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1390055 tn?1365618655

Weird Genital Herpes Symptoms? Or something else?

Well hello. 23 year old homosexual male here. I have major depression, anxiety disorder, a lot of stress, ADD, ADHD, Hypochondria and/or Body dysmorphic disorder (BDD), and panic disorder (or paranoia).

Here's my sexual history so far.
- My last sexual contact was on May 5th, 2010 (or somewhere around there).
- May 12th, 2010: Tested positive on both HSV-1 and HSV-2 IgG and IgM.
- I had a RPR, HIV-1/2 Anti-Body, and Hep C RNA test ran on July 28th, 2010, all 3 were negative.
- I went to a health department on the August 2nd, 2010, and they ran a Syphilis IgG and another HIV-1/2 Anti-Body test (the HIV test was complimentary with the Syphilis IgG, as it was protocol to run both at the same time), and both came back negative.
- Chlamydia and Gonorrhea test ran on July 8th, 2010, both were negative.
- The only "STD" I have ever been diagnosed to be infected with is HSV-2, aka Genital Herpes.

Stress and anxiety levels are sky high at the present time, and I believe I am in constant outbreak, however, that is just speculation, because I haven't been diagnosed this by a doctor or anything. I don't have the classic outbreaks of genital herpes like I have read that everyone else gets. I don't get fever blisters or cold sores on around my penis. (However, I have been told I have Pearly Penile Papules). I was told by my previous Primary Care Physician that my outbreaks present when I get sores inside my urethra which is called "herpetic urethritis", which causes dysuria, aka urethra discomfort/pain, which has only once or twice been accompanied by discharge out of all of the countless outbreaks, and I was told the discharge was mucoid, which I was told means that my discharge is probably not being caused by bacteria. (And the tests ran on me confirm this, my previous Urine Samples are completely free of bacteria)

So, anyways, I experienced some weird testicle pain today in my right testicle...it came and it went, but the pain attacks happened about 3 times, I believe, the 3rd happening as I was typing this. I've tried checking my testes to see if one is bigger than the other or swollen, and at first one seemed bigger than the other, but I think I was just being crazy and I checked them again and they are pretty much the same size, it seems (but still I am not sure of this). The 1st pain attack was bad but ignorable, the 2nd was pretty bad (that was when I thought I noticed swelling), and the 3rd was some pain, not bad, and went away pretty fast (within 60 to 120 seconds). At some points during these pain attacks, my lower right abdomen hurt a bit as well, and I could feel it shooting up from my pelvis. Within the past couple of days, I've also had some urethra discomfort and pain that normally accompanies the Genital Herpes outbreaks. No discharge, or VERY little if any (I didn't notice any). Tests were ran back then and there were no Urinary Track Infections, and my doc did conclude that the discharge was also coming from the Herpes infection.

So, on to the question, ladies and gentlemen. Can Genital Herpes or any Herpes infection in general cause testicle pain? Or is this something else? Maybe psychological Prostasis from all of the anxiety? I have never had my current doctor look at Prostasis as a possibility, or is it possible this is just plain stress causing this?

Thanks for reading that huge wall of text there...thanks to anyone in advance who replies :)
38 Responses
101028 tn?1419606604
I'd stop the valtrex immediately. you don't want to be on it and trying to get accurate swabs done of symptoms. I'm sure you don't want to be doing the swabs multiple times to get better answers.  

the herpes igm test is a flawed test and we never recommend its use to diagnose herpes. not sure if your post you just typed igm when you meant igg or not.

you certainly do not have hsv2 on multiple body parts if you even have it at all.  I'd stop antivirals and even though it's a pain to do so , follow up every time you have symptoms both orally and genitally for a proper diagnosis.
897535 tn?1295210035
Sounds for the most part anxiety driven, as you suggested. I've heard Dr. Hook/Handsfield comment that there's no STD that causes testicular pain. Have you discussed all of this with your doctor? Have you considered talking to a therapist for your anxiety?

