Aa
So anxious about possible herpes
Hi doctor. First and foremost I want to say thank you for all you do on this forum, I have read many posts and it is truly admirable that you both take your time out to do this.
A little history of my worries, I have been with the same man for a few years and we engaged in unprotected sex. In those few years I was tested yearly for chlamydia, gonorrhea, pap, syphillis, hiv, and hsv-2(not hsv-1 since cold sores since young age). All testing was negative. My boyfriend and I broke up for a few months and in that time period I engaged in unprotected vaginal sex with one other man on ONLY ONE occasion. I know this man was with someone in a monogamous relationship for a few years right before sleeping with me and I was the first he'd been with since her, and claims to have been tested and negative but I know in the past he has been many girls. I was fully tested for everything (gonorrhea, chlamydia, syph., hsv-2, etc) at 5 1/2 weeks past exposure and all were negative. However, for the first time my pap came out abnormal showing ASCUS and it was positive for HPV which seems like it may have been related to the man I slept with once while broken up with my boyfriend but I know thats not for sure. Also, my swab test came back showing Gardernella for which I was prescribed 7 days of Metrondiazole orally. I should also mention I was tested for HIV 7 1/2 weeks after exposure in a rapid test and that was negative. Is this conclusive? My main fear as well is this morning I started noticing a dull aching pain in my pelvic area and an increased vaginal discharge, although I feel like I always have vaginal discharge. I am on metrondiazole still (3 days in). I went to the OBGYN and she did a urine test for a UTI and it came back with no bacteria but she said it showed "a trace of white blood cells" and she did a vaginal culture and looked under the slide and said no WBC's on that so must be due to urinary infection of some sort since seemed to only be in urine. Continued below.
A little history of my worries, I have been with the same man for a few years and we engaged in unprotected sex. In those few years I was tested yearly for chlamydia, gonorrhea, pap, syphillis, hiv, and hsv-2(not hsv-1 since cold sores since young age). All testing was negative. My boyfriend and I broke up for a few months and in that time period I engaged in unprotected vaginal sex with one other man on ONLY ONE occasion. I know this man was with someone in a monogamous relationship for a few years right before sleeping with me and I was the first he'd been with since her, and claims to have been tested and negative but I know in the past he has been many girls. I was fully tested for everything (gonorrhea, chlamydia, syph., hsv-2, etc) at 5 1/2 weeks past exposure and all were negative. However, for the first time my pap came out abnormal showing ASCUS and it was positive for HPV which seems like it may have been related to the man I slept with once while broken up with my boyfriend but I know thats not for sure. Also, my swab test came back showing Gardernella for which I was prescribed 7 days of Metrondiazole orally. I should also mention I was tested for HIV 7 1/2 weeks after exposure in a rapid test and that was negative. Is this conclusive? My main fear as well is this morning I started noticing a dull aching pain in my pelvic area and an increased vaginal discharge, although I feel like I always have vaginal discharge. I am on metrondiazole still (3 days in). I went to the OBGYN and she did a urine test for a UTI and it came back with no bacteria but she said it showed "a trace of white blood cells" and she did a vaginal culture and looked under the slide and said no WBC's on that so must be due to urinary infection of some sort since seemed to only be in urine. Continued below.
MEDICAL PROFESSIONAL
I agree you are over-thinking things, and partly as a result, your questions are frankly difficult to follow. I think I perceive the following questions embedded in all those words:
Chance of HSV-2 from any single exposure, if one person is infected but without an overt outbreak, probalby is under 1 chance in 1,000. Many (perhaps most) regular sex partners of infected persons remain uninfected even years into the relationship.
A negative HSV-2 test at 5 1/2 weeks is quite reliable; most people (probably 75-80%) develop measurable antibody by then, even though it sometimes takes 3-4 months.
All HIV antibody tests, including the rapid tests, are virtually 100% reliable by 7 weeks. For sure you don't have HIV. Scan the HIV forum for lots of discussions about time to reliable test results.
Urethritis is fairly common in initial genital herpes, but only in association with other obvious manifestations, i.e. painful genital sores. It is rare for urethritis to be the only manifestation. And as we already said, your "urethritis" symptoms are not typical of herpes. Combining your multiple negative tests, the low likelihood of exposure several week ago, and lack of symptoms typical of herpes, you can be highly confident you do not have it.
