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Scare and Confused!!
Dear Doctor,
I am a 43 year married female, about eight years ago I had a hysterectomy(ovaries not removed), I have from that moment not been the same vaginally. In November of 2000, everytime I had any sexual relations with my husband I would get these paper like cuts that would come very sore and red. I went to my OB/GYN and they performed a blood test and a culture for herpes which I knew would come back negative. I want you to know my husband does get cold sores and has since he was a child, but when we have had oral sex we have been careful for 24 years. As the years went by I still would get these pper cuts but they would not get so sore, I must admit I do examine myself often when this happens and have found that my vaginal skin will tear even if I pull it apart to hard. So now to the real issue I am contacting you. Christmas Eve me and my husband were having sexual relations and I could feel him tearing my vaginal area as he entered me. I did not notice to much discomfort over the next couple days and on wednesday night I noticed that it was burning and I had these cuts again, I proceded to examine myself to find that my vaginal area is red and swollen again, I went to my OB/GYN on Thursday and she examined me took a herpes culture but this time no blood test, I asked her right up front was this herpes she said that to her it looked like little cuts and tha she thought I would be fine, she gave me some aquaphor for babies and said for me to stop pulling my vaginal area apart to examine myself. Question if she suspected herpes would'nt she have said yes after I specifically asked her if it was herpes? Oh, my lat tests in 2000 were for both HSV1 and HSV2. I am so confued and scared it is on my mind every waking day and I cannot concentrate, it has me crying myself to sleep at night. Oh and both me and my husband have never strayed in our marriage. PLEASE HELP!!
Desparate for answers
I am a 43 year married female, about eight years ago I had a hysterectomy(ovaries not removed), I have from that moment not been the same vaginally. In November of 2000, everytime I had any sexual relations with my husband I would get these paper like cuts that would come very sore and red. I went to my OB/GYN and they performed a blood test and a culture for herpes which I knew would come back negative. I want you to know my husband does get cold sores and has since he was a child, but when we have had oral sex we have been careful for 24 years. As the years went by I still would get these pper cuts but they would not get so sore, I must admit I do examine myself often when this happens and have found that my vaginal skin will tear even if I pull it apart to hard. So now to the real issue I am contacting you. Christmas Eve me and my husband were having sexual relations and I could feel him tearing my vaginal area as he entered me. I did not notice to much discomfort over the next couple days and on wednesday night I noticed that it was burning and I had these cuts again, I proceded to examine myself to find that my vaginal area is red and swollen again, I went to my OB/GYN on Thursday and she examined me took a herpes culture but this time no blood test, I asked her right up front was this herpes she said that to her it looked like little cuts and tha she thought I would be fine, she gave me some aquaphor for babies and said for me to stop pulling my vaginal area apart to examine myself. Question if she suspected herpes would'nt she have said yes after I specifically asked her if it was herpes? Oh, my lat tests in 2000 were for both HSV1 and HSV2. I am so confued and scared it is on my mind every waking day and I cannot concentrate, it has me crying myself to sleep at night. Oh and both me and my husband have never strayed in our marriage. PLEASE HELP!!
Desparate for answers
MEDICAL PROFESSIONAL
Please accept my condolences, as well as surprise. But don't panic. It isn't the end of hte world.
It would be good to know exactly what test was done. If it was a culture, the result almost certainly is reliable and valid.
I don't know why you assume you'll never know which virus type; the lab can easily determine that from the positive specimen. If for some reason that isn't possible, you still can have a blood test, which will tell whether you are infected with HSV-1, HSV-2, or both viruses. Finally, in the event of a future recurrence, you can have another culture - with specific instructions to the lab to type the virus.
If you have HSV-1, you might have few future recurrences. But the apparently frequent symptoms suggests that HSV-2 is more likely. Your husband could have a blood test to help sort this out.
Your reaction to the diagnosis is not atypical, but truly most cases of genital herpes are not that big a deal in the long run. You should first have a discussion with your provider about the specific test done, learn the virus type, and consider whether additional testing of you and/or your husband is a good idea. You should also start reading up on genital herpes. An excellent place to start is the American Social Health Association (www.ashastd.org). You can also call ASHA's Herpes Resource Center for personal telephone counseling by an expert.
Best wishes-- HHH, MD
It would be good to know exactly what test was done. If it was a culture, the result almost certainly is reliable and valid.
I don't know why you assume you'll never know which virus type; the lab can easily determine that from the positive specimen. If for some reason that isn't possible, you still can have a blood test, which will tell whether you are infected with HSV-1, HSV-2, or both viruses. Finally, in the event of a future recurrence, you can have another culture - with specific instructions to the lab to type the virus.
If you have HSV-1, you might have few future recurrences. But the apparently frequent symptoms suggests that HSV-2 is more likely. Your husband could have a blood test to help sort this out.
