HSV Education

[petrified]

First,I want to start with how valuable your service/forum is....unfortunately, my GP/OB/GYN isn't all that knowledgeable when it comes to STD's.  So, when I ask follow up questions....they just don't know how to answer.

I posted a few days ago re:  HSV risk and genital opposition - - I appreciated the response and will not be expading on the question.  I have more "generic" questions about how to distinguish HSV symptoms from "run of the mill" symptoms.

Bottom line, I am trying to "calm my own nerves"....ie:  be the "master of my own brain" and not feel the need to ask a professional for their opinion every time I get a "twitch".

Here goes:
(1)  I have been diagnosed with Vulvodynia....(after 6 months of testing and being anxiety ridden) Unfortunatley, VVS flares up quite often and I can be in mild to moderae to severe pain depending upon the day/time of the month etc.  Do you have any "tips" of how I may be able to distinguish between Vulvodynia and the potential onset of Herpes aside from a genital breakout?  If not, I'll just continue to assume the pain is due to VVS.  (I have found a great VVS provider in Philadelphia that is trying to help treat the symptoms).

(2)  I have Keratosis Pilaris...........and guess where it is....of course, on my buttocks!!!  So, everytime I get a "flare up" .... a few inflammed bumps, I wonder whether it is KP or the start of a Herpes Lesion.  Is there any way for a lay person to distinguish easily between the start of an HSV lesion and KP?  To this point, I just "wait" 48 hours to see if it develops into anything else or just fades away.  Sometimes, however, I am "stupid" and pick at it.........which just makes it worse.  

(3)  Is there a way to distinguish between a benign genital itch and an itch caused by HSV?  The itch I have been getting the past couple of days is in the pubic area....if I put benzocaine of it, the itch goes away.  Per one of Dr. Rockoff's post....most HSV positive patients complain of "soreness" versus "itchyness" - - would you concur?  Aside from when I scratch, the area doesn't look red.

(4)  Again, another distiguising factor between VVS and HSV....I know with Vulvodynia you can get a burning sensation down the inside of your thighs........which I have been getting on again/off again for 5 days now.  Since it's on again/off again I am assuming it's the VVS.........   Is this is true predome symptom of HSV?  

(5)  On top of all of it...........my rectum/anus has never been the same since the delivery of my first child (I even had hemroidectomy surgery).  Suffice it to say, I have redundant skin on my anus that at times flares up because of hemroids.  One thing that confuses me with some of the sites is the claim that "some people think they just have a hemroid" versus an HSV breakout.  I am assuming this is because they haven't looked and seen that it's not a hemroid - - I unfortunately, know all too well what they look like.

Thanks again for your input! Regards

[H. Hunter Handsfield, M.D.]

I am not an expert on vulvodynia (whenever we suspect such cases, most STD clinics, including mine, refer them to gynecologists for care).  I'm afraid I don't have any insight on distinguishing any of the symptoms you describe as being due to vulvodunia versus from herpes, except to examine the symptomatic area to look for lesions typical of herpes.

I don't know what keratosis pilaris is.  I think you're on the right track to get opinions from both dermatologists and gynecologists--but in person, not online.

Sorry I can't be more helpful.

HHH, MD

[llle]

Dr. H has stated to others in the past that although HSV testing may not be necessary based on risk factors/lack of symptoms, if it will give you piece of mind and allow you to move forward, then get a Herpeselect blood test at 3 months from exposure.  If it's positive, then at least you know and can move forward.  If it's negative, then you can move past this and not have to worry about every little sensation/bump/pain being due to herpes.  Like many have posted in this forum, it's amazing the symptoms that disappear once you hear/see the negative results.  And as for piece of mind, it is worth it!

[H. Hunter Handsfield, M.D.]

Thanks to Ille for that comment.  It made me realize that I misinterpreted HRF's question.  I was assuming you had been diagnosed with both conditions.  In relooking at your question and your one of a few days ago, I can only say Ille is right:  You should totally disregard herpes as a potential problem unless and until you have a positive test for it.  Based on the exposure you described a few days ago, herpes is very unlikely.

HHH, MD

[petrified]

Thanks for your posts (and thank you Dr. HHH for re-reading my initial post).

Bottom line, because of the conditions I do have (Vulvodynia, Keratosis Pilaris ("chicken skin" - - acne looking lesions)) I will most likely "never" really know if it's just those conditions or potentially Herpes (I have never been diagnosed with HSV....cleared through lots of testing - - matter of fact, over the top testing because of the Vulvodynia).

Was just trying to figure out if there is an "easy" way to discern typical Herpes symptoms from "run of the  mill" symptoms.

Obvioulsy, that's not an "easy" question to answer..........so, we'll just leave it at that.

Thanks.

[monkeyflower]

You're lucky to have a very well known vulvodynia specialist in your town, and I'm assuming that's who you're seeing. I replied to your post about finding a sex therapist, but she has connections in that field and would be able to personally refer you to good local sex therapists as well :-)

[petrified]

Thanks for getting back to me (next on the list of things to do....it never seems to end - - LOL)  .............the person I'm seeing is in Philadelphia (about 1.5 hours from me - - but worth the trip).  Where is the provider you're talking about located?  It's always good to have a 2nd opinion.

Thanks!

[monkeyflower]

She's in Philadelphia (which is where I thought you lived ;-)). I don't think I can post her name, but she's the Director of Sexual Medicine/co-founder of the Pelvic Floor Institute at a hospital. Don't know if that was helpful ;-)

[petrified]

I think I'm seeing the person you are referring to............thanks!  Very bubbly personality and very direct/blunt & upfront.