I can't even guess at the likelihood you have endometriosis. It's not an STD issue and I'm not a gynecologist.
Reading between the lines, it seems to me that your gynecologist is quite knowledgeable about STDs and other genital infections. I think you can rely on his or her advice on these and other questions.
That will end this thread. Take care.
Chance of HSV-2 from any single exposure, if one person is infected but without an overt outbreak, probalby is under 1 chance in 1,000. Many (perhaps most) regular sex partners of infected persons remain uninfected even years into the relationship.
A negative HSV-2 test at 5 1/2 weeks is quite reliable; most people (probably 75-80%) develop measurable antibody by then, even though it sometimes takes 3-4 months.
All HIV antibody tests, including the rapid tests, are virtually 100% reliable by 7 weeks. For sure you don't have HIV. Scan the HIV forum for lots of discussions about time to reliable test results.
Urethritis is fairly common in initial genital herpes, but only in association with other obvious manifestations, i.e. painful genital sores. It is rare for urethritis to be the only manifestation. And as we already said, your "urethritis" symptoms are not typical of herpes. Combining your multiple negative tests, the low likelihood of exposure several week ago, and lack of symptoms typical of herpes, you can be highly confident you do not have it.
I can't even guess at the likelihood you have endometriosis. It's not an STD issue and I'm not a gynecologist.
Reading between the lines, it seems to me that your gynecologist is quite knowledgeable about STDs and other genital infections. I think you can rely on his or her advice on these and other questions.
That will end this thread. Take care.
Also just a side note, I never really experienced symptoms other than vaginal discharge, which may have been due to BV and then the dull pelvic aching and increased urinary frequency that started last night. Also, could endometriosis cause any of this? My mother and grandmother have it and I have wondered if I may have it as well being that my period cramps are so severe I vomit every time I have my period because of the pain.
Thank you so much for your response, I appreciate what you do here so much. Just a few quick questions....I had an HIV rapid test at 7 1/2 weeks after my sexual encounter, is this conclusive? Also, I fear maybe asking these questions was not the best idea for me because I over-think things so much and it seems as though you still think herpes could be possible in my case, even if not too likely. I just started noticing the UTI like symptoms last night and that was why I went to be seen today and why the WBC's in my urine freaked me out. I just feel like it has been such a hard month with the HPV, abnormal pap, and now these weird symptoms. I don't get burning at all really when I urinate and I just feel a dull sensation in my pelvic area and increased urinary frequency. I have had multiple HSV-2 blood tests in the past but only one at 5 1/2 weeks past sexual encounter and I know that is not usually accurate until 3 months. The thought of waiting another month is honestly making me crazy, it's just so weird to me that all of these things popped up at once and it's all I can think about, which I know sounds ridiculous but being that I am with my boyfriend I can't even bring myself to have sex with him or be intimate because I'm so worried that I could possibly have herpes and give it to him. It seems like every next problem I have whenever I look it up online points to possible herpes. I apologize for my ranting but just another question, in a rough estimate, assuming the man I had sex with that one time has HSV, what do you think the likelihood of me having contracted herpes from a one time unprotected sexual exposure would be? And if so, is herpetic urethritis common? These will be my last questions I promise, I just wanted further clarification on that.
MEDICAL PROFESSIONAL
There's an awful lot of information here. This is a complex picture, but I doubt herpes is part of the problem.
You have had a number of gynecologic problems, some perhaps sexually related, others maybe not. HPV/ASCUS is pretty much normal; not desired, but so common as to be considered as normal as getting, say, a cold. Everybody gets genital HPV; like almost all infections, this one almost certainly will clear up without any long term problem. You also probably had bacterial vaginosis (BV). (Gardnerella is normal in every woman's vagina, but it is among the many bacteria that overgrow in BV.) While inconvenient, for the most part BV is not apparently harmful. Your negative tests for gonorrhea and chlamydia are reliable, so those are not of concern at this point.
As for your possible UTI symptoms, you could have had a real UTI, but I'm inclined to doubt it. However, there is no reason to focus on herpes as an alternative explanation for the same symptoms. While it is true that herpes can sometimes mimic UTI, the large majority of UTI-like problems are not due to herpes.
