not sure if I have this because I am about to get my period and its just a harmless itching or it is herpes.  Please help as I am very concerned.  I ended the relationship and hoped that in the short time frame of the relationship that I did not contract the disease.  When I tested in April I was negative for hsv2.  Should I test again?  I don't see any open sores and the bumps that I have are very small and the itching is there but not severe.  Any assistance that you can provide would be a great help.  Thanks.

[auntiejessi]

Its external, usually around the area of the sores.

If you have itching, you should be seen to get checked for yeast, bacterial vaginitis, etc.

Aj

[jill730]

thanks.  one last question regarding symptoms.  the itching that typically is experienced from an outbreak - - it is typically external (in the public hair area) or internal (in the actual vagina or labia area)?

[auntiejessi]

There is some debate about whether or not hsv1 offers protection, but if it does, we do know its not strong enough to rely on for prevention transmission of hsv2.

Aj

[jill730]

thanks.  i read somewhere that the fact that i have hsv-1 may make it a bit more difficult for me to contract hsv-2 but i'm not sure about that.  thanks again for your sage guidance.

[auntiejessi]

Since you have a prior hsv1 infection, you might not get any symptoms.  If you do, they will probably be mild - small blisters or sores, etc.

Aj

[jill730]

Thanks very much.  If I am infected, what types of symptoms would I experience?

[auntiejessi]

A few things pop out here, and I'm just going to be blunt.

Using condoms just before ejaculation doesn't offer much more protection for anything, and its defeating the purpose of using them.

Herpes is spread by skin to skin contact, and condoms offer about a 50% reduction in transmission if used from start to finish - as in the condom goes on before any contact has happened, and don't come off until after he ejaculates.  There isn't any risk from semen unless the semen comes into contact with an outbreak, and oral hsv2 is rare.

Your bf's doctor is wrong.  Using suppressive therapy offers at least a 50% reduction in transmission, and it makes NO difference if he has NO outbreaks, or 10 a year.  He still sheds.  The CDC recommends suppressive therapy for all discordant (one pos, one neg) couples.  He can show this to his doctor - http://www.cdc.gov/std/treatment/2006/genital-ulcers.htm#genulc3  Pay specific attention to the part about Suppressive Therapy for Recurrent Genital Herpes.

In the absence of symptoms, your chances of getting hsv2 from him per year are:

* just avoiding sex during an outbreak - 8-10%
* using daily suppressive therapy OR condoms correctly, each and every time - 4-5%
* using condoms correctly and suppressive therapy - 2-3%

If you are infected, the infection takes place immediately, but you might not get symptoms for 2-20 days, and that's only the typical time line.  Given that you have hsv1, if you got hsv2, it would probably be very mild.

If you are so concerned about getting hsv2, perhaps this relationship isn't for you.  If you can't come to terms with a 90% or better chance per year that you WON'T get this, then you should probably leave the relationship.  It stinks, but its not fair for either of you if you stay while you are so concerned.

But your actions aren't really supporting that concern - you all decided on no suppressive therapy, and are sort of half using condoms.  

I think you both should read the herpes handbook at www.westoverheights.com for more info on this, and then you can make an informed decision.

Aj

[jill730]

In addition, how long after exposure does it usually take to catch the virus?

[jill730]

I am starting to grow a bit more concerned about whether I have HSV2 and whether I am going to get it.  We've decided not to take the suppressive daily therapy.  His doctor told him that his test figures do not warrant him having to take the therapy.  We use condoms, but we tend to put it on soon before he is ready to ejaculate so the condom is not always on during intercourse.  In addition, we have oral sex regularly.  Sometimes I have swallowed his semen, but I'm not sure if this is a risk.  I have not had any outbreaks and neither has he.  I've felt itchy recently, but it is very mild and I'm not sure if that matters.  I'd like to know whether I have HSV2, what are my chances of getting it under these circumstances (particularly from oral sex) and whether his test figures being low or high matters at all.  We haven't been having sex that long (since March) but I'm starting to grow concerned about my risk of getting HSV2.  Thanks.

[scared_half_to_death]

Oops...just saw the test results. The comments above still stand. He needs to be vigilant for symptoms. Many people that are educated about HSV2 recall symptoms after they were educated. If he does not have symptoms, #2 and #3 still apply.

[scared_half_to_death]

Why dont you do what AJ suggested and get the explicit test name and test results for your significant other. There really is nothing that can be done until you clearly understand those results.

If he has HSV2 and you do not want to get it then the options are:

1. No sex during or after outbreaks (if they occur)...if you do this the risk is 8-10% chance per year that you will catch it.
2. He takes suppressive therapy daily, i.e. Valtrex or Acyclovir...if you do this the risk is cut in half to 4-5%
3. He uses condoms...if you additional do this the risk is cut in half again, i.e. 2% per year. However some believe that the risk is even lower.

Also, if you ever get a cold sore in your mouth, you should avoid giving him oral sex. Until you get his results the above is all that can be discussed.

[auntiejessi]

Oh sorry - that's without condoms.  Condoms reduce the risk by about 50% or so.

Aj

[jill730]

is that 8-10 percent chance with or without condoms? we are trying to figure out whether condoms are necessary for the rest of our lives. thanks again.