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Stuck Traveling - Need Help/Advice
Dear Dr.s - I have looked at other threads & seen related topics but no answer to this yet, so appreciate your help.
I am on a multi week sales trip. About 2 weeks ago, I woke up feeling off - my lower abdomen felt slightly distended & the skin outside my vagina was sore. After that, my vulva became quite inflamed & a thick white, discharge developed (no smell). I got a Diflucan prescription on a phone consult.
The 2 prior events that probably matter were 1) unprotected sex with my boyfriend for the 1st time 10 days before and 2) a bath in a hotel bathtub that probably wasn't the cleanest the night before (not sure if this matters but seems possible). Plus I’ve been traveling a lot and tired. I took 150 mg Diflucan 6 days ago.
The pill cleared up the discharge and the redness diminished, localizing to my left labia. When things cleared up on that side (4 days ago), two creamy white ulcerous sores were left. The redness reduced down to a halo extending out maybe a quarter inch from the sores - recently 2 new smaller white sores appeared with red skin around them - one in the fold of skin underneath my clitoris (ouch) and one in the fold under my vagina. The discharge is back too - lighter and more watery then before. No fever, no flu, no noticeable swollen lymph nodes. The initial sores don't seem to be going away though - still creamy & white looking on red skin 4 days later. They hurt when the skin is moved or if urine touches them.
I am getting very freaked out. I don't know if this is the yeast or if I need to be worried about herpes. I did stop eating sugar and found some acidophilus - but it doesn’t seem to be helping.
I have another 10 days of travel ahead. I am getting terribly stressed.
I would really appreciate your help: 1) what does this sound like? 2) are there any serious risks I need to be worried about in the next 10 days? and 3) is there anything I can do to manage this until I can get to a professional?
Thank you.
I am on a multi week sales trip. About 2 weeks ago, I woke up feeling off - my lower abdomen felt slightly distended & the skin outside my vagina was sore. After that, my vulva became quite inflamed & a thick white, discharge developed (no smell). I got a Diflucan prescription on a phone consult.
The 2 prior events that probably matter were 1) unprotected sex with my boyfriend for the 1st time 10 days before and 2) a bath in a hotel bathtub that probably wasn't the cleanest the night before (not sure if this matters but seems possible). Plus I’ve been traveling a lot and tired. I took 150 mg Diflucan 6 days ago.
The pill cleared up the discharge and the redness diminished, localizing to my left labia. When things cleared up on that side (4 days ago), two creamy white ulcerous sores were left. The redness reduced down to a halo extending out maybe a quarter inch from the sores - recently 2 new smaller white sores appeared with red skin around them - one in the fold of skin underneath my clitoris (ouch) and one in the fold under my vagina. The discharge is back too - lighter and more watery then before. No fever, no flu, no noticeable swollen lymph nodes. The initial sores don't seem to be going away though - still creamy & white looking on red skin 4 days later. They hurt when the skin is moved or if urine touches them.
I am getting very freaked out. I don't know if this is the yeast or if I need to be worried about herpes. I did stop eating sugar and found some acidophilus - but it doesn’t seem to be helping.
I have another 10 days of travel ahead. I am getting terribly stressed.
I would really appreciate your help: 1) what does this sound like? 2) are there any serious risks I need to be worried about in the next 10 days? and 3) is there anything I can do to manage this until I can get to a professional?
Thank you.
MEDICAL PROFESSIONAL
Welcome back. I'm sorry to hear the diagnosis was confirmed, but obviously not surprised.
Almost certainly this is your first HSV infection. It could be either HSV-1 or HSV-2; the test from the swab probably will tell, but if not, the blood tests will. (If both swab and blood are negative, you'll need to have another blood test in a few weeks, expecting it to become positive to one type or the other.) In other words, probably your boyfriend is infected. Up to half the population (in the US) has HSV-1, usually orally, often without symptoms -- so in that sense, your partner might not have an STD at all. Or he could have an asymptomatic genital HSV-2 infection, from some past partner. Up to 20% of all people have HSV-2, and most of them also have no symptoms.
As for figuring out "what to say": Just be straightforward, calm, and non-accusatory. He'll probably be as upset as you are. As it happens, I just addressed this issue in more detail in a new question that I answered just a few minutes ago. Please read that thread: http://www.medhelp.org/posts/STDs/vaginal-sore/show/1108188
In addition, use the search link for lots of other information (try entering terms like "initial herpes"). Also take advantage of MedHelp's excellent herpes community forum, where the moderators are genuine expert herpes counselors. You'll find many discussions about talking with partners. Finally, try looking at the information available from the American Social Health Association (www.ashastd.org) and the Westover Heights Clinic of Portland, OR (www.westoverheights.com). (Full disclosure: Dr. Hook and I serve on ASHA's Board of Directors, and WHC is run by Terri Warren, who moderates MedHelp's herpes forum).
Almost certainly this is your first HSV infection. It could be either HSV-1 or HSV-2; the test from the swab probably will tell, but if not, the blood tests will. (If both swab and blood are negative, you'll need to have another blood test in a few weeks, expecting it to become positive to one type or the other.) In other words, probably your boyfriend is infected. Up to half the population (in the US) has HSV-1, usually orally, often without symptoms -- so in that sense, your partner might not have an STD at all. Or he could have an asymptomatic genital HSV-2 infection, from some past partner. Up to 20% of all people have HSV-2, and most of them also have no symptoms.
