Questions about std testing

[pr2]

Hello Doctor,

Over the last 6 weeks I have had vaginal inflammation and soreness. I went to the doctor and was tested for HIV, gonherrea, chlymadia, trich, bacterial vaginitis and yeast. While the doctor did acknowledge I looked very inflamed, she couldn't pinpoint why and said it was probably nothing to worry about. Two weeks passed and I still wasn't feeeling better so I had another BV panel done and gonherrea and chlymadia done as well, all negative. I also independently took a urine test for gonherra and chlymadia two weeks ago. I also had a herpeselect antibody test done a few days ago that came back negative for 1 and 2. I am married and the last time I had unprotected intercourse with my husband was a little over 12 weeks ago, the rest of the time it was protected. I asked the doctor about herpes and she said I didn't have it because I have no lesions or sores.

My questions are:
1. Is it possible to have false negatives on cultures for trich, gonherrea and chlymadia????? I have had them done twice, along with the urine test. Do I need to test again???

2. Is herpes antibody testing accurate??? I have read on this forum that sometimes it can't be.

3. My husband has HSV 1 and would like to get tested for HSV 2. Because he has 1, will that effect the outcome of the antibodies test??? Could he not show antibodies for hsv2 because he already has 1???


I appreciate you taking the time to answer my questions. Thank You.

[Edward W Hook, MD]

The BV panel is not a perfect test but having had it three times makes it rather unlikely that it would miss what is going on with you three times running.  

A Pap smear is the test for abnormal cells that allows health care providers  to detect precancerous lesion early so they can be treated.  It is done during a pelvic examination.  Tests for the STDs you mention are also done during pelvic examinations.

At this point, I think the right thing to do is to continue to work through this with your docter.  There may be some trial and error needed.  EWH

[pr2]

Sorry doctor, one more question. Is a vaginal culture the same thing as a pap test??? I have been reading that pap tests for yeast, trichomonas and bacterial vaginosis are not that accurate. I just know that I had a culture done each time that was sent to the lab, my doctor never said pap test she just said culture.

Thanks.

[pr2]

Thank You for getting back to me. Is there any other testing for trichomonas other than a vaginal culture??? I have tried to change all my scented products etc-laundry detergent, switched from Ivory to Dove Soap, tiolet paper with no luck. I'm sorry I should have mentioned that I have had the-BV panel ( bacterial vaginitis, trichmonas, yeast)  tested 3 times(vaginal culture) in the last 6 weeks as well. Possible to keep missing it???
If its allergic reaction I can live with it but I worry like you mentioned that possibly it is something that is difficult to detect.

[Edward W Hook, MD]

It sounds as though the irritation you note has been present for all or most of the past 6 weeks.  If that is the case, that is somewhat helpful in sorting this out (see below). Before I address your questions, let me tell you what I got from your post, then go on to the questions.

You've been tested three times for gonorrhea and chlamydia.  Therefore, you can forget about them.  Similarlry, I would not worry that this is herpes.  The symptoms of herpes go away after about three weeks even for first episodes and are still shorter for recurrences. Thus the duration of your symptoms makes herpes unlikely too.  My guess is that, if it is an infection, it is most likely to be either trich, a hard to detect fungal infection or bacterial vaginosis.  As for trichomonas infections, they can be missed from time to time.  The tests performed for trich in most settings are not as sensitive as most other tests.  Similarlry yeast and BV can sometimes be a bit tough.  

Finally, I worry that there may be something else.  Are you taking any medications, using a ****** of some sort, or other scented products?  An allergic reaction to any of the above could also be causing these problems.

Now to your questions:

1.  See above.  You don't have gonorrhea or chlamydia. Trich could be a possiblity.
2.  In this setting, believe the HerpeSelect.   Herpes doesn't fit with what's going on here.
3.  If he is tested with the HerpeSelct the answers are usually reliable.

Finally, with this kind of problem, you need to work with your helath care provider to get it sorted out.  There may be some trial and error involved.

I hope this helps.  EWH