What's wrong with me? It can't just be anxiety.

[BadDay1972]

Hey Doc,

I don't know if you remember me but i wrote awhile back about unprotected sexual encounter i had early march with a woman i didnt know. I had tingling in my penis 1 week after and irritation of my meatus and very sore testicles. I had flu about 11-14 days after the encounter lasted about 1 week. Went to STD clinic and they told me it was maybe yeast. Tested neg for chlamydia, ghonoreah and syphillis. This and flu went away after a week or two...no visible sores. I thought for sure I had herpes. 2 months later I had a bump on very base of my penis near pubic hairs that i popped - don't think it really seemed like a blister...but i scraped it off and it left a little crater for a few days but i'm almost positive that there was a hair in the middle of it...didn't hurt at all and you told me it was probably just an ingrown hair.

In mid july I received protected oral sex w/out ejaculation and unprotected masturbation w ejaculation from a stripper. In mid August I began to feel the same tingling feeling in the tip of my penis but w intense burning in my genital area and clear discharge from my penis lasted a few days. tingling went on for about 5 days or so. Went to clinic they were able to get a tiny bit of discharge out of penis but couldn't find anything although the clinician said i probably had infection because my lymph nodes were apparently swollen. Again, tested negative for chlam and ghon...

So, I went to Planned Parenthood and had HSV blood test about 24 weeks after unprotected sex exposure (august 13th - when symptoms began) Came back pos for hsv1 (i get cold sores on lip) and neg for hsv2 .05 - they told me it was herpeselect. So, then I went to a urologist 2 weeks later and he told me it could only be herpes because of tinging and had me take another blood test through quest...again, pos for hsv1 and neg for hsv2 igg (i think herpeselect). They also tested me for hsv igm which was undetectable.

Symptoms finally went away after a week but now since Nov 4 they are back again. Same symptoms started saturday - itching, burning in genital area - especially on the penis(not at all when i urnitate), irritated meatus - looks red and somewhat bubbly, clear discharge from penis that has subsided over the past few days and just overall irritation in my genital area - sore testicles. Also burning feeling and tingling in my right calf and a weird tingling feeling on my head almost on my hair - it feels very weird. Please answer my questions.

1Are my herpes results accurate or should i retest 1 more time because of oral encounter with the stripper? Or can I put that virus to rest and it?

2Do u think the flu I had was just a coincidence? I had tingling/rub burn feeling in a few spots on my lower back when i had the flu - where those herpes symptoms?

3What else could i possibly have if not herpes, chlam, ghon or syphillis? Could it be NGU? Do untreated bact infections reoccur?

4Where should i go? STD clinic?

5Whats the burning?

Help!

[H. Hunter Handsfield, M.D.]

Despite the title you chose for this question, an emotional origin for you symptoms is by far the most likely explanation for your symptoms.  Despite what the urologist said, herpes simply does not cause such symtoms:  never, period, full stop.  (The urologist clearly was reaching for a possible explanation, not making a specific diagnosis; s/he probably found it easier to speculate about herpes than to confront you with the mental/emotional probabilities.)

1) There is no reason to suspect your herpes blood test results are wrong.

2) Of course the flud was a coincidence.  Or maybe you caught a respiratory virus from your sex partner.  But nothing to suggest herpes.

3, 5) See comments above about emotional/psychological origins.

4) Mental health professional.  Your symptoms are absolutely classical for genitally-focused physical symptoms of anxiety, depression, or any number of psychological issues.  There is no point in further STD testing.

In the meantime, the first step in either resolution of your symptoms, or in your learning to live with them, is that you can be 100% confident you have no medical condition that will ever harm you or a future sex partner.  Just go on with life. Some people just live with back pain, unexplained joint or abdominal pain, or headaches.  Same for genital discomfort. Not all symptoms mean disease.

