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Painful Sex -Yeast? Herpes? Abrasions?
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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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Painful Sex -Yeast? Herpes? Abrasions?

Hi Doctor,

I posted here a few days earlier. I was concerned about Herpes and I was asking a few questions as of why -in your professional opinion - I was experiencing pain after sex.

I went to see my doctor. She did a gyne check and she said, she didnt see any obvious herpes-like symptoms. No blisters, lesions, or sores. She did claim that there were cuts present in my vagina - she also said that this was "perhaps due to sex".

I have a few questions...

Im confused as of what a Herpes lesion is supposed to look like? How do you differentiate between lesions, ulcers, and  sores? Are these terminilogies all mean the same thing? Do they look the same?

Ive done a few research and Ive read that you do not need lesions/ulcers/blisters/ to have Herpes. It stated that Herpes can come as cuts or abrasions. A few sites also claimed that Herpes can be an explanation to why Im experiencing pain starting sex and after sex. It also says that the outbreak can last for weeks - and i must say... its been weeks.

My doctor says its probably abrasions - what I dont understand is, if its "just" abrasions - they why is it taking forever to heal? I mean I have experienced abrasions and they were fine with in a day.

Yeast Infection seems to be out of the question. I do not experience any itching or abnormal discharge. I just feel a bit of a sting when im penetrated. I do not feel any pain during sex... then i feel burning after. It burns right after I urinate. I urinated a few hours later and it felt fine. It feels hot and it burns right now (burns when touched,it feels a bit weird when sitting-it does not sting unless touchd)

My doctor is really nice and she is quite friendly. She brushed it off and she says that maybe im worrying a bit too much. She joked and told me not to look at myself (mirror). I thought reading would give me some answers - it did - however it brought up so many questions. Maybe its just the worry but I feel like although my symptoms are mild and subtle they point to Herpes. I have cuts/abrasions that are starting to persist when I have sex. They ease little by little as the day passes, I guess its taking a while to heal since I touch and look at myself all the time.

Im just so lost and i feel frustrated. I do not understand why Im experiencing recurring pain everytime I have sex. The fact that Yeast infections and Abrasions from sex are "quite commonly mistaken for Genital Herpes" dont help much. I guess I came to this site to ask your opinion. Could you offer me input? Another question is, am i just stressing too much? Is my doctor not taking me seriously and should i find another doctor?

and last question, if im realy just experiencing abrasions from sex - i think the abrasions have gotten worse since it hurts a bit more... how long should i abstain from sex? How long does it take for vaginal abrasions/cuts to heal? Does this sound like Herpes - in fact does this sound like a STI at all?

Thankyou for your time
Tags: abrasions
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239123_tn?1267651214
Burning pain during sex is a fairly common problem, often classified as idiopathic vulvodynia (which doesn't really tell you much; it's Latin for "vulvar pain of unknown cause").  It's not an STD.  But if you have overt "cuts", vulvodynia probably isn't the problem.

Except when sex is forced or in the near-total absence of sexual lubrication, it doesn't cause abrasions.  You already know that herpes and yeast indeed are by far the most common causes, and many herpes lesions indeed look like "cuts", "abrasions", etc.  On the other hand, if it were herpes, the symptoms would last a few days at a time with no pain or discomfort between outbreaks.  So I doubt that's the explanation.

However, you don't say what tests were done to check for herpes; simple visual inspection is not sufficient to exclude it.  If not done, you should have a blood test for HSV infection.  (See numerous other threads about the right and wrong kinds of blood tests; you can search for "herpes diagnosis" and "HerpeSelect test".)

Also, I'm not sure how to interpret your certainty that you don't have a yeast infection.  If your doctor did tests that were negative, and especially if you have tried a course of treatment against yeast without benefit, then you're probably right.  But otherwise yeast seems possible.  Contrary to common belief, most women with yeast infections don't have increased vaginal discharge, and itching doesn't have to be present.

