Vaginal irritation

Dr. Handsfield,

You probably remember my post from the HIV Prevention forum. Considering what you told me, I'll disregard HIV (at least I'll try). I trust the words of a doctor such as yourself more than the ones of a paramedic at the HIV support forum. Here's my problem, for the past month I've had an irritation on my vaginal area under my labias. There are no sores but small bumps. At my last appointment, my OB told me it was a yeast infection and gave me a prescription for it but it hasn't really done much. It's usually just uncomfortable but when I'm intimate with my husband, it's pretty painful, it burns. My next apointment will be in less than 2 weeks and I can't see him now due to my work schedule. I know you can't give me a diagnosis but I'd appreciate your input until my next OB appointment. Thank you.

[H. Hunter Handsfield, M.D.]

You are doing the right thing in planning to visit your Ob; that's the only way to know for sure what's going on.  But a good best is that you have a persistent yeast infection,  Some strains are resistant to the usual treatments. For example, if you were given the drug nystatin, yeasts often are resistant to it. Even if you were given miconazole, clotrimazole (or any of the many other 'azole' treatments), some strains of yeast are resistant.  If you can't get in for an appointment right away, you might try to speak with your Ob or another provider in his/her office; perhaps they will prescribe an alternate treatment by telephone.  In any case, I doubt you have anything serious.  Your symptoms don't suggest herpes or anything else that I would worry about.

Good luck--  HHH, MD

[verystressed07]

I think I should add that 3 weeks post possible exposure I tested negative for chlamydia, gonorrhea and urinary tract infection.

[verystressed07]

Thank you. I talked to one of thenurses at his office and she said that persistent yeast infections are very common among pregnant women. I just don't remember it being this persistent with my last pregnancy.

[verystressed07]

I forgot to mention that I've been getting sores in my mouth, they don't look like typical canker sores, they look more like small bumps and they're uncomfortable at worst. I just got one under my upper lip. I seem to get one after another but I can go weeks without getting any. I started noticing them when I began stressing over HIV which I'm still trying to move on from. I've been prone to them as a child but it's causing me some concern. If you get a chance to respond to this I'd appreciate it.

[H. Hunter Handsfield, M.D.]

I didn't realize you were pregnant.  Many infections first show up during pregnancy, because pregnant women have naturally suppressed immunity.  (Your immune system has to tolerate a large and growing foreign body--your baby and its placenta.  If your immune system were not suppressed, it would reject the baby.

So you probably just need more prolonged yeast treatment. Show your oral sores to your Ob provider.  You might have oral herpes, which could show up in pregnancy--or can reappear--for the same reason.  Stress has nothing to do with it.  The effect of stress on people's immune system is overrated; and in any case is far less than the effect of pregnancy on the immune system.)  

[verystressed07]

Yes, I am pregnant, 28 weeks along. I posted a message for you at the HIV forum on 5/11 because my husband cheated on me 7 weeks prior to that and I was exposed a little less than a week after he told me. I got tested at a little over 5 weeks post exposure and the results came back negative. I was relieved but still worried about seroconversion but you say that 90% of infected people test positive at 4 weeks and 99% at 6 weeks. It's reassuring even though there are exceptions. My husband had unprotected vaginal sex once with a woman he met online, as hard as it was for me, I forgave him and we went through 4 weeks of marital counseling. For one week my husband and I we were having protected sex but we later starting having unprotected sex because I realized I was exposed (possibly) once and he dislikes condoms. That woman claims she had no STDs and she got tested for HIV prior to meeting with my husband and she was negative. Hopefully this is all true because I've been a nervous wreck since that time. I started getting some small oral sores ever since I started stressing over that and the sores have been coming and going. From what I read about herpes sores on webmd.com herpes sores normally appear near the mouth and on the lip. Today I just saw a picture of a syphillis (syphilis) chancre on the mouth and that began to worry me. I intend to show my OB these sores. I also have some bumps on my inner things but I've had skin problems in the past and still do and I figure it's from my inner thinghs rubbing against each other when I walk. I work with children at a daycare center and I have to be on my feet a lot there. I asked my husband to get tested for HIV next month as that'll be the 12 week mark. I'm sure my OB will ask me to retest and maybe if my husband gets tested, I won't have to. Thank you very much for your patience and dedication to these forums.

[verystressed07]

and I forgot to mention my husband is not circumcised. Does that really increase the risk of him getting any STD's?

[H. Hunter Handsfield, M.D.]

Sorry, online forums are not what you need.  You need to speak frankly with your doctor about your fears.  There is nothing in any of this that suggests you have an STD.  You probably have a yeast infection, and that's probably all.

I won't have any further comments.  Feel free to take it over to the STD support forum if you wish.

[verystressed07]

I will bring all this to my OB's attention. I'm sure he'll tell me the same thing as you. He's the kind of doctor who will speak up if I had anything to worry about. Again, thank you for the reassurance. I did take a lot of my health issues to both the STD support forum and the HIV support forum but I thought it would be better to get the input from a doctor, especially one with your expertise. My donation was worth it.