As for figuring out "what to say": Just be straightforward, calm, and non-accusatory. He'll probably be as upset as you are. As it happens, I just addressed this issue in more detail in a new question that I answered just a few minutes ago. Please read that thread: http://www.medhelp.org/posts/STDs/vaginal-sore/show/1108188
In addition, use the search link for lots of other information (try entering terms like "initial herpes"). Also take advantage of MedHelp's excellent herpes community forum, where the moderators are genuine expert herpes counselors. You'll find many discussions about talking with partners. Finally, try looking at the information available from the American Social Health Association (www.ashastd.org) and the Westover Heights Clinic of Portland, OR (www.westoverheights.com). (Full disclosure: Dr. Hook and I serve on ASHA's Board of Directors, and WHC is run by Terri Warren, who moderates MedHelp's herpes forum).
MEDICAL PROFESSIONAL
Welcome to the STD forum.
The most common cause of genital ulceration is herpes, so that has to be a signficant consideration. And some of your other symptoms are consistent with an initial herpes infection, including pain when urine contacts the lesions and "thin" vaginal discharge. On the other hand, the initial problem almost certainly was a yeast infection; your symptoms were typical and they largely resolved on treatment that is effective for yeast but nothing else --- and severe yeast infections can relapse after diflucan and sometimes can cause ulcertation.
I have no advice that can safely tide you over for 10 days. This needs medical attention now, both for proper diagnsosis and decent treatment. If your have herpes, the tests work best when done early in the infection; and treatment probably won't work at all unless started within the next few days. You don't say where you are traveling. But unless you are deep in the jungle, you should be able to take half a day from your work related travels and find a competent health care provider. The local or state health department should be able to help; or call the local medical society and find a gynecologist, perhaps one who specialized in infectious diseases.
Good luck-- HHH, MD
The most common cause of genital ulceration is herpes, so that has to be a signficant consideration. And some of your other symptoms are consistent with an initial herpes infection, including pain when urine contacts the lesions and "thin" vaginal discharge. On the other hand, the initial problem almost certainly was a yeast infection; your symptoms were typical and they largely resolved on treatment that is effective for yeast but nothing else --- and severe yeast infections can relapse after diflucan and sometimes can cause ulcertation.
I have no advice that can safely tide you over for 10 days. This needs medical attention now, both for proper diagnsosis and decent treatment. If your have herpes, the tests work best when done early in the infection; and treatment probably won't work at all unless started within the next few days. You don't say where you are traveling. But unless you are deep in the jungle, you should be able to take half a day from your work related travels and find a competent health care provider. The local or state health department should be able to help; or call the local medical society and find a gynecologist, perhaps one who specialized in infectious diseases.
Good luck-- HHH, MD
Dear Dr Handsfield - Thank you for your response. Am sorry I didn't thank you earlier but this is terribly upsetting. I was able to find a clinic & got tested (blood test & swab). I am still waiting for the HSV results but everything else is clear and the clinic said HSV is almost definitely the problem & gave me acyclovir. Everything has cleared up since then.
This is devastating news & I am trying to figure out how to get through it & how to talk to my boyfriend. He swore he had never had any stds but I haven't either - at least I thought - am now finding the tests I took didn't include HSV. Had a couple yeast infections in college (20+ yrs ago) but no other problems since then. I haven't had unprotected sex since my last long term relationship which was 8 years long & ended 12 years ago. How likely is it I have carried HSV unknowingly for 12+ years & it is just now showing up in an unrelated coincidence - 2-3 weeks after having sex the 1st time with my new boyfriend? That seems wildly unlikely to me - but is it possible?
We've been dating for 6 months and, though we had kissed & played around a lot, I had turned down sex a couple times b/c he didn't want to use a condom. He had a vasectomy & said he had lost some feeling due to that. I am getting ready to go home now and have to face talking to him and I can't figure out what to say (I haven't told him what's been going on yet).
Thanks for your help. Everytime I think about this I start crying and can't stop.
This is devastating news & I am trying to figure out how to get through it & how to talk to my boyfriend. He swore he had never had any stds but I haven't either - at least I thought - am now finding the tests I took didn't include HSV. Had a couple yeast infections in college (20+ yrs ago) but no other problems since then. I haven't had unprotected sex since my last long term relationship which was 8 years long & ended 12 years ago. How likely is it I have carried HSV unknowingly for 12+ years & it is just now showing up in an unrelated coincidence - 2-3 weeks after having sex the 1st time with my new boyfriend? That seems wildly unlikely to me - but is it possible?
We've been dating for 6 months and, though we had kissed & played around a lot, I had turned down sex a couple times b/c he didn't want to use a condom. He had a vasectomy & said he had lost some feeling due to that. I am getting ready to go home now and have to face talking to him and I can't figure out what to say (I haven't told him what's been going on yet).
Thanks for your help. Everytime I think about this I start crying and can't stop.
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
