Continous Outbreaks are perplexing

[Rae1111]

I have been infected with herpes for over 25 years and it was never really a problem.  In the past, my outbreaks (OB) were very mild and would only occur about twice a year – no big deal.  The OB would heal up and disappear after 7 days.  This has recently changed.   About 3 months ago, I noticed red itchy small bumps on the right external side of the vagina.  Initially I did not think it was an outbreak since it did not look or feel the same.  There were a lot of bumps – but small –more like a rash.  Eventually a few of them started looking like herpes blisters– only  smaller then they were in the past.    Since then, these bumps/herpes keep healing and then re-appearing somewhere else – always on the outside of my vagina.    Initially the OB was staying on the right of my vagina.  After about a month, the OB moved over to the left side. Now it just sporadic – sometimes the left side, sometimes the right side or sometimes on my inner thigh.  Most of the time, there is no blisters – just a red bumps (like a mosquito bite).  They usually disappear after about a day or two and then another one appears somewhere else.     I went to the doctor where he felt it was probably a herpes OB and gave me a prescription for  a daily dose of Valtrex.   I tried the Valtrex for about 1 month - but stopped since it did not seem to make any difference in the OBs.   I am in good health and have been tested for other STD’s – which all came back negative.  I am wondering if this has something to do with my ago (50) and that I am currently going though menopause.   When these OBs first started, I was experiencing all the symptoms of menopause; ei night sweats, vaginal dryness etc.  I have since started using the patch (hormone therapy).  It cleared up the menopause symptoms – but I am still having continuous herpes outbreaks.  I have not had any sexual activity since this has started 3 months ago. Any ideas what this can be or what I should do?  

[Terri Warren, RN, Adult Nurse Practitioner]

Neither can I, but the first step is to rule herpes in or out.  It could be a bacterial infection, a fungal infection, other things, but since you HAVE herpes, you need to rule out herpes first, I believe.

Terri

[Rae1111]

Thank you Terri.  I will go back to the doctor for another swab test.  He did do some sort of swab before - and it came back negative, but I assumed it was because he took the swab from the inside of my vagina and the bumps were on the outside.  I will ask for the PCR as you have recommended.  I have been off the Valtrex for about two weeks now so it should be out of my system.

This is just so strange.  I can't imagine what else this could be.

[Terri Warren, RN, Adult Nurse Practitioner]

The things you are describing as outbreaks really don't sound like outbreaks to me.  I think the best way to sort this out is for your provider to do a swab test for herpes from the rash - a PCR is the best one.  But come off of the Valtrex before you do that or it will confuse the results.

I don't think it is a herpes outbreak because
1) it is distinctly different from outbreaks that you have had before
2) it is lasting a very long time
3) herpes outbreaks don't come and go in a day or two
4) Valtrex didn't make a difference.

Try to get swab tested

Terri