Your reaction to the diagnosis is not atypical, but truly most cases of genital herpes are not that big a deal in the long run. You should first have a discussion with your provider about the specific test done, learn the virus type, and consider whether additional testing of you and/or your husband is a good idea. You should also start reading up on genital herpes. An excellent place to start is the American Social Health Association (www.ashastd.org). You can also call ASHA's Herpes Resource Center for personal telephone counseling by an expert.
Best wishes-- HHH, MD
MEDICAL PROFESSIONAL
I really can't help much. You're describing a problem much more suitable for a gynecologist, not an STD expert. The only STD that could possibly cause the symptoms you cause is herpes, and even that seems very unlikely. To be completely certain, your might talk to your ObG provider about having another HSV blood test, since the last one was 7 years ago. (Conceivably you were infected since then, and back than many labs were using tests no longer considered accurate.)
Don't misunderstand: I doubt this is herpes. If your blood test remains negative for HSV-1 and -2, that will prove herpes isn't the problem. In the event the result is positive for either virus, then a repeat culture test (taken within 24 hours of onset of a "cut" or sore) might be needed to check it out further.
Aside from herpes, I wonder about insufficient estrogen, i.e. if you are menopausal or approaching menopause. You should ask your ObG about that possibility. But any number of other non-STD problems could be responsibile, and I will not speculate about things other than STD.
I hope this helps reassure you about herpes. Sorry I can't be more helpful about other possibilities. Happy new year-- HHH, MD
Don't misunderstand: I doubt this is herpes. If your blood test remains negative for HSV-1 and -2, that will prove herpes isn't the problem. In the event the result is positive for either virus, then a repeat culture test (taken within 24 hours of onset of a "cut" or sore) might be needed to check it out further.
Aside from herpes, I wonder about insufficient estrogen, i.e. if you are menopausal or approaching menopause. You should ask your ObG about that possibility. But any number of other non-STD problems could be responsibile, and I will not speculate about things other than STD.
I hope this helps reassure you about herpes. Sorry I can't be more helpful about other possibilities. Happy new year-- HHH, MD
MEDICAL PROFESSIONAL
New lesions often appear for a day or two after starting treatment. It doesn't mean anything. Indeed, this sounds like your primary infection.
How do you know it is HSV-1? If that is just your doctor's best guess, you still need lab testing to confirm it. That is the only way your doctor can know for certain - unless your husband has previously been diagnosed with HSV-1 and is known for sure not to have HSV-2. Even then, it would be smart to confirm that by specific testing.
If you have HSV-1, you definitely should not start suppressive treatment after the initial 10 days treatment. Among people with new genital HSV-1 infection, 40% have no recurrent outbreaks at all and most have just 1-2 recurrences over the next 1-2 years, then no more. That is, most people with genital HSV-1 do not need chronic suppressive therapy.
This is truly my last comment. Please address all further questions to your own provider. Happy New Year.
How do you know it is HSV-1? If that is just your doctor's best guess, you still need lab testing to confirm it. That is the only way your doctor can know for certain - unless your husband has previously been diagnosed with HSV-1 and is known for sure not to have HSV-2. Even then, it would be smart to confirm that by specific testing.
If you have HSV-1, you definitely should not start suppressive treatment after the initial 10 days treatment. Among people with new genital HSV-1 infection, 40% have no recurrent outbreaks at all and most have just 1-2 recurrences over the next 1-2 years, then no more. That is, most people with genital HSV-1 do not need chronic suppressive therapy.
This is truly my last comment. Please address all further questions to your own provider. Happy New Year.
Hello, as you may know or remember, I first had signs of my outbreak on Wednesday last week, they have since opened and become extremely painful, I have taken 1500mg Valtrex and today I noticed 2 new little sores that were not there 6 days ago. Is this possible? Ad should'nt the Valtrex stop this from happening? And does this prove what the Doctor told me yesterday that this has to be a primary infection? And last but not least I am infected with HSV1
MEDICAL PROFESSIONAL
Complete the 10 day regimen for sure. If your doc is convinced that the symptoms you describe going back a few years were due to recurrent herpes, then it might make sense to go ahead now with suppressive therapy. But if she suspects you are currently experiencing the initial infection, I strongly suggest you not start the suppressive regimen until you know the virus type and recurrence pattern. If it's HSV-1, you might never have another recurrent outbreak (recurrences are far less common than for HSV-2 and 40% of people never have a second outbreak). Even for HSV-2, you might have only 2-3 outbreaks a year and might decide it isn't worth taking a fairly expensive drug on a continuing basis.
Another factor here is that suppressive therapy might not work as well when started soon after the initial infection; long term efficacy might be better if started later, after the infection "matures". I know what I'm talking about: there is only one published study addressing this and it happens to be my own research. In case your doc is interested, the citation is Sexually Transmitted Diseases 2007;34:339-43 (June 2006).
That will have to be my last comment. Best wishes.
Another factor here is that suppressive therapy might not work as well when started soon after the initial infection; long term efficacy might be better if started later, after the infection "matures". I know what I'm talking about: there is only one published study addressing this and it happens to be my own research. In case your doc is interested, the citation is Sexually Transmitted Diseases 2007;34:339-43 (June 2006).
That will have to be my last comment. Best wishes.
I will do that immediately to find the type! I wanted to let you know my doctor is prescribing Valtrex at a very high dose 2 pills for ten days then putting me on a suppressive therapy regimen.
MEDICAL PROFESSIONAL
The nurse is mistaken. A simple call to the lab (quickly, before they discard the specimen) can result in testing to determine virus type. If the local lab doesn't do it, a nearby reference lab can do so.
In the circumstances you describe, HSV-1 indeed seems more likely than HSV-2. (Those are the only two types.) But the nurse also is wrong in saying the virus type makes no difference. It makes a very big difference in a) predicting how frequently you can expect recurrent outbreaks and therefore b) in whether ongoing suppressive treatment is likely to be helpful in the future. The virus type should be determined without exception in every person with newly diagnosed genital herpes.
Presumbably your provider has prescribed treatment. But if the sores are already healing, it may not be necessary. However, you shouldn't start continued suppressive therapy without knowing virus type and also waiting to see what sort of recurrence pattern you experience.
Please follow through with the advice above about ASHA or other sources of expert personal care. Since the nurse seems not to be up to speed on herpes, you should try to discuss these issues directly with your doctor. If necessary, print out this thread and take it to them. Or find another herpes-knowledgeable provider.
Please follow my advice above about reading about genital herpes. In addition to the ASHA website, other good ones are www.metrokc.gov/health/apu/std (where I largely wrote the herpes information myself), www.cdc.gov/std, or www.westoverheights.com. A forum like this isn't appropriate for more detailed information than this, so I won't have more to say. Good luck.
In the circumstances you describe, HSV-1 indeed seems more likely than HSV-2. (Those are the only two types.) But the nurse also is wrong in saying the virus type makes no difference. It makes a very big difference in a) predicting how frequently you can expect recurrent outbreaks and therefore b) in whether ongoing suppressive treatment is likely to be helpful in the future. The virus type should be determined without exception in every person with newly diagnosed genital herpes.
Presumbably your provider has prescribed treatment. But if the sores are already healing, it may not be necessary. However, you shouldn't start continued suppressive therapy without knowing virus type and also waiting to see what sort of recurrence pattern you experience.
Please follow through with the advice above about ASHA or other sources of expert personal care. Since the nurse seems not to be up to speed on herpes, you should try to discuss these issues directly with your doctor. If necessary, print out this thread and take it to them. Or find another herpes-knowledgeable provider.
Please follow my advice above about reading about genital herpes. In addition to the ASHA website, other good ones are www.metrokc.gov/health/apu/std (where I largely wrote the herpes information myself), www.cdc.gov/std, or www.westoverheights.com. A forum like this isn't appropriate for more detailed information than this, so I won't have more to say. Good luck.
Before I forget THANKS!! for being so kind and helpful and putting it up with all these question. :))
I asked the nurse that told me my results and she said the culture only detected the herpes virus but did not specify which type. Because my husband has never had any symptoms and we have never used condoms I am wandering if this is a primary infection from HSV1? I asked this of the nurse and she said at this point would it matter to you with a positive result? I said probably not. So I do not know what type of culture only that it was a herpes culture. Is there different types and what should I know about them?
Well here I am again will NOT so good news my herpes cult came back POSITIVE and I am devastated. The OB/GYN told me when she examined me I would be fine, and her I am not so fine. My husband has no symtoms and never has except cold sores. I guess I will never know whether I have HSV1 or HSV2 and maybe its best I dont know, but I know since Wednesday I have had great pain and the sores are not healing like before. So my question is we had oral sex On Monday last week, he had a cold sore the week before could this have been the time I became infected? Because my husband is still asymptomatic? I just called him at work and he is mortified to say the least as am I. I really do not know where to turn and what to say only that I feel like damaged goods! :( Should I retest the culture or are they pretty accurate? THANKS!!
MEDICAL PROFESSIONAL
I always tell my patients the full and complete truth about my clinical opinion. Most do so, but of course I cannot speak for yours. If uncertain, ask her! Maybe she did the herpes culture in order to reassure you, if you told her your concerns about it. Also, herpes is the single most common overall cause of genital ulceration, so it's a reasonable test even when the suspicion is low.
A positive culture proves herpes, regardless of blood test results, but cultures often miss the diagnosis; a negative culture never is proof against herpes. But herpes outbreaks do not behave the way you describe. Among other things, they are not triggered by sex.
A positive culture proves herpes, regardless of blood test results, but cultures often miss the diagnosis; a negative culture never is proof against herpes. But herpes outbreaks do not behave the way you describe. Among other things, they are not triggered by sex.
Thanks much for answering so quickly. I was wandering one other question. As a physician yourself if a patient asked you directly after examining them if you thought they had herpes would you answer them yes? Because my OB/GYN said she thought I would be fine. But yet she still did a herpes culture and no blood test. And how accurate is a culture without a blood test confirmation? Thanks for everything Doctor have a wonderful and happy new year!!! :))
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
