Good afternoon doctors. I am a 27 year old heterosexual male and was diagnosed with genital herpes when I was 21. I have been in relationships since my diagnosis but I always tell my partners about my diagnosis before having sex. Here is the issue I'm having:
In the past year and a half or so, I have dated 4 different girls. I have had unprotected sex with all 4 of them, because we mutually agreed that we would take the chance of having unprotected sex when I don't have outbreaks. The strange thing is that all 4 of these girls have ended up having a strong, fishy-smelling vaginal odor that they did not previously have after engaging in intercourse with me. Considering that all 4 girls have ended up having this, it has led me to question if I am passing something to these girls that is causing them to have this odor? Am I giving them sort of yeast infection? Does it have anything to do with my herpes infection? What would you speculate is causing me to pass on this vaginal odor to my sexual partners, or is it merely coincidence? Thank you for time and the service you provide.
Welcome to the STD forum. Congratulations on a sober attitude and responsible management of your genital herpes with respect to your partners.
It is unclear from your question whether you are referring to odor immediately after sex, or if one of more partners later complained of onset of a vaginal odor problem. I think you mean immediately, however.
This phenomenon is very common and it likely means that at least some of your partners may have have bacterial vaginosis, the most common of all vaginal infections. (Or perhaps trichomoniasis, although that is statistically less likely because it is less common than BV.) Contrary to popular beliefs, yeast infections do not cause odor.
When certain bacteria grow to high levels in the vagina, which can occur either with overt BV or in borderline cases, they produce chemicals that smell fishy* become volatile -- i.e., released into the air -- when alkalized, i.e. with elevate pH (reduced acidity). Semen is alkaline. Therefore, a fishy odor immediately following sex is one of the most common symptoms of BV.
BV, including borderline cases, is sufficiently common that it's not particularly surprising that this happened with 4 consecutive partners. This does not suggest you are infecting them or that that you have any health problem of any kind. BV is not sexually transmitted, at least not in the usual sense, and women's partners typically have nothing wrong and do not need treatment.
If this symptom is bothersome to any of your partners, and especially if they have other symptoms -- especially odor not necessarily associated with sex or increased vaginal dishcarge -- they should see their health care providers. In addition, BV is more common in women who also have other STDs, so it would be a good idea for your partners to be examined and tested for common STDs (chlamydia, gonorrhea, and trichomonas in particular).
If an STD turns up in any of your partners, of course you will need to be examined, tested and perhaps treated. Otherwise, nothing need be done. However, another issue here is that you have had 4 different partners recently, all with unprotected vaginal sex. This alone puts you at substantial risk for STD, regardless of whether or not your partners have BV or anything else. Men with such lifestyles should have routine STD and HIV testing from time to time, like every 1-2 years. If it has been that long since you were tested, this probably is a good time to do it.
I hope this helps. Best wishes-- HHH, MD
* The chemicals in fact are identical to the ones that are responsible for all "fishy" odors, including the smell of decaying fish flesh. When you see the two of the names, you will never forget them: putrescine and cadaverine (no joke!).
On re-reading your question, I'm less certain you're talking about immediate onset of odor, but perhaps about your partners developing a vaginal odor problem in the course of your relationships with them. If so, this gets to one of the major uncertainties about BV: Where does it come from? Is it in fact a "real" STD, i.e. that the women catch something from their male partners?
Despite repeated research studies over 3 decades, the answers remain unknown. In some ways, BV behaves like an STD, e.g. increased rates in women who have multiple partners, when they have new partners, etc. In others, not: study after study has shown no consistent abnormalities in the male partners of women with BV, and treating male partners with antibiotics has no effect clearing up the women's infections or on recurrence of BV.
If this more accurately describes your situation, it would make sense for you to see a provider (such as your local health department STD clinic) for examination and STD screening. But most likely nothing will turn up.
Thank you for taking the time to answer my question in such detail, doctor. For clarification, the vaginal odor I was referring to was during and immediately after sex. I really never discussed the odor with any of my partners so I do not know whether or not they experienced it at other times when we were not having sex. One of my partners did mention to me that she noticed the strong odor while we were having sex, but I did not ask her if she noticed it at other times as well.
I will certainly take your advice regarding getting an STD screening. It has been probably 2 years or so since my last one, so I know I am definitely due, especially since my sexual lifestyle does put me at risk for catching something. I don't make a habit of sex without condoms, if I ever have a one night stand I ALWAYS use condoms, but if I am in a serious relationship then I usually have unprotected sex with that person, provided they are comfortable doing so given my positive genital herpes status. I really don't ever worry about catching HIV. I don't date drug users and I only have sex with women, so I figure I've got a better chance of an airplane landing on me than catching HIV.
Thank you for your information, it was very helpful. I will go and get an STD screening ASAP.
Your priorities are fine; there is nothing wrong with moving away from condoms in relationships that are (or are likely to become) committed for substantial periods of time. I wish more sexually active young persons mirrored your approach.
Still, the STD/HIV screening makes sense. But you can expect negative results.
As a brief update, I spoke tonight with the girl I am currently seeing and let her know that I had consulted with you about the vaginal odor issue. She told me that she only notices the odor when we have sex. During all other times, she does not notice any type of odor or any other abnormality.
I have a question with regards to my genital herpes infection, doctor. Over the years, my outbreaks have become much less frequent and less severe, and whenever I have gotten an outbreak, I have always told my partner and we have either abstained from sex or used a condom. We usually do this for a period of three weeks or so. I have often noticed, however, that even after my outbreak has healed and I am no longer experiencing any pain from it, small traces of the outbreak can still be seen in the area where the outbreak occurred, usually in the form of some tiny bumps in the area. Sometimes these bumps linger for quite a while, more than a month in some cases. My question is, in order to keep from infecting my partner, is it important to refrain from unprotected sex until these bumps have completely disappeared and there is no longer any visible trace whatsoever of the outbreak? Or is it safe to assume that there is no longer any active outbreak and it is OK to resume unprotected sex? Thank you for your info.
PS. I apologize if I am violating forum rules by asking this additional question. My current girlfriend requested that I ask it since we are confused on this particular issue and wanted to know your recommendation. If I am violating the rules please let me know and I will make another payment in order to ask the question. Thanks.
Avoiding sex around the time of symptoms helps reduce the risk of HSV-2 transmission, but does not prevent it entirely. You can be sure there are times when the virus is present without any symptoms whatsoever. Your partner probably is at less risk than would have been the case several years ago; the reduced frequency of your outbreaks probably means that periods of asymptomatic virus shedding also are less common. But some level of risk undoubtedly continues.
There have been lots of discussions about asymptomatic viral shedding and prevention of herpes transmission on this forum; use the search function to find them. But if you need more detail than this, you'll need to start a new thread, either on this forum or the herpes forum.
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