What were the numeric results of your IgG?
1390055 tn?1365618655
Actually from what I've read, Chlamydia can cause testicular discomfort/pain. But that has tested negative, of course.

I was seeing a therapist before I was diagnosed for stress and anxiety, but I quit therapy because I had a hold on the anxiety. But I have very recently re-entered therapy.

Both HSV-1 and HSV-2 IgG test were positive as stated, and the HSV-1 IgM was 5.01, HSV-2 IgM was 1.70. If you are referring to the Syphilis IgG, it didn't come with numeric results, but the doctor spoke with a lab tech at the lab who was directly overseeing my blood test, and they run a double check on it, and the lab tech said that Syphilis is currently not in my system, nor was it ever in my system. I think I have definitively waited past all of the window periods for my STD tests. Even though my last sexual contact was May 5th, 2010, my last penetrative intercourse encounter was on April 28th, 2010.

And I've spoken to several out-patient clinic doctors and my primary care physician about this testicle pain, but they never gave me a conclusive explanation. This was back in October of course, when I believe my herpes infection started (that's when the dysuria began), but it took about 15 to 20 out-patient and doctor's visits combined until May of this year before they got it right, and I even had to force it down their throats then to test me for HSV as well.

The testicular pain happens very seldom though, like maybe 2 or 3 times since October. It has me worried of course, I mean what male wouldn't be worried about it? Testicular cancer would not be a fun thing to have at 23, with herpes and all of this other crap going on.
897535 tn?1295210035
IgM is a flawed test for herpes and is never recommended. You should have been tested with an IgG type specific blood test.

Has your doctor suggested testicular cancer? Or is that your anxiety talking?

Even if you have herpes, your symptoms don't sound indicative of herpes. Pain in the absence of lesions is almost certainly not herpes. I'd continue to work with your doctor and a therapist to work through what could all be symptoms based on anxiety.

Lastly, you may want to consider Dr. Hook/Handsfield on the expert's STD forum. They tell it like it is.
1390055 tn?1365618655
I was tested with an IgG specific test as mentioned, Both HSV-1 and HSV-2 IgG tests were positive. My doctor has not suggested anything. My lesions are in my urethra from what I am told, and it is called "herpetic urethritis".
897535 tn?1295210035
You have it listed as IgM with the numeric values: "and the HSV-1 IgM was 5.01, HSV-2 IgM was 1.70" - that's where the confusion lies.

Your HSV2 result is a low positive and would need confirmatory testing with the Western Blot or Biokit. As to your HSV1 result, it's not shocking as about 60% of the adult population has oral herpes.

Did you have the urethral lesions cultured to confirm herpes? Only a swab/culture can confirm that diagnosis.
1390055 tn?1365618655
They ran two tests, IgG and IgM were run separate, all tests were positive. No viral cultures have been done, I asked them and they said performing them was not necessarily, because they said the prior tests and their diagnosis is conclusive.
897535 tn?1295210035
http://www.medhelp.org/posts/STDs/Confusiion-over-other-IgM-Herpes-posts/show/248394  is a former post by Dr. Handsfield that goes into details as to why the IgM test for herpes is a flawed test.

Your HSV2 is a very low positive, so you can't say you have HSV2 without the confirmatory test.  In the absence of a lesion culture, you also cannot say it's herpes.

But, in the end, you're asking if herpes causes testicular pain. No, it does not. As to saying you have HSV2, you cannot at this point based on the testing you've had done. Any good clinician would agree with that.
1390055 tn?1365618655
Ok so next time I go to the doctor, what are the name of the tests do I need her to send out to confirm that these are positive?
897535 tn?1295210035
Either a Western Blot or Biokit. Dr.Handsfield has a great post here about low positives and testing:

http://www.medhelp.org/posts/STDs/Confusing-Igg-Test-Results/show/771141%C2%A0
101028 tn?1419606604
testicular pain as you've described is not a symptom of herpes either. Have you been seen when you have it? have you received any treatment for it?  

your hsv2 igg definitely needs further testing. a Herpes WB is helpful or even a biokit hsv2 igg if you can get one done in a clinic near you.

next time you have your urethritis symptoms, you should be seen. They should be doing an urine test on you at that time. they also should be examining your prostate at that time too.  they also can do a urethral swab for herpes during them - I suggest pcr if you can get it.  also ask about a mycoplasma swab too.

have you been taking any antivirals at all during this time?

