Confused about symptoms - several negative tests.

[glass98]

Doctor:

I have had two negative HerpesSelect HSV1/HSV2 tests through tstd and performed at a Quest Lab (i am negative for both). Both tests were taken almost a year after a protected encounter. Two weeks ago I had protected sex with a new "larger" partner - prior to that I hadn't had sex in a year.  About a day or so after I began to get burning and tingling sensations in my buttocks and anus followed by itching.  Now it has moved to my vagina.  I can see that my vagina inflamed on the inside.  There is some discharge and one of those home vaginal irritation tests indicates I have a yeast infection (I have a call into my DR).  This irritation has continued for a few weeks.  Note, last year I had a protected encounter and I had similar issues.

I get itching and burning on the left inner side of my outer labia and anus every so often for years.  When I look in the mirror my whole vagina is swollen and red. I also get these tingling and burning sensations in my buttocks.  It gets more intense with sitting and occasionally my whole bottom will burn. I should note that during these episodes, I have never seen a lesion or sore.

I'm not sure if I am getting chronic yeast infections, I'm allergic to spermicide/condoms or I am one of those people that doesn't serocovert.  Anytime I go to my gyn - they tell me I have a yeast infection, not herpes and basically to get over it.  

From what I've read on this forum and from what my doctor tells me, there is no need for me to get another follow up HSV-2 test, in light of my two negative tests, and what I am experiencing is likely not herpes.   I am posting here because I'd like assistance from someone that is an STD expert.  Thank you so much for your time.

Also, if you do not believe it is herpes, what type of doctor should I see, neuro, gyn, derm? Thanks so much for your time.

[Edward W Hook, MD]

Sometimes after an exposure that, in retrospect, one has misgivings about, persons tend to examine themselves and be far more attuned to genital sensations than in periods when they are not concerned.  This in turn leads to noticing what turn out to be normal sensations that might have been not noticed or ignored at other times.  I suspect this may be contributing to your difficulties.  No change in my opinion.  EWH

[glass98]

Hi Doctor,
Doctor,

Since I posted this I've been treated for yeast infections three separate times and I finally believe it has cleared up. While this was all going on, my provider did another STD panel which came back negative for everything including HSVI and HSV II (The testing was done through LabCorp this time).  My last vaginal panel was a general vaginitis panel that came back negative for everything including BV, Yeast and Trich.  However, I am back to being paranoid again because I have this weird feeling in one of my outer labia has been going on for almost 10 days.  The folds between the inner and outer labia are red on both sides from the top all the way to the bottom but I can definitely only "feel" it (i.e the throbbing) on one side.  I'm not nervous about this being an initial outbreak I'm nervous that its a recurrent outbreak.   Does any of this change your opinion?  Thanks!

[Edward W Hook, MD]

Good question.  No, if the irritation was simply from the encounter it should have improved over a day or two.  As I read your note I wondered if you had one thing that was then replaced by a second (such as BV or a yeast infection).  EWH

[glass98]

Doctor:  Thank you so much for your response. I think it is a wonderful thing that you take your time to help us people in internet land!

Just one follow up question - why would irritation and itching from an encounter last for so many day as it does with me?  Thanks!

[Edward W Hook, MD]

Welcome to our Forum.  I have several comments which I hope you will find helpful.  first let's discuss herpes.  You do not have it.  From all that you have described you have taken all appropriate steps to minimize infection and they worked.   It is time to stop testing and believe the tests.  In medicine we use tests to help us differentiate between various possible explanations for things.  There are many possible causes of the sensations you describe in your buttocks when there are no signs of irritation (I also appreciate that you currently also have sensations associated with other irritation- we'll discuss that in a minute).  I find that just about everyone will experience sensations they were not previously aware of simply by focusing on a specific area. For instance it I think about how my watch feels on my wrist focusing on my wrist or how may rear end feels sitting in a chair, I notice sensations in those areas I was not otherwise aware of.  this may be part of what you are experiencing.

Now let's discuss your current inflammation and irritation.  This is likewise unlikely to be herpes as well.  The fact that you experienced burning and irritation a day after contact with a partner is not suggestive of any STD. STDs typically take several days following contact to become symptomatic.  Immediate irritation could be due to the activity itself (too much friction) or, as you suggest, a reaction to latex or a spermicide, if you used them.  You can check out the latter possibility by placing a condom into your vagina with a finger and seeing if you react.  Latex allergies are rather common.  In addition however, it also sounds as though you may have another discharge.  Evaluating which type (there are several types, non-STD causes such as a problem called bacterial vaginosis or yeast infections being among the most common) is something done by a medical professional.

I hope these comments are helpful to you.  It is time for you to move on from your concerns about herpes.  EWH