Am I Being Paranoid?

[elmo9]

7 months ago I had a brief unprotected encounter with an acquaintance.  Two days later, I developed the symptoms of what I assumed was a yeast infection (burning, redness, thick white discharge).  I self-treated with OTC medication but I had never had vaginal infection before and after looking up symptoms on the internet I was freaked out about herpes so I went to the doctor.  I was told it was a pretty classic yeast infection. They ran a bunch of swabs, dismissed fears about herpes and gave me diflucan.  All of the tests came back negative (yeast, BV, trich, chlamydia, gonorrhea).  I was surprised about the yeast but I had already used monistat.

However, since then I have been suffering from pretty constant vaginal symptoms including burning, itching, stinging, redness, and white discharge that ranges from thick to milky.  The symptoms are unrelated to my menstrual cycle and diflucan doesn't help.  They occur alone or together and can affect my vaginal opening, and labia, as well as the area at the top of the outer labia.  I have seen 4 doctors, all of whom thought it was yeast and dismissed herpes in the absence of any sores/cuts/lesions/bumps/pain with urination.  I also recently had a pap and internally appeared fine aside from the copious white discharge.

I have no reason to suspect the person I slept with has herpes but I can't get the idea out of my head.  I realize the risk from a single exposure is low, especially if his status is unknown, but everything I have read on the internet about herpes and yeast being mistaken for one another is freaking me out.  I live in Canada so blood tests are expensive, and difficult to obtain.  Plus, I realize that a blood test can't guarantee the cause of my symptoms.

Given what I have written, do you believe I need to be worried about herpes as the cause of my current symptoms?  Or am I just being paranoid?  Would herpes affect me pretty much continuously for 7 months?  Would I be likely to have no lesions/bumps?  

[H. Hunter Handsfield, M.D.]

I agree with the response you had on the herpes community forum.  This pretty clearly is a yeast infection.  Your symptoms were typical to start and pretty much remain so, and definitely not typical for herpes.  Herpes would show overt blisters sores and never lasts more than a couple of weeks at a time, with no symptoms whatsoever between outbreaks -- which rarely occur more often than every 1-2 months.  While it is true that herpes and yeast symptoms can be similar, this leads to confusion primarily by inexperienced patients, not well trained health care providers.   An experienced health care provider's diagnosis of a yeast infection is highly reliable -- and the consistent opinion of 4 of them really nails the diagnosis with certainty.  When you add the fact that you haven't obviously been at risk for an STD, there simply is no realistic change of herpes.

I wouldn't use the term "paranoid", but you're definitely too concerned about herpes. It is not a realistic possibility.  I suggest you trust your doctors and put herpes out of your mind and not be tested for it.  

Best wishes--  HHH, MD