If you can get an urologist referral too ( not sure if your insurance makes you get referrals or not ), that also is in your best interest.

grace
1390055 tn?1365618655
I've been seen twice for the Urethritis symptoms since my diagnosis of HSV-2, and they did a urine test both times. No chlamydia or gonorrhea were detected (both PCR tests), no UTIs were detected, nor are there any other STDs detected in my system (this has been confirmed multiple times as well). The 1st urine test was done on May 20th, and the 2nd urine test was done on July 8th. There was also a urine test conducted a week before I was diagnosed with HSV-2, on May 5th, and I was negative for Chlamydia and Gonorrhea on that as well. I'll keep the Herpes PCR swab in mind and request a prostate exam on my next visit to the doctor, even though the two are very painful, and I speak from experience because I've been swabbed once before. It's not fun!

It seems to be that my urethritis symptoms occur after I experience a vast amount of stress (which was within the last week, and my testicle was in pain for a short while following that time). But the urethra pain usually doesn't follow until a few days after the stress (it varies, it can be as short as 24 hours, to as long as a week it seems), and any discharge comes the week following the peak of stress, but this has only happened to me once, which was after my diagnosis of HSV-2 on May 12th, which followed with a Chlamydia and Gonorrhea PCR on May 20th, which as I said before, came back negative. If I am having discharge right now, it's seldom, very little, very infrequent, or I am confusing it with ejaculate. The discharge I had back in May was either clear, or white. I also have no pain during ejaculation or urination. Afterward ejaculation, however (an hour and maybe for the rest of the day), there is pain that is sporadic in my urethra.

Yes, I am taking antivirals, Generic Valtrex. I have seen a urologist before I was diagnosed as having HSV-2, and he sent me away with a clean bill of health despite all that is going on, with the pain in my testicles, urethra pain, stuff like that. He ran a UTI check on me then as well, and it came back clean, too. I also had another Chlamydia and Gonorrhea test around then as well, and those tests came back negative. I have seen other doctors for the testicle pain, and they examined my testes, and they did not detect any abnormalities or lumps or anything of the sort.

I have also been seen for the back of my mouth being sore (around my tonsils), and I suspected that maybe I have HSV-2 in my throat around my tonsils that came from oral sex, but the doctors I have seen say that it looks like allergies after examination, and plus, I have read on here that Oral HSV-2 is very uncommon (but still, not impossible). The pain in the back of my mouth near my tonsils come and go. It's there one day, and then the next day, it's gone. Sometimes it will even be sporadic, like it will come and go in the same day, maybe even multiple times. While proofreading this, I even had a sporadic pain in the back of my throat around my tonsils, and it has already disappeared. That sounds very unusual for herpes, anyways. It could just be my tonsils screaming "TAKE ME OUT YOU IDIOT!"

Also, as stated above, Syphilis and HIV tests have been confirmed as negative multiple times (it's been tested monthly since May). There's also something called Trichomoniasis, but that is only caused by penis-to-vagina contact, or vaginal intercourse, and I have never had vaginal or heterosexual intercourse. However, I still asked for them to test for that as well, and the test was negative. It would have gone away by now if it was Trichomoniasis anyways.

So yeah, it seems to be as though this one is a real head-scratcher. No matter how hard I've been trying, I haven't been able to get to the bottom of this for the past year. I guess we will have to go to the extreme and do invasive tests to find out. It is unfortunate.
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