[Question #1444] Very worried.

45 months ago
I consulted with Terri a few days ago and here are my updates. I had PROTECTED sex with a man about two weeks ago. Then last week I noticed a bump that was flesh colored. It didn't hurt, itch or burn. I wouldn't have noticed it, had I not looked in the mirror to check myself. It went away a few days later. I don't know if I should be concerned about that being herpes?

Well, I had PROTECTED sex with the same guy again Sunday night. I actually visually checked his penis and did not notice any sores or lesions.  However, I'm now feeling itchy all over my vagina and pubic area. My vagina is not internally itchy, nor is it burning. My discharge is also normal so far. But i'm worried that it could be herpes. I'm going to the doctor tomorrow to get checked for Yeast, BV and Chlamydia/Trich/Gonnorhea, so hopefully it's not that either and it comes back negative for all of them, and I can cross those possibilities off the list. 

Lastly, I started getting sick a day after having protected sex and now i have rashes around my eyes. Could this be hiv?

Questions:
1. Do you think the skin bump was herpes?
2. What could the itching around my vagina be? Do you think it's herpes?
3. Would hiv symptoms show up after 1-2 days?
4. Do you think I will acquire hiv from these 2 sexual incidents?
5. How likely is it that I would acquire genital herpes from these 2 protected sex incidents?

Edward W. Hook M.D.
Edward W. Hook M.D.
45 months ago

Welcome to our Forum.  I will try to help.  In preparing to answer your question I reviewed your earlier interaction with Terri and support what she said including the underlying message that your risk for any STI, including herpes is very low following just a few exposures, all of which were condom protected.  Please know that when a person has sex with a partner who has herpes and does not have lesions present very few - less than 1%)- of exposures lead to infection.  You do not know that your partner has herpes and you used a condom, both or which further reduce your risk for infection.  Even before I answer your questions, I would urge you to do your best not to worry about herpes from this exposure.  Now, on to your questions:

1. Do you think the skin bump was herpes?
From your description, this lesion is unlikely to be herpes. Herpes lesions classically appear as small blisters filled with clear fluid.  they may go on to break to then cause discomfort.  A fleshy bump that went away in just a few days does not sound like typical herpes.

2. What could the itching around my vagina be? Do you think it's herpes?
When people develop herpes, it typically takes about 5-7 days for lesions to appear (of course sometimes they can appear a little sooner or later) - your symptom appear to have come on sooner than that.  In our experience itching is sometimes apparent when people start "looking" for symptoms- the focused attention causes people to notice sensations which are typically present but that we ignore or "edit out" as we go through our activities of daily life. 

3. Would hiv symptoms show up after 1-2 days?
No, this is far too early to be HIV.  further, the exposures you have described are virtually no risk events.

4. Do you think I will acquire hiv from these 2 sexual incidents?
No, I am confident you will not get HIV (or herpes) from the exposures you have described.

5. How likely is it that I would acquire genital herpes from these 2 protected sex incidents?
Please see above.

As I write this my sense is that you are very nervous about your recent sexual encounters.  Does this reflect something you are worried about related to this partner or regarding sex with a new partner in general.  Please remember, most people do not have STIs, that STIs are typically not transmitted even following exposure, and that condom protected sex is VERY low risk for STI acquisition.  I hope you find these comments helpful.  EWH,
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45 months ago
Thank you for your advice and expertise, Dr. Hook!

However, something has came up that is concerning me. Just a brief reminder, I had protected sex about 2 weeks ago. On Friday (about 11 days after sexual intercourse), I noticed that I was a little itchy down there and had chunky greyish/white discharge. I went to urgent care last night and was put on diflucan and I'm going to the gyno today to see what's going on. I'm worried because in the past I've heard that genital herpes can mimic a yeast infection. I visually looked in the mirror and do not see any lesions, but I will also have the gyno double check. 

Questions:
1. Does this sound like genital herpes?
2. Why do doctors say that genital herpes can mimic a yeast infection? 
3. Would I be getting genital herpes symptoms 10-11 days after protected intercourse? 
4. How likely is it to acquire herpes from protected intercourse? 
Edward W. Hook M.D.
Edward W. Hook M.D.
45 months ago

I'm sorry that you continue to worry so much about herpes.  I continue to believe that your hyper vigilance and anxiety are not warranted and are causing you more problems than your exposures or observations warrant.  With respect to your specific questions, I will provide the facts but would also preface my comments to emphasize that your posts do not suggest that you have acquired HSV from your recent partner.:

1. Does this sound like genital herpes?
Assessments of this sort involve consideration of both the sorts of exposure that might have occurred as well as any observable findings. In your case, neither the history nor what you describe give me any reason to worry about herpes. 

2. Why do doctors say that genital herpes can mimic a yeast infection? 
Many women tend to assume that most genital symptoms are something "benign", like yeast infections rather than worrying about other problems such as STIs which many clinicians are uncomfortable discussing.  Further, there really is not as much training of health professionals about STI diagnosis and management as, in my opinion, they warrant based on their frequency.  This leads to misunderstandings. 

3. Would I be getting genital herpes symptoms 10-11 days after protected intercourse? 
Condom protection reduces risk about 60% but not entirely.  When persons develop herpes lesions, most do so between five and 10 days after exposure.  In your case, I suspect the timing is coincidental.

4. How likely is it to acquire herpes from protected intercourse? 
In the absence of lesions, a good general estimate would be the risk of HSV would be less than 1 in 5000, perhaps lower.

I hope these comments help.  I would suggest that you consider talking with a trusted counselor about your concerns and fears related to STIS and, in particular herpes.  I do this purely out of concern for your future happiness and relationships.  EWH
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45 months ago
Thank you Dr. Hook, I appreciate your concern. I am currently in therapy to deal with my OCD and fears.

Here's an update: I went to the gyno and she said I didn't have the typical yeast symptoms but my discharge was a little thick. She said i probably did have a YI and to just keep on with treatment. However, come Monday night I started getting a bad UTI. I was prescribed meds for it and am going back to the gyno tomorrow to make sure everything's fine. I am specifically worried about herpes of the urethra. My gyno said everything looked fine the other day, but it burns when I pee in the beginning of the stream and after I'm done peeing. I just started my antiobiotics today and am feeling a little relief. Sometimes it burns after I pee for a while and it scares me. 

1. How likely would it be to contract herpes of the urethra if I used a condom during sex? 

2. I got the UTI 2 weeks after the incident. I wouldn't be getting genital herpes symptoms this far out if I was infected, correct?

Thank you for your patience and expertise! 
Edward W. Hook M.D.
Edward W. Hook M.D.
45 months ago

There is little risk of acquiring herpes of your urethra with condom protected sex and had there been herpes present to account for your discomfort, there should have been visible lesions present as well.  Further, as you suggest, two weeks after exposure would be on the late side for the appearance of HSV.  Finally, if you were having an intial herpes outbreak, rather than getting better so quickly with antibiotics, I would anticipate that your symptoms would be progressing.  I anticipate that your gynecologist will not see evidence of herpes.  EWH

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