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STDs (Expert Forum)
What's Going On?
Answered by
University of Washington
Seattle - WA
Welcome to the STD Forum, which 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.
What's Going On?
by PC4447, Jun 19, 2006 12:00AM
Hi-
Last October, I had unprotected oral and vaginal sex with someone whom I have known for years. I wasn't able to shower for several hours afterward. A few days after that, I developed what felt like a pretty bad cold for around 72 hours. Two weeks after the sexual encounter, my partner told me that she had herpes. Four days after that, I began to experience soreness in my penis; a few days after that, I began to notice small bumps on my shaft. I assumed that I had contacted the disease and began taking Valtrex daily for suppression.
Oddly, the bumps never formed into blisters, nor did they go away. They still haven't. More seem to be popping up with time -- they're small and round, not terribly noticeable unless I have an erection (at which time they're quite apparent). They're pretty well spread out, though there are some clusters. About half of them are situated at the base of a pubic hair. The pain has continued as well; several times a day, I experience soreness in my shaft. It's more noticable when I sit. I've also noticed that the veins in my penis are far more pronounced than before.
I began talking to doctors to see why my "outbreak" didn't go away. None of them thought that I had herpes (as my symptoms didn't go away or look like herpes, and herpes doesn't tend to cause the pain I described). After waiting enough time for antibodies to develop (5 months), I took a HerpeSelect blood test, which came out completely negative for HSV-1 and 2. I stopped taking Valtrex upon receiving those results. I've also tested negative for syphilis and HIV. I went to an infectious disease specialist; he (as much as he could) ruled out the possibility of my having an STD. Unfortunately, none of them knew what was going on. I've taken antiboitics, but they didn't do anything.
Here are my questions:
1) Is it possible that I contacted herpes and couldn't develop antibodies for it, which is why my symptoms won't go away?
2) What could be causing the pain in my penis?
3) Do you think this could be a hair follicle infection? If so, is there anything I can do about it? How about some kind of fungal infection?
4) Could my symptoms have been originally caused by stress? Could stress be the reason my symptoms have persisted for so long (I highly doubt this, but it's worth asking)?
5) And, generally, what's going on and what should I do about it?
I'm obviously very upset about this. I just want to know if whatever I have will eventually go away. I can't thank you enough for offering this service. Best to you.
Last October, I had unprotected oral and vaginal sex with someone whom I have known for years. I wasn't able to shower for several hours afterward. A few days after that, I developed what felt like a pretty bad cold for around 72 hours. Two weeks after the sexual encounter, my partner told me that she had herpes. Four days after that, I began to experience soreness in my penis; a few days after that, I began to notice small bumps on my shaft. I assumed that I had contacted the disease and began taking Valtrex daily for suppression.
Oddly, the bumps never formed into blisters, nor did they go away. They still haven't. More seem to be popping up with time -- they're small and round, not terribly noticeable unless I have an erection (at which time they're quite apparent). They're pretty well spread out, though there are some clusters. About half of them are situated at the base of a pubic hair. The pain has continued as well; several times a day, I experience soreness in my shaft. It's more noticable when I sit. I've also noticed that the veins in my penis are far more pronounced than before.
I began talking to doctors to see why my "outbreak" didn't go away. None of them thought that I had herpes (as my symptoms didn't go away or look like herpes, and herpes doesn't tend to cause the pain I described). After waiting enough time for antibodies to develop (5 months), I took a HerpeSelect blood test, which came out completely negative for HSV-1 and 2. I stopped taking Valtrex upon receiving those results. I've also tested negative for syphilis and HIV. I went to an infectious disease specialist; he (as much as he could) ruled out the possibility of my having an STD. Unfortunately, none of them knew what was going on. I've taken antiboitics, but they didn't do anything.
Here are my questions:
1) Is it possible that I contacted herpes and couldn't develop antibodies for it, which is why my symptoms won't go away?
2) What could be causing the pain in my penis?
3) Do you think this could be a hair follicle infection? If so, is there anything I can do about it? How about some kind of fungal infection?
4) Could my symptoms have been originally caused by stress? Could stress be the reason my symptoms have persisted for so long (I highly doubt this, but it's worth asking)?
5) And, generally, what's going on and what should I do about it?
I'm obviously very upset about this. I just want to know if whatever I have will eventually go away. I can't thank you enough for offering this service. Best to you.