Good luck--  HHH, MD

[BadDay1972]

Dr.,

I don't understand why you think this is all linked to my "anxiety" of stds. When the majority of these symptoms started in the middle of august I was not even remotely thinking about stds. So, how could anxiety be the cause of all my symptoms - the burning, red meatus, sharp pains down the leg, sore groin, abdomen pain, discharge, etc.? I also forgot to mention that after a while 3 or 4 tiny flat brownish dots developed scattered on my penis - they dont hurt or itch but they spontaneously appeared - does that sound like anything? There has to be something else behind it. Terri Warren from webmd suggested to have the discharge checked for other causes that could be ngu but of course i don't have discharge now. These symptoms seem to recur every couple of months or so. Wouldn't herpes be the only std that would cause recurrences??? I took your advice last time about forgetting about it as you suggested that it was just anxiety. Didn't even think about STDs anymore and the symptoms came back...what am I supposed to do? It's hard to just "live with the symptoms" when you have a loved one that you desperately do not want to infect.

I'm sorry to be so blunt but it seems like you too are settling with anxiety as my explanation for my symptoms. The thing is...the symptoms are real! So, I'll end with this...please, as an expert, doctor and professional tell me whether or not i should have further testing done for any std...or should i see a urologist, etc. etc for other possible causes. Or, do you truly believe in you heart that I have something that will just subside on its own and I can forget about ever infecting my girlfriend with something that could harm her? Hope to hear good news from you soon.

Thank you again.

[monkeyflower]

Your symptoms can most definitely be due to anxiety yet totally real. Why not consider the possibility, and seek therapy? If nothing else, you're still clearly dealing with what seems to be lots of anxiety and guilt. Talk with someone. It can help.

[fed up 25]

From the sound of your anxiety your probably married. If so the only way to feel better is to tell your wife or you will do this for the rest of your life

[H. Hunter Handsfield, M.D.]

There is nothing in your story that is inconsistent with a psychological origin of your current symptoms, including when and where they started.  And nothing in your description is particularly suggestive of any STD, especially since you have already had a comprehensive evaluation that didn't find anything--notwithstanding the comment you attribute to my colleague and close friend, Terri Warren.  Psychologically generated symptoms are every bit as real as those attributed to physical causes.  It's probably not so much that anxiety etc create symptoms out of the blue, but psychological factors certainly magnify minor symptoms or otherwise normal body sensations.

My original response already expressed my opinion and advice "as an experrt, doctor and professional", and I don't think I can state it more clearly than I already did:  "You can be 100% confident you have no medical condition that will ever harm you or a future sex partner. Just go on with life. Some people just live with back pain, unexplained joint or abdominal pain, or headaches. Same for genital discomfort. Not all symptoms mean disease."

HHH, MD

[BadDay1972]

Thanks Doc,

It looks like you've concluded that I don't have any stds and that this is stemming from anxiety. So, I guess my last questions are:

1) Should I stop worrying that I have any stds even though they only tested me for the more common stds (not ngu, trich, etc)?

2) Should I put herpes out of my head with the 24 week negative despite the symptoms that recurr every couple of months or should I get one last test now that I am 36 weeks out from the original exposure?

3) What should I do if I completely put stds out of my mind and the symptoms come back yet again in another couple of months?

4) From what I've told you about my genital symptoms (which I forgot to tell you included frequent urinitation at night with little emptying when I first felt everything 9 months ago - my doc told me that was just because i was nervous) can I FINALLY put any chance of having an std out of my mind?

Thanks again.

[H. Hunter Handsfield, M.D.]

To repeat from my initial response:  "You can be 100% confident you have no medical condition that will ever harm you or a future sex partner. Just go on with life. Some people just live with back pain, unexplained joint or abdominal pain, or headaches. Same for genital discomfort. Not all symptoms mean disease."  The answers are 1) Yes.  2) Yes. 3) Nothing.  4) Yes.

I won't have any further responses on this thread.

HHH, MD