STDs Expert Forum
Possible herpes 2?
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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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Possible herpes 2?

Hi doctors 24 year old male so I come here and this will sound odd to you looking for answers as to symptoms I've been experiencing close to 4 years. 4 years ago, I had brief protected intercourse with a female who I found out was very promiscuous. Bout a week later I began getting a constant burning sensation inside of penis that comes and goes, before, not as much during, and after urination. Even burning without urination. I got tested for the routine Stds which all came back negative. So I chalked it up to a similar situation i had the year prior to some urinary infection. And just dealt with it. However other symptoms that presented themselves were itching and general pain inside the urethra, almost throbbing back pain before ejaculation, and burning during and after masturbation. And urination after ejaculation was accompanied by burning stinging and difficulty voiding. Very uncomfortable.i have also been abstinent for these 4 yearsI write now only cause I researched online to find these symptoms could be herpetic urethritis cause by hsv 2.these urinary symptoms have been daily for these 4 years and wax and wane from what I can remember. I also get pimple like bumps on buttocks time to time but recently they appear more frequently and my entire buttocks itches and burns this has been going on since August and they are spreading down my thighs with burning and itching . I've been getting these for a few years now but never bothered me until now. An the sides of my groin feel swollen and achy, so now I think my lymph nodes are swollen. Again I read these are symptoms of herpes. Now after all the years I'm freaking out, so I ask you Is this something along the  lines of herpes? I will be scheduling a doctors appoint to figure this mess out just wanted a little peace of mind before hand. Thanks in advance.
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Welcome to the forum.  Thanks for your question.

Just like all the cliches about good news and bad news, I have both for you.  The good news is that almost certainly your symptoms are not due to genital herpes.  The bad news is that I cannot give you a good alternate diagnosis -- or at least, my ideas about the diagnosis (below) might not be ones you like or that help resolve the symptoms.

If you read lists of herpes symptoms, often you will find such things as genital itching, pain (in the urethra or elsewhere), pimple-like bumps on areas other than the genitals, and some of the other things you describe.  However, such lists often do not provide context.  The fact is that the pattern of symptoms you describe simply cannot be herpes.  Here are some reasons:  herpes outbreaks never last more than 1-2 weeks; do not recur more often than once every 4-6 weeks; and between those episodes there are no symptoms at all.  That pattern alone means your more or less continuous or frequently recurrent symptoms aren't herpetic.  Although recurrent herpes skin lesions could start as "red bumps", recurrent herpes is typically limited to a patch less than an inch in size, always in more or less one spot, and always on one side or the other of the body midline; bumps of both thighs cannot be herpes.  Finally, I'll add that herpes does not cause painful ejaculation or intermittent burning on urination.  When herpes does cause urethritis, it is usually accompanied by typical penile skin lesions, and causes much more severe pain than you seem to have.  (Some of my patients have described it as one of the worst pains they ever experienced.)

I could go on further about your symptoms, but there's no point.  There is no chance herpes is the cause of most of your symptoms, and probably not any of them.  That said, you don't mention any diagnostic tests.  If you want to pursue the HSV idea, you could have a blood test for HSV.  But if you do that, understand this:  10-40% of healthy adults have positive blood tests for HSV-2, indicating genital herpes, so just on that basis, your test might be positive.  But if so, it will not connect HSV to your symptoms.  It would almost certainly mean you have asymptomatic HSV-2 that does not explain the symptoms you have described.  On the other hand, a negative HSV-2 result might help convince you herpes isn't the cause.

So what IS the cause?  Most people with symptoms like yours have no defined physical cause, even after extensive medical evaluation.  The usual explanation probably is genitally focused anxiety.  This seems to be most common in persons whose symptoms began soon after a particular exposure that seemed high risk or that they otherwise regret.  Of course, no distant forum expert can make a specific diagnosis, and I'm not doing so in this case.  But you can consider this a heads-up:  if you continue your plans to see a doctor about working up these symptoms, you should prepare for the likelihood that nothing much will be found.

Having said all that, I definitely think you shouldn't be worried you have anything serious.  Such symptoms virtually never turn out to be due to any STD, HIV, cancer, or anything else that causes long term harm either to affected persons or their sex partners.

I hope this helps put things in perspective for you.  Good luck with it--

HHH, MD
4 Comments
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Thanks so much for the timely response doc certainly clarified a lot . I'll follow up in  future after I visit my PP with the outcome.
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Hey doctor sorry for the  quick response I had one more question, could the urinary symptoms be along the lines of prostitis or chronic pelvic pain syndrome? When I had the urinary issues before the above mentioned encounter my doctor did throw those terms out there
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239123_tn?1267651214
Well, you haven't described the vague testicular or low abdominal pain that often go along with CPPS or chronic prostatitis.  On the other hand, some of your symptoms are consistent. And in any case, if you have read my previous discussions of CPPS/prostatitis, you may already know there is a big overlap with genitally focused anxiety.

In other words, this certainly sounds possible, although not entirely typical.  It's a reasonable thing to discuss with your doctor.  A good way to approach it might be to print out this thread as a framework for discussion with him or her.
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