Yeast or herpes?

[Confused8]

I know you have answered several questions on yeast or herpes but mine is a little different.  I have been in a monogamous relationship for several years.  We recently separated for a short time and I had sex with someone else.  We used protection however the condom broke.  Didn't notice at first so were probably unprotected for 2-5 minutes.  About 2-3 days later, I noticed typical yeast infection symptoms (irritation and burning with some itching and a little discharge).  I chalked this up to hormones since I used a morning after pill the day after the incident.  I always get yeast infections when starting birth control pills.  Used Monistat 1 and it cleared up pretty much right away.  I didn't really think twice about it and resumed sex with my normal partner when we got back together.  I have never noticed any "typical" herpes symptoms and don't think that the person was high risk for any STDs (not many partners, practices safe sex), but with herpes I guess you never know.  Now, about 10 weeks after the incident, I have another yeast infection which has me a little concerned.  Same symptoms as last time.  I chalked this one up to a lot of oral sex but now I am starting to get really worried the more I have read on herpes.  I took a Diflucan on Sunday night and the symptoms seemed to have improved but aren't completely gone yet but it says it can take 5 days.  I am going to get tested (Herpeselect), probably today, but wanted to see what you thought.  Does this sound like yeast or herpes?  A slight twist to all of this is about 1 1/2 weeks after the incident I began taking low dose steroids (prednisone)for arthritis.  Would this have made me have a severe outbreak that I would have noticed?  Also, would this affect how quickly I develop antibodies?  Would a test today be accurate?  I took the steroids for 5 weeks and have been off them for about 4 weeks.  The highest dose I was on was 40 mg.  Thank you for your time.

[matt4862]

I forgot to mention a few things....going into detail...her bumps are not in clusters, they are raised, and if she has any discharge at all it is coming from the bumps. Some of her bumps are located just above or around her vagina.

My bumps are nothing like hers. We compared and she told me that hers never ever looked like mine do. Mine pretty much seem like there going away. I have no swollen glands or anything.

[matt4862]

My girlfriend and i had noticed some problems. I noticed a few small red bumps on the head of my penis and on the shaft. They were not painful, itchy or anything. My girlfriend noticed about 20 small red bumps around her vagina and hers were very itchy. Two days later we both got checked and the doctor told us he was sure it was herpes. My small red bumps have scabbed over and still never turned to an open sore or anything. My girlfriends have progressively gotten worse and make it very uncomfortable fore her. She can walk sit or do anything. We are both talking acyclovir and its too early to tell if its working adn we are both waiting for results on the HSV 1 and HSV 2 tests. I am wondering....neither of us has gone outside the relationship and my symptoms are so much different than hers.....could this be soemthing else........

[matt4862]

following up...my symptoms maybe lasted for a week or less.....

we are wondering if this could be  a bacterial infection, yeast infection, lichen etc

please help us

[H. Hunter Handsfield, M.D.]

It is true that yeast and herpes can cause similar symptoms in women, and the timing of your apparent yeast infection would suggest the possibility of herpes.  That said, if your symptoms are typical of yeast and no different than previous yeast infections you have had, that's probably much more likely than herpes; and the response to fluconazole (Diflucan) favors yeast, even if not complete - you're right that it takes several days for symptoms to resolve completely after yeast treatment.  Finally, taking prednisone indeed can predispose to yeast infections, but not herpes. Finally, usually herpes would cause specific sores.

So it is a judgment call as to whether you need herpes testing.  If you happen to have a positive HSV-2 result, it won't necessarily mean herpes was the cause of your symptoms.  Type-specific HSV-2 antibodies usually are present by 6 weeks after infection, but it takes 3 months to reach 90% reliability--and sometimes longer.  If you pursue herpes testing, probably best to wait 3 months.

If your symptoms reappear yet again, however, don't assume anything.  See a health care provider right away, before you treat yourself against yeast.  Most likely yeast will be confirmed, providing reassurance against herpes.  And if you indeed are one of those who gets recurrent yeast--whether or not due to steroids--your provider might give preventive treatment.  For example, some women in that situation are advised to take fluconazole once a week on a regular basis.

Good luck--  HHH, MD