Genital Herpes Anxiety

[stressedout999]

I need some closure to this chapter in my life, and I was hoping you could help.  I posted a question on the HIV forum, but now I’m afraid I have genital herpes.  I’m a 20 year old male and over 4 months ago I had unprotected vaginal intercourse.  2 months later I began feeling a tingling sensation in my scrotum. A week later I continued to have this sensation and I then started feeling as though I had to urinate constantly. I went to the doctor and was checked for gonorrhea and chlamydia, both negative. I was put on doxycycline for two weeks. It seemed to help for a week, but then I experienced the same urination urgency during the second week of taking the medication. I went back a few weeks later and another physician’s assistant checked my prostate, said it was a little enlarged, and then put me on ciprofloxacin for month.  It cleared up the problem for the most part.  I was tested for all STD’s 12.5 weeks after incident: genital herpes (the test was herpeselect and less than .90), chlamydia, gonorrhea, hepatitis b and c, and syphilis.  All was negative, except I did test positive for type 1 herpes.  However, I am terrified that I have genital herpes even after the negative test.  I am afraid that I have not produced any antibodies that would’ve showed up on the herpeselect test because I keep having terrible irritation in my genitals.  The tingling sensation in my scrotum still continues and has been there for more than 3 months.  The skin on the head of my penis is really dry causing wrinkles and tiny raised, flesh colored bumps to appear when the skin is stretched.  The tip of my penis is also really dry so much so that it frequently opens and causes my underwear to rub on the inside of the penis.  There is a brownish/purplish discoloration on the underside of my penis and has been there for 3 months now.  A week ago, for several days, after every time I urinated, it felt as though there was still urine towards the tip of my penis and was extremely uncomfortable.  At the same time, it felt itchy inside my urethra.  I’ve had pain in my lower abdomen and lower back as well as in the testicles.  I’ve been checked by a urologist who has told me there isn’t anything wrong, but everything I’ve been experienced the last 3.5 months hasn’t been normal.  There’s always something irritating in my genitals and it’s driving me crazy.  I’ve never had the visible sores that genital herpes is known for but I guess not many people do.  Can I rely on a negative herpeselect test at 12.5 weeks after the incident?  It’s almost 100 dollars to have another test done so I am really wondering whether I should be tested again.  Can HPV cause these symptoms?  I’ve been worrying for a long time now, and I just wish it would go away.  It’s nearly impossible to get through each day.  Thanks for the help.

[H. Hunter Handsfield, M.D.]

Let me see.  Your symptoms are not those of herpes or any STD (they don't even HINT at herpes!).  You have tested negative.  Health care providers including a urologist have told you that you don't have it.  And now you think I might come up with something different?  HPV also is not the cause of such symptoms.  You do not need further testing for HSV or any other infection.  You need professional counseling to deal with your purely anxiety-driven symptoms.

Here is something I have posted many times.  It applies to you:

"It is a fact of life that human beings get various aches and pains. Out of the blue there is knee pain, a headache, abdominal discomfort, a stich in the side, tingling down a leg. Sometimes such problems are continuing or recurrent, yet no specific cause ever is found and clearly no important infection or disease is present.

Why should the genital area be any different? Not every symptom means disease. People with such symptoms of course should see a health care provider. But when a comprehensive evaluation comes up with no good explanation, and if the symptoms persist after treatment of the potential infectious causes, it is wrong to assume a serious health problem. Just as some people have to learn to live with unexplained but benign headaches or abdominal pain, others have to live with unexplained genital symptoms.

Our genitals have a special place in our psyches, and unexplained discomfort can be harder to ignore than a painful joint or even a headache. But the principle holds. It's fine to look for harmless things that might help control symptoms. But potentially harmful treatments (e.g., repeated high doses of antibiotics, potent pain controllers) make no sense, and doctor-shopping (or internet shopping) for different answers is fruitless."

I will have no further comments or responses on this thread.

HHH, MD

[Gladfor the help]

I am sorry for what you are going through.  Let me start by saying how much I appreciate the Doc and his very helpful and comforting answers.  

I suffered from nearly the same thing you did for nearly 18 months.  I just knew I had an STD.  I had 4 full STD panels run and 6 urinalysis tests.  They were all negative, even during the worst of the symptoms.  I have seen a urologist 3 times for prostate exams (normal, with very low PSA levels) and an internal medicine specialist twice.  I have been on Doxy for 21 days and Tequen for 3 months.  

Finally the internal doctor took a spine X-ray and determined I had a curvatour of the spine which referred pain from the spine down into my groin.  He stated without doubt there no infections and if there had been the antibotics would have cleared them out.

My point in all this is that after so much testing and exams you must come to grips with the fact that the cause for your discomfort probably lies somewhere besides an infection.

I say this in an effort to comfort you conscience and hopeful you can look elsewhere for the cause of your problem.

Good luck.

[stressedout999]

How have your symptoms been ever since you realized that it forsure was not an std?

[Gladfor the help]

They have significantly reduced.  After reading many of the doctor's comments, I began to understand that if it was an STD causing the problems, the current testing procedures now available would have found them, or the antibotics would have curred them.  Most of these infections are not very difficult to find.  For the most part, the ones you are concerned about don't play hide and seek.

Also, the further away from the event you go, the less you think about it since your life takes on other priorities.  The longer you go without finding any sort of actual cause and nothing bad happening the less you are concerned about it.  

I also went for counseling which helped, but that was mostly for the guilt trip.

A change in life style, so as not to get into this situation again, also helps. That could mean not sleeping with strangers or at least using protection each and every time.  I chose not to sleep with strangers again.

Hope this helps.

[stressedout999]

I appreciate the advice from both of you.  It has helped enormously...more than you could imagine.