Few genital herpes patients have symptoms like yours. Genital herpes symptoms cannot persist as long as you seem to have had your symptoms; herpes symptoms never last more than 10-14 days, recur no more often than once every 4-6 weeks, and between outbreaks there are no symptoms at all. In addition, herpetic urethritis usually is much more severe than the minor urinary discomfort you seem to have had. I have had patients who described it as the worst pain they ever experienced. Finally, in the absence of painful genital blisters or sores, herpes is unlikely.
So in answer to your concluding question, I very much doubt you have herpetic urethritis, or herpes of any kind. My advice is to have an HSV blood test; I expect your HSV-2 test to be negative. But even if positive, it probably would not explain your symptoms and other problems. Anyway, you might discuss this advice with your physician and see what he says about it.
I hope this helps. Best wishes-- HHH, MD
You have had a number of gynecologic problems, some perhaps sexually related, others maybe not. HPV/ASCUS is pretty much normal; not desired, but so common as to be considered as normal as getting, say, a cold. Everybody gets genital HPV; like almost all infections, this one almost certainly will clear up without any long term problem. You also probably had bacterial vaginosis (BV). (Gardnerella is normal in every woman's vagina, but it is among the many bacteria that overgrow in BV.) While inconvenient, for the most part BV is not apparently harmful. Your negative tests for gonorrhea and chlamydia are reliable, so those are not of concern at this point.
As for your possible UTI symptoms, you could have had a real UTI, but I'm inclined to doubt it. However, there is no reason to focus on herpes as an alternative explanation for the same symptoms. While it is true that herpes can sometimes mimic UTI, the large majority of UTI-like problems are not due to herpes.
Few genital herpes patients have symptoms like yours. Genital herpes symptoms cannot persist as long as you seem to have had your symptoms; herpes symptoms never last more than 10-14 days, recur no more often than once every 4-6 weeks, and between outbreaks there are no symptoms at all. In addition, herpetic urethritis usually is much more severe than the minor urinary discomfort you seem to have had. I have had patients who described it as the worst pain they ever experienced. Finally, in the absence of painful genital blisters or sores, herpes is unlikely.
So in answer to your concluding question, I very much doubt you have herpetic urethritis, or herpes of any kind. My advice is to have an HSV blood test; I expect your HSV-2 test to be negative. But even if positive, it probably would not explain your symptoms and other problems. Anyway, you might discuss this advice with your physician and see what he says about it.
I hope this helps. Best wishes-- HHH, MD
Very sorry about that, would you like me to repost my question in shortened form? Im confused as to what you meant by "reply to follow below"
MEDICAL PROFESSIONAL
Reply to follow below. The reason for the 2,000 character limit (about 400 words) is to require that questions be short, and intial questions should not spill into a comment window. (Some MedHelp moderators set their browsers to block their comment windows; they never see anything except the initial question.)
HHH, MD
HHH, MD
...She gave me Bactrim to treat UTI because thats what she thought it was however I recently have looked things up and it says a lot of times UTI's are misdiagnosed as UTI's when it really is herpetic urethritis. The doctor did a vaginal and pelvic exam and said she did not see anything suspicious or any lesions of any sort and I obsessively check myself lately and have not noticed anything although I do feel a sort of burning feeling all the time within my vagina, not when I am urinating really though. I read one thing online which particularly freaked me out which said..."Intermittent pain with urination that yields small numbers of white cells on a urine dip and no growth on culture is somewhat worrisome for herpes lesions in the urethra. " Now I am just so worried about this because I am since back together with my boyfriend and we've had unprotected sex. I'm so scared I could have herpetic urethritis and thats why I only show a trace of WBC's and dull pelvic pain and no bacteria or anything else. I have been obsessively checking myself and I know I am a hypochondriac and honestly have been brought to tears today thinking about this and worrying that this could be the reason for that. Ive never had any STDs in the past and the abnormal pap, positive HPV, and now this weird trace of WBC's in urine with pelvic discomfort seriously freaks me out its just so much to handle right now being that I am already a worrier by nature and have been trying to get that under control. I have been urinating more frequently and I was tested for HSV-2 5 1/2 weeks after the exposure and it has only been roughly 2 months now since exposure so I know this isn't accurate yet for a blood test and the thought of waiting another month to get accurate results is driving me insane. The man I was with that one time said hes never had symptoms so I don't know what to think because I know a lot of people are asymptomatic with HSV. Could you please just tell me the likelihood that this is herpetic urethritis or something of that nature? In your professional opinion, do you think thats it?
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
