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Possible HSV or other STD??

A little history:  

1.) 30 y.o. F & not sexually active for 2 1/2 years  
2.) Tested for STDs in March of 2007 - all neg. Provider said HSV test was type-specific. Testing was done 14-15 weeks after last intercourse with long-term partner. Only encounters with him in 2006 were July - Dec. & totaled 5-6.  
3.) 4 more encounters w/ him between March & June of 2007 & have not had sex since.  

In March this year I started BC for heavy periods. I had itching & irritation in the vaginal area with my next period. I did not see any lesions, blisters, etc. There was some redness & slightly raw skin. I applied OTC ointment & within 4-5 days the symptoms were gone as my period ended. I thought this could be a reaction to the BC, so I stopped it, & the symptoms did not return with subsequent periods.  

In Sept. I tried the BC again. In Oct. & again this month I had the same itching/irritation close to my period. I checked myself & did not see anything out of the ordinary, & I used a mirror & looked as thoroughly as possible. The symptoms lasted a few days in Oct. & then subsided as my period ended. I am on my period now & it is very itchy & irritated around the vaginal area, & slightly around the anal area. It is an external itch. I applied a topical home remedy, (vegetable shortening), & do get some relief. I have conducted "self exams" with a mirror a couple times a day for the last few days & can't see anything resembling blisters, ulcers, etc.

I read that BC can cause these kind of symptoms, but my mind goes to STDs. I was on the same BC 2-3 years ago & didn't have these symptoms. I have read that HSV can cause redness & irritation/itching & that sores can be deeper in the vaginal canal & not visible on the outside.  This worries me & I think "initial & recurrent outbreaks of HSV".  I also read about atypical herpes symptoms & know herpes can lie dormant for a long time before showing symptoms.  Your thoughts?  Thank you very much in advance.
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Avatar universal
Thank you very much.  I truly appreciate all of your help.  I did go to see an OB/GYN today & she also had very little to no concern about herpes - more likely contact dermatitis or a response to fluctuating hormone levels with the birth control.  I will certainly look into these possible causes & appropriate treatment.  Thank you.

Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
The additional information does not change my opinion or advice.  You came here for reassurance and I gave it:  all the evidence makes is virtually impossible that herpes explains any of your symptoms.  But an online advisor cannot make a specific diagnosis and we have gone as far as possible on this forum.  That will have to end this thread.  
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Avatar universal
Thank you again, Dr. Handsfield.  I have just a couple final concerns/questions, if you don't mind reading one last time.  

I saw a family doctor in urgent care on Tues. evening.  He did an exam & said he did not see anything indicating herpes, (sores/blisters).  He just noticed redness/irritation around the vaginal opening.  He couldn't do a wet prep because I have my period, so I am still uncertain as to if it's yeast related.  He recommended OTC hydrocortisone cream, which I applied to the entire area when I got home Tues. night & then again Wed. morning.  This has greatly improved the itching/discomfort & it is pretty much gone at this point.  Things feel "back to normal" down there.  

Wed. evening I noticed a couple very small marks in the genital area, (I know, I know -  another self exam).  One is on the left labia somewhat close to the vaginal opening & looks like what could be described as a vaginal fissure, based on a little online research.  It is a very thin, elongated (maybe 3/4") scrape-looking mark.  The best way to describe it is if someone took a pen & drew a thin line.  I also see a couple other similar marks now - both of which look similar except they are very tiny & more "dot" sized - not elongated, ("someone took a pen & made a dot").  One is on the upper right side close to the clitoris, & the other is in the perineal area.  Each of these is a little red, but again - does not look anything like a typical herpes ulcer or blister, & there isn't any pain or itching associated with them.  

So, my questions are:

1.)  Is it likely these are herpes related?  Again, my online reading is getting the better of me & I've read that herpes lesions sometimes appear like paper cuts.  So, of course now I'm concerned!  I haven't noticed anything like this before, (was never really looking or attuned to things like this before now), & as I said, haven't been sexually active in close to 2 1/2 years.  Again - just concerned about a possible atypical outbreak???
2.) If these are herpes related, what is the typical healing period for these lesions, & is the healing period different for an initial vs. recurrent outbreak?  

Thank you one last time!  :)
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
The more detailed symptom description doen't change my view:  this isn't herpes.  Consider following up with your doctor or clinic about the yeast possibility.

Quest lab owns the company that produces HerpeSelect and has done that as their only standard HSV test for 10 years or more.  It is the standard, most-studied, most reliable HSV antibody test.

Thanks for the thanks about the forum.  Best wishes.
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Avatar universal
Thank you, Dr. Handsfield.  I greatly appreciate your opinion/advice.  

As far as I can tell, the itching/irritation has always been generalized; occurring all around the vaginal opening.  Does it make a difference if it's all around the vaginal opening or directly on the labia?  (Not sure as to exact terminology & which part is technically which).  I don't ever recall just one side or the other being affected.  I do recall reading a posting of yours that referred to herpes occurring "on one side of the body's midline or the other".  I assume this is what you meant by that.  I've also had some itching of the labia closer to/just around the clitoris; further from the vaginal opening, so this is against your description of it being more localized.  I still do not see anything that would resemble a herpes lesion that accompanies any of this, & I realize I may be making the problem worse by consistently conducting self exams & "poking around" down there, (I tend to be a bit of a "worry wort").  Right now the vaginal area feels generally "uncomfortable" more than itchy, & I do feel it more after I've examined myself, (I should probably just stop that all together).  :)  

Also, I ran into some road blocks with the clinic when I tried to verify the specific test that was done for me.  I've been bounced all over the place.  The lab was able to tell me that they use Quest Diagnostics for any non in-house lab work.  I checked the Quest website & it lists HSV 1/2 IgG, HerpeSelect®′ Type-specific Antibody as a test that is performed there.  Is this most likely what was ordered for me if I confirmed with the provider that the test was type specific?  Was this test available back in 2007?  I remember reading in the forum that the IgG test is recommended & IgM is useless.  

Again, thank you in advance for any comments/information.  This is a wonderful forum & provides a great service to people; with obviously much more reliable information than that which is found with a Google search.  :)
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the STD forum.

This doesn't really sound like herpes.  Itching can result from herpes lesions, but it is rarely the primary symptom.  And when itching occurs, it is because the sores themselves itch; your description of itching in one part of the genital area but no sores in that spot is against herpes as the explanation.  Further, herpes outbreaks do not involve the genital area as diffusely as this seems to be.  If I correctly understand your description, you have recurrent itching of the labia when this happens.  Recurrent herpes always is one side or the other, i.e. could not involve the labia on both sides; is quite localized, i.e. rarely over 2 cm (1 inch) in diameter; and finally, every outbreak is in more or less the same place, give or take an inch.

In addition to all this, the blood test results are highly reliable, and you can be certain you were not infected with HSV-2 as of March 2007.  (HSV-1 isn't an issue, since it rarely recurs in the genital area with the frequency you describe.)  And apparently there has been no appreciable opportunity for a new infection since then.

If the symptom pattern I describe above sounds like an accurate description, then despite the other evidence, it would be worth seeing a clinician (preferably during such an episode) andor having another HSV blood test.  Otherwise, however, I would look to other causes and not worry about herpes.

As for other possibilities, this sounds more like recurrent yeast than anything else.  I don't know that birth control pills can do anything like this, but I'm not a gynecologist.  In any case, on this forum we don't get into speculation about non-STD problems.

I hope this helps. Best wishes--  HHH, MD
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