Vaginal Herpes?

[bb1211]

Hi, I am 22 years old and have only been sexually active for one year. I have had a total of three partners and have usually been really careful about protection. However, 9 days ago I had a one night stand with a casual aquaintance. We did not use a condom. After we had finished having sex, he informed me that he had slept with 40 people! He said he didn't have any diseases and always gets tested. I was shocked and really upset with myself for not being more careful. The next day, I noticed some pain in my vaginal area which I attributed to all of the sex since I don't have a lot of sexual experience. The pain seemed to continue and 5 days later I noticed a lesion between my vaginal opening and anus. It has been 9 days and the lesion is still there. I went to the doctor and she did a culture for herpes and the results should come in in about a week. She said there's a possibility it could also be a skin tear? She also said that he might have herpes and not know it. The only other symptoms I am having are it burns when I urinate and the urine passes over the lesion, and the area around it is a bit red. I also have developed a yeast infection which I think is because I am on antibiotics for tonsillitis. I treated it with Monistat and the yeast-like symptoms have seemed to go away. It seems to me like there's a really good chance I could have herpes and I have been crying and not sleeping for the past three days. I can't believe it! What is your take on the situation? Does it really sound like herpes?

[Edward W Hook, MD]

Some of what you describe sounds as though it could (it is not for sure) be herpes but most of what you report do not. The good news is that your doctor took a culture which should help to clarify things a great deal.  For starters the discomfort you noted the next day was almost certainly not herpes.  It typically takes 4 or 5 days after sex for first episodes of herpes to appear.  That you noted the lesion at five days however suggests it could be herpes, although if it was, I would have expected it to have gotten worse over the next few days and for you to notice some additional little blisters or other lesions. All in all, my guess is that it is probably not herpes although it can sometimes be hard to tell.  You are fortunate that your doctor took a culture.  If this is your first episode, the culture should be positive.  

The topic of herpes is a complex one.  The disease is common with HSV-1 being present in over 60% of adults and HSV-2 (the virus which causes most genital herpes) being present in about 1 in 5 Americans.  For both infections, the majority of people who have the infections are not aware that they are infected, either because they either acquired it without knowing in the past or because they misidentified their herpes as something else.  I will do my best to answer your questions but in general, many of these questions and information about herpes can be obtained by accessing excellent informational web sites such as the one run by the American Social Health Association (disclosure, Dr. Handsfield and I are both on the Board of Directors of ASHA).

Hope this helps.  As I worked through it, I have come to the conclusion that this is propbably not herpes.  Please let un know wha the culture shows.   EWH

[bb1211]

Some additional questions I had were...what else could this be if it's not herpes? I have heard of people getting skin tears but how long do they usually take to heal? This looks more like a lesion than a cut.

[Edward W Hook, MD]

The list is quite long and beyond the scope of this forum.  Guessing without the benefit of an exam is not in your best interest.  You need to be examined.  Not trying to be coy, it just would not be of service to you for me to start guessing. EWH

[bb1211]

I understand, I will just have to let you know when I get my results back. Does a herpes outbreak usually consist of more than one sore? Because I have been checking constantly and there is only one for sure. Also, today it looks like it's starting to go away..I can barely see it and it's not painful anymore.

I had one other question. I mentioned that I had symptoms of a yeast infection and did a one-day Monistat treatment and those symptoms went away. However, the next day they came back (I am still on the antibiotics); those symptoms were redness, discharge and minor irritation. Is it possible for that to happen if a person is on antibiotics for an extended time period? I only have one day left on my dose.

[Edward W Hook, MD]

Most often HSV presents with multiple small sores.

Yes, if you are still on the antibiotics, the yeast could come back and even cause the sypmtoms you describe.  EWH

[bb1211]

How long does an outbreak normally last? I have heard all sorts of things...I've heard 2-4 weeks and I've also heard only a few days. I noticed my sore 6 days ago and not it's mostly gone.

[bb1211]

Just wanted to let you know that my results came back negative...what a scare! I really appreciate all your help, it was really helpful to get an expert's answer to all my questions!

Take care.

[Edward W Hook, MD]

Glad to hear it.  Take care.  EWH