To answer your last question:  Unless it turns out to be herpes, which seems unlikely, I don't think you have an STD of any kind.

It sounds like you like your health care provider. Nevertheless, if you aren't sure she has the necessary knowledge, then you should ask for a referral for another opinion.  For example, if you are in or near a major medical center or medical school, you probably could find a gynecolgist with particular expertise in infectious diseases; or an infectious disease specialist who knows STDs well.

I hope this helps.  Best wishes--  HHH, MD
6 Comments
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Avatar_n_tn
Id like to make it clear that I did have Yeast Infection. I was prescribed a cream which I used for a week. I engaged in sex a week or so and it tingled/itched a bit when penetrated. Its been 4 weeks when I was diagnosed with Yeast.

Although it stings right after sex, it feels better the next day. However everytime I have sex -everytime AFTER sex the pain is worse than it was previously.

i asked my doctor if she could do a culture -she said there was nothing to culture. (No Blisters)

Please give me advice, Im getting desperate. Im not sure if I should just calm down, stop looking and touching myself and worrying so much. Or if I should be even more concerend?!

Thank you
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239123_tn?1267651214
Sorry, I don't have any other ideas.  However, do you and your doctor understand what I'm saying about the herpes blood test?  It is different from culture, and lesions need not be present for the blood test to accurately diagnose herpes.

Not knowing what you ahve, I don't have any other advice for you, other than in my first reply:  HSV blood test, perhaps consultation with another provider.

HHH, MD
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Avatar_n_tn
You said...On the other hand, if it were herpes, the symptoms would last a few days at a time with no pain or discomfort between outbreaks. So I doubt that's the explanation.

So if Im having Herpes outbreaks right now - Im not suppose to experience pain or discomfort? why? could you explain?

Im sorry, English is my second language and I got a bit confused there.

As for pain and discomfort - I only experience that when I touch my vagina -touching and stretching the labia to get a better look etc.

Thank you for your advice

I really do appreciate it
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Avatar_n_tn
As for Yeast, well I havent had a swab done lately...

As mentioned earlier, I was diagnosed with Yeast (this was probably 5 weeks ago)

I had sex a week later after my diagnoses, then I experienced pain after sex. 2 days later I went to teh doctor for a swab and it came out negative. So from that date until now (3/4 weeksish) I havent done any swabs. I thought that since it was negative 3 weeks ago, maybe there was no point doing it again.
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239123_tn?1267651214
What I meant is that herpes symptoms don't last for several weeks.  Your description suggests you have had this problem for a few weeks.  If it were herpes, you would have symptoms such as pain and sores for a few days, then healing, then maybe another outbreak.  In between those episodes, you would feel entirely normal.  Also, those painful episodes do not come and go over just 2-3 days; typically a few weeks pass between outbreaks.

Yeast often causes mild symptoms that can be made worse during sex.  You really should re-check with a health care provider.

Best wishes--  HHH, MD
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Avatar_m_tn
A related discussion, scared was started.
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Avatar_f_tn
Okay i had sex on Sunday with no pain. Although the next day i started having pain, a little bit of an itch and some discharge. Monday i had sex again with alot of pain. Its now Wensday and the pain has stayed the same but still hurts and is very irritated. I know something is deffenatly wrong, i'm just not to sure what it is. I have no bleeding, spots, blisters or anything along those lines, but just pain during and after sex.
Could you pleasee help narrow down my possible options on what i could possibly have.
Please respond, ASAP!
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Avatar_f_tn
Okay i had sex on Sunday with no pain. Although the next day i started having pain, a little bit of an itch and some discharge. Monday i had sex again with alot of pain. Its now Wensday and the pain has stayed the same but still hurts and is very irritated. I know something is deffenatly wrong, i'm just not to sure what it is. I have no bleeding, spots, blisters or anything along those lines, but just pain during and after sex.
Could you pleasee help narrow down my possible options on what i could possibly have.
Please respond, ASAP!
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239123_tn?1267651214
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University of Washington
Seattle, WA
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