Doctor's Answer
by H. Hunter Handsfield, M.D., Jun 19, 2006 12:00AM
, Jun 19, 2006 12:00AM
The penile bumps you could not have been herpes, which simply never causes persistent lesions. Herpes always heals over 1-3 weeks; it they can recur, but between outbreaks the skin is totally normal in appearance. HerpeSelect test result prove you don't have it. Add the fact that your providers, including an ID specialist, don't think you have it. (It was a mistake for you to treat yourself, or for a doctor to prescribe Valtrex for suppression, without confirming the diagnosis. Nobody ever recommends suppressive therapy until someone has been infected long enough to be certain of the diagnosis and to see if recurrences are going to be a problem.)
To your specific questions:
1) No, contracting herpes and not developoing antibodies is not an explanation. The clinical course of herpes (persistence, recurrence, etc) is no different in people who have antibodies and the rare people who do not.
2, 3) You'll have to follow up with your own providers about your pain. I cannot guess the cause, exept I'm sure it's not herpes or any other STD. Someone who actually has examined you will have to judge the possibilities of folliculitis, fungal infection, or other causes.
4, 5) Stress cannot cause visible bumps in the skin, but it might affect your judgment of them, which might just have been normal anatomic variation). And stress might be a good bet for unexplained genital pain. You're in a better position than I am to judge your own susceptibility to anxiety-related symptoms. However, that you bring it up yourself also raises my suspicion of it.
If you haven't done so, consider visiting a dermatologist. But in any case, you can be confident you have nothing serious and I don't think you have anything you should be so upset about. Here is an exerpt from a reply I gave several months ago in response to a question not unlike yours. I recycle it from time to time. You should consider whether it applies to you:
"It is a fact of life that human beings get various aches and pains. Out of the blue there is knee pain, a headache, abdominal discomfort, a stich in the side, tingling down a leg. Sometimes such problems are continuing or recurrent, yet no specific cause ever is found and clearly no important infection or disease is present.
Why should the genital area be any different? Not every symptom means disease. People with such symptoms of course should see a health care provider. But when a comprehensive evaluation comes up with no good explanation for genital symptoms, and if they persist after treatment of the potential infectious causes, it is wrong to assume a serious health problem. Just as some people have to learn to live with unexplained but benign headaches or abdominal pain, others have to live with unexplained genital symptoms.
Our genitals have a special place in our psyches, and unexplained discomfort can be harder to ignore than a painful joint or even a headache. But the principle holds. It's fine to look for harmless things that might help control symptoms. But potentially harmful treatments (e.g., repeated high doses of antibiotics, potent pain controllers) make no sense, and doctor-shopping (or internet shopping) for different answers generally is fruitless."
Good luck-- HHH, MD
To your specific questions:
1) No, contracting herpes and not developoing antibodies is not an explanation. The clinical course of herpes (persistence, recurrence, etc) is no different in people who have antibodies and the rare people who do not.
2, 3) You'll have to follow up with your own providers about your pain. I cannot guess the cause, exept I'm sure it's not herpes or any other STD. Someone who actually has examined you will have to judge the possibilities of folliculitis, fungal infection, or other causes.
4, 5) Stress cannot cause visible bumps in the skin, but it might affect your judgment of them, which might just have been normal anatomic variation). And stress might be a good bet for unexplained genital pain. You're in a better position than I am to judge your own susceptibility to anxiety-related symptoms. However, that you bring it up yourself also raises my suspicion of it.
If you haven't done so, consider visiting a dermatologist. But in any case, you can be confident you have nothing serious and I don't think you have anything you should be so upset about. Here is an exerpt from a reply I gave several months ago in response to a question not unlike yours. I recycle it from time to time. You should consider whether it applies to you:
"It is a fact of life that human beings get various aches and pains. Out of the blue there is knee pain, a headache, abdominal discomfort, a stich in the side, tingling down a leg. Sometimes such problems are continuing or recurrent, yet no specific cause ever is found and clearly no important infection or disease is present.
Why should the genital area be any different? Not every symptom means disease. People with such symptoms of course should see a health care provider. But when a comprehensive evaluation comes up with no good explanation for genital symptoms, and if they persist after treatment of the potential infectious causes, it is wrong to assume a serious health problem. Just as some people have to learn to live with unexplained but benign headaches or abdominal pain, others have to live with unexplained genital symptoms.
Our genitals have a special place in our psyches, and unexplained discomfort can be harder to ignore than a painful joint or even a headache. But the principle holds. It's fine to look for harmless things that might help control symptoms. But potentially harmful treatments (e.g., repeated high doses of antibiotics, potent pain controllers) make no sense, and doctor-shopping (or internet shopping) for different answers generally is fruitless."
Good luck-- HHH, MD
