Just wanting reassurance

[marieuk]

Hi,

I know you get hundreds of posts similar to this but I just wanted some reassurance from a professional who obviously knows this subject area very well.
The concern I have is that I have been sexually active since 18, I am 23 now and have had regular STD tests all of which have come back negative. However, for the last six months, I have had regular discomfort in the vaginal region with soreness, aching, some abdominal pain and am often sore after sex. This is only recent and is accompanied by a daily creamy discharge which I assume to be yeast. I have taken pessaries and used creams and while they work for a little while, the discharge soon returns. I believe this to be reoccurent yeast and so am now taking acidophilus tablets. The question I have is could this be herpes? I have no cuts, lesions or blisters. I do have HSV-1 which affects my lips but have shown no similar symptoms to the ones I experience with HSV-1 in my genital region. The reason I am asking you this is because it's always in the back of my mind and have been refused a specific blood test. I have been with my current partner over 7 months, if I had HSV-2 would it be apparent. I know most cases don't display symptoms.
Thank you so much for reading and apologies for the length of my question.

[H. Hunter Handsfield, M.D.]

I'll try to help.  You describe nothing that sounds particularly like herpes or any other STD.  That said, you should not try to guess at the cause and treat yourself:  abnormal vaginal discharge is not to be taken lightly, and contrary to popular belief, increased vaginal discharge is not a usual symptom of yeast infections.  I cannot judge whether you in fact have yeast, some other vaginal infection (bacterial vaginosis, for example), or--less likely--chlamydia, gonorrhea, herpes, etc.  But herpes is not a likely cause of any of your symptoms.

For what it's worth, acidophilus tablets are witchcraft:  they have no benefit in preventing or treating vaginal yeast infections.  Well, not exactly witchcraft:  replacing depleted Lactobacillus bacteria in theory might help various vaginal infections.  But Lactobacillus acidophilis does not normally colonize the human vagina, and it has no effect whatsoever.  (It comes from cattle, not people!)  Active research is underway in an attempt to identify the right lactobacillus and make it into a useful treatment product, but no lactobacillus product currently on the market is known to provide any benefit against yeast infections or anything else.

Bottom line:  See your health care provider for proper evaluation.  In the meantime, I wouldn't be terribly worried that anything bad (or sexually acquired) is going on, but better safe than sorry.

Good luck--  HHH, MD

[marieuk]

When I had my first STD test about 3 years ago, I had recently come off the contraceptive pill and I was experiencing severe vaginal dryness and as a result had two minor cuts above my clitoris. I asked the Dr who examined me, could it be HSV-2 and she said the distribution of the cuts and the symmetry of them suggested not but she took a culture anyway and that came back negative. I sometimes also experience pains in my pubic hair region but I attribute that to shaving the area, is that feasible?
Last point promise, my current partner has been tested for STDs also and his results were all negative.
Many thanks, sorry for being a bit neurotic!!

[H. Hunter Handsfield, M.D.]

Still doesn't sound much like herpes.  But you can be tested for HSV-2.  I have no patience with providers who would "refuse" to test a patient who is concerned about herpes.  If your provider won't do it, find one who will.  This doesn't mean I think herpes explains your symptoms; I do not.