Herpes or yeast infection??

[jlm728]

I last had sex 8 days ago.
When I woke up yesterday morning and peed, it stung my skin directly outside my vaginal opening, at the bottom and slightly towards the left side.  When I looked at the area in the mirror, it looked kind of red, but no bumps can be seen. Later in the day it itched a little and felt raw for a little while, almost like the feeling after rough sex.  After the first time, it hasn't stung when peeing anymore, and today it feels a tiny bit itchy and is a little red, but better than yesterday.
The day before yesterday, I was wearing very tight jeans and also noticed a copious amount of discharge that had a very strong 'yeast-like' odor.  However, I did not notice this yesterday or today.
Does this sound more like herpes or a yeast infection?
I've also read about lichen sclerosus and am wondering if that's a possibility--I have the crinkly-looking skin close to my vaginal opening (it's always this way).  I also get *extremely* easily irritated and swollen during/after sex.
Thanks so much for your help and for this great forum!

[H. Hunter Handsfield, M.D.]

Your symptoms sound most compatible with herpes or a yeast infection, and yeast is the most common misdiagnosis in women who actually have herpes.  In other words, they can be hard to tell apart even by direct examination, and I certainly can't tell from your description.  Lichen sclerosis, lichen planus, trichomoniasis, and other possiblities also come to mind.  I doubt tight jeans has anything to do with it.  Association with vaginal discharge is more suspicious for herpes or trich.  Yeast infections usually cause irritation without discharge, and any discharge usually is odorless, so "yeast-like" odor doesn't help much.  Vaginal discharge with odor suggests bacterial vaginosis or trichomonas; and all your symptoms could be due to gonorrhea or chlamydia.

Bottom line (no pun intended):  it is dangerous to speculate; you need to be examined.  The sooner you do it, the greater the likelihood of a prompt diagnosis, without having to wait several days for test results.  In the meantime, speak with your partner(s) and find out if there are any symptoms, sex with other persons, etc.

Good luck--  HHH, MD

[jlm728]

Thanks for your help, I will go get checked as soon as I can.  I've been doing some more reading online about herpes, and 'prodrome' is often mentioned--stinging, burning sensations in the genitals before an outbreak.  In the past, I have intermittently felt pain in my genital area that comes out of nowhere--it's mainly on the perineum.  This is a sharp, stabbing pain that will usually only last for a minute, no tingling or burning. Does that sound consistent with prodrome?

[H. Hunter Handsfield, M.D.]

"Prodrome" refers to tingling, numbness, or other symptoms that may precede a herpes outbreak.  Prodrome symptoms usually aren't painful or stinging, and they last for a day or two before lesions appear.  Your symptoms don't sound like herpes prodrome.

HHH, MD

[Ineed2relax]

You don't say if you had protected or unproctecd sex, or was it vaginal, anal or oral. It may have made it easier to answer your question. Give the Dr. all the information you can,(be honest) it helps him to answer your question with more insight. Good luck to you.

[monkeyflower]

I once had a "yeast infection", that I have now come to believe was a herpes outbreak. However, my "yeast infection" differed from other yeast infections I've had in the past in a couple of significant ways. First, it was *painful*. It started while I was on my period, and inserting a tampon was absolutely excruciating. The other noticeable difference is the fact that the 3-day OTC yeast treatment I bought - that has always worked in the past (and since) - did *nothing* but exacerbate the discomfort and pain. My guess would be you just have a yeast infection. However, a better idea would be to actually see your doctor while you have this irritation, so you can get an accurate diagnosis :-)

A couple of other points: I'm not sure what you mean by crinkly-looking skin, but that's probably just your normal labia. Lichen sclerosus, from what I understand, usually involves thinning skin, white patches, and ferocious itching. I don't think it just develops overnight :-) Vulvas are like snowflakes - all are different, and all are beautiful. Unfortunately, women don't often get to look at other women's vulvas, so we often wonder whether we're "normal". So, you might check out the book "Femalia", by Joani Blank, for some great pictures of vulvas. Also, www.the-clitoris.com has a link to some excellent photos of vulvas. Betty Dodson's site, www.bettydodson.com, also has some great illustrations.

As for the irritation after intercourse, are you fully aroused and well lubed? If not, that will definitely cause soreness and irritation. Are you using condoms? Spermicide? If either of those are true, try using polyurethane condoms instead of latex, or more importantly, non-spermicidal condoms. Spermicide is very irritating to many people, and just generally not a very good idea. Also, if you have an infection, intercourse will certainly trigger or exacerbate any irritation, itching or soreness you might feel.

Hope you feel better soon!

[mizzmel]

A related discussion, Irritation was started.