[Question #1812] Very Concerned I Have Herpes

54 months ago
Almost a year and half ago I had both unprotected oral and vaginal sex w/ a girl. Several days after our encounter I noticed 2/3 bumps, similar to a zit, around the base of my penis shaft. I was scared to death at the time that it was herpes/std. Symptoms cleared up after a week or two. In my own research I came to feel more and more that it could've been folliculitis, as they were singular bumps around/near hair follicles. Other than that instance, I've never had any symptoms of herpes or STDs...until today. While taking a shower, I randomly noticed a patch of small bumps on my shaft w/ a light itching/tingling sensation. Although I know I can't be certain until I visit my doctor (already scheduled), I am fairly certain it's herpes, or at least something I'd rather not have or deal with. I'm 28 yrs old and have been with 14 different women in my life, unfortunately over half of those were w/o protection. I was very stupid. I've finally found the girl of my dreams and can't imagine how difficult it will be to have to discuss this issue her. She is a virgin and we are waiting until the right time/marriage to have sex, which makes the topic even more tricky. She deserves the best and deserves to be with someone clean and healthy. We have been dating now for 9 months and I worry sharing this info will be too much for us/her to overcome. Any help or advice would be greatly appreciated. Im hopeful that these symptoms could be something other than herpes or an STD, but it seems highly unlikely. Additional to the small bumps, I've felt feverish and achy today, although I've also been under great stress because of the fear its caused and work/responsibilities/etc. Thanks in advance for your help and advice.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
54 months ago
Good morning,
when is your doctor's appointment?  You need to get in ASAP to get an accurate swab test.  And I would suggest that you ask for a PCR swab test rather than a culture - far more sensitive.  And ask that if it is positive, that it be typed. These are both important things.  Is it correct that no one visualized the first set of bumps?  It is possible that if this is herpes, and I must say your description concerns me, it could be HSV 1 since your first recurrences, if it is that, is so far away from the first outbreak.  That is a much more minor problem because it recurs less, sheds less and most of the population already has this virus either orally or genitally. 


So does your current partner also feel you are the man of her dreams?  If yes, I cannot imagine that this issue is going to break the relationship.  It might help if you start looking at this differently, if it does turn out to be herpes. You say she deserves someone healthy and clean.  This implies that you are not healthy and clean.  Herpes certainly doesