Medication Not Suppressing Outbreaks

[duke7762]

Never been tested but know I have herpes. Had it for 7 months now. Had oral contact with a girl who had what I presume was a sore on her upper lip. I was a little worried about it at the time so after the "oral" contact I washed my penis with soap and water almost immediately. Exactly 1 day later I started feeling a pinch inside my urine hole (urethra). I knew I had something but was afraid to go to the doctor so I didn't go. I also read that if it was herpes it would go away soon anyways. I don't know how long the initial episode lasted because I would constantly feel symptoms. Stinging inside urethra, slight burning during urination, pounding headaches (migranes), severe testicle pain (orchitis), lower back pain, constent tingling only in scrotum, stabbing pain in hips / pelvic region, stinging in urethra. Non stop for past 7 months. I did end up going to the doctor. The first time at about 3 months after the contact. I explained to him what happened and he was convinced I didn't have herpes because there were no lesions on the outside. He said I would for sure have lesions on the outside if I had herpes and that it would be very difficult for me to get herpes inside the penis. He put me on Cifro for 10 days. It seemed to help a little bit with the sore testicles but not with the other symptoms. The testicle pain did come back and I went in for a second time. He put me on another antibiotic, Keflex, which didn't seem to help much at all. I never really demanded a herpes test because I'm afraid of being diagnosed with it. I guess I've been waiting it out and hoping it will just calm down and go away. From what I've researched, there is a very high probability that if I do have it, I have HSV1 which occurs much less frequently (oral contact). Could genital HSV1 really cause non-stop symptoms for this long? At about the 4.5 month mark, I broke down and order Valtrex over the net. It seemed to help with the simptoms but did not suppress anything. I was taking 500mg 2x/day and still had non-stop symptoms. I've also tried taking 500mg 3x/day (even though I know it's not FDA approved) and it seemed to work better but still no suppression (allows me to go out in public without severe pain). In addition, I've tried Acyclovir and Famvir. Acyclovir didn't work well at all unless I took 400mg 4x/day. Famvir worked a little better at 250mg 2x/day than Valtrex 500mg 2x/day but still no suppression. How long does it take for suppression to start working with these meds? I've tried each one for around a month at a time and no luck. If suppression at regular FDA approved doses does not work, do any doctors prescribe higher doses? Is there anything else that can be done if suppressive medication doesn't suppress?  I'm on Propecia, take vitamin C 1000mg 3x/day, Lysine 1000mg 3x/day, Olive Leaf Extract 1000mg 2x/day. Could the Propecia be causing outbreaks to be constant? Does it lower DHEA levels (which helps fight off viruses)? -28 yr. old male in great health

[duke7762]

I guess I was concerned that after masterbating, backflow in the semen / fluids could cause the virus to travel back and infect other areas such as the testicles.

[duke7762]

Another question....if I did have herpes in the urethra...could masterbating cause it to spread to my testicles or other areas?

[duke7762]

I feels like I have sores inside my urethra that keep coming back, one right after the other.  That's why I think I have this.  Also, the sharp pains feel like nerve pain which I also think would suggest herpes.  In addition to the other medications, I just got done taking a 10 days of Levaquin 750mg 1x/day.  For the first 3-4 months I was also on Adoxa (doxycyline) 100mg 2x/day for acne. I would think this series of antibiotics I've taken would have killed any type of Chlmydia or Gonnoria if I had it.  Is there anything else you suggest that this could be?  If I did have herpes, is it possible my body has still not built up a big enough defense against this?  ...or would this be my normal outbreak schedule...weekly...continuous?  By the way, is it safe to take Valtrex 3x/day continuously if I do have it and this dosage seems to work better?

[H. Hunter Handsfield, M.D.]

Herpes in the urethra is not the cause of your symptoms.  Herpes does not spread to the testicles by masturbation or by any other method.  The antibiotics you have had would have cleared up gonorrhea, chlamydia, or any other bacterial infection that might cause those symptoms.

I told you the only solution:  get a proper diagnostic tests.  All else is useless; you're never going to get the necessary answers online.  I will have no other replies unless and until you have those tests and tell us the results.

HHH, MD

[H. Hunter Handsfield, M.D.]

You almost certainly do not have genital herpes; or if you happen to have HSV-1 (or HSV-2) infection, it is not the cause of the symptoms you describe.  I don't know what you read online, but your symptoms don't suggest herpes at all.  Further, if your symptoms were due to herpes, the antiherpes drugs you have tried would have resolved them.

To answer some of your specific questions:  Suppressive therapy starts working within 4-5 days.  No, herpes (neither HSV-1 nor HSV-2) can cause persistent symptoms like you describe.

You need to be tested for HSV-1 and HSV-2 antibody using a proper type-specific test (see many other threads on the right tests, such as HerpeSelect).  You have to admit it is illogical to believe you have herpes yet be afraid to have a test to prove it (or disprove it, which is more likely).  After you are tested, I will be happy to provide further advice.

Best wishes--  HHH, MD