STDs Expert Forum
Herpes Testing needed?
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Herpes Testing needed?

One lifetime partner - my wife until 11 mos. ago (6/6/10) Brief unprotected vaginal and oral sex with stripper.  Approx a day and half later started having penis tip sensitivity/more of an irritation than painful.  No discharge/sores/blisters.  Day 4 (PE) went to GP she saw nothing irregular.  Constantly checking myself.  Test for Chlam/Ghon/herpes.  GP treat me for both  Zpack and butt shot for Ghon as I was really freaking out.  Tests negative.  SEVERE ANXIETY/GUILT/REMORSE. 3 wk PE still irritation/Thought urethral herpes. GP saw nothing and said that if herpes in the urethra it would be very painful.  
5 wk PE still irritation/Back to doc for Metronidazole (in case of Trich). GP recommended no further STD tests and said, don’t have herpes.  GP felt anxiety causing.  6 wk PE started having lower abdominal pain for2 wks-still no lesions/sores. GP felt it was anxiety. 8 wk PE went to a dermatologist for spot on testicle said it was highly unlikely to be herpes and called it a keratosis and froze it off.  It healed nicely and has not recurred.  Recommend against herpes blood test. 3 mo PE had a rash appear on penis both sides.  Red sirritation.  No bumps/blisters. Back to derm looked at quickly said not herpes but rather dermatitis.  Asked about herpes blood test and he said, not necessary advised against.  Followed advice-didn’t test.  I was pulling weeds and said I prob had PI.  Day later rash all over legs, chest etc.  Treated penis rash with steroid cream. Cleared up in 6 days.  

7 mo PE AND 10 mo PE slight penis tip irritation back.  Lasts 2.5 wks.  But at the 10 mo episode I have pinkish spot/bump then another irritation area.  No red bumps and no blistering or sores.  Back to derm 4 days after appearance. Said looked non herpetic, didn’t swab- said non infectious.  didn’t suggest a blood test.  Irritations gone in 6 days.

Should I have a herpes blood test?  Anything I should be concerned about? Or can I move on?  
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Welcome to the forum.

Herpes is not a plausible explanation for your symptoms.  Many genital HSV infections are asymptomatic, but if there are symptoms, individual herpes outbreaks go from a cluster of superficial red bumps to blister-like lesions to pimple-like or open ulcers to scabs and then healing, all over a course of 1-2 weeks.  Then there are no symptoms at all until another outbreak occurs, and outbreaks never are more often than once every 4-6 weeks (usually longer).  The penile feelings you describe, rashes, etc for sure are not herpes.  I agree with your GP about anxiety; in my 30+ years in the STD business, that has been the usual explanation for people with complaints like yours.

And even if your stripper partner had HSV, the chance of transmission during any particular exposure is in the range of once for hundreds or thousands of events.  That low risk plus lack of herpes symptoms add up to virtually 100% certainty you were not infected.  And the HSV blood tests are not perfect; results sometimes are misleading.  I'm sure this combination of factors is behind your doctor's advice against testing.

However, if your fears of herpes continue, you certainly could be tested.  If negative, especially for HSV-2, it might help resolve your fears about it.  Just be aware that there are frequent low-positive results that are hard to interpret.  And be very clear:  if you should have a positive result, it definitely will not explain your symptoms.  A positive test would show you have asymptomatic HSV plus some other explanation for the symptoms -- still just the anxiety and nothing more.

In other words, I think you can move on without testing.  You don't say whether you have continued unprotected sex with your wife.  I hope so.  Certainly I would not have stopped if I had I been in your situation.

I hope this helps.  Best wishes--  HHH, MD
2 Comments
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Avatar_m_tn
Thanks a lot Doc.  With the character limit, I had to leave out seeing a urologist who also saw no redness or swelling and a normal meatus.  I have an enlarged prostate with high PSA a few years ago and even had a cancer biopsy...negative. The urologist felt that it could also be causing some irritation. Your forum is AWESOME.  I feel a lot better and will move on.  I did start having unprotected sex with her but only after i had been tested.

Thanks again and best wishes to you and Dr. Hook.
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H. Hunter Handsfield, M.D.Blank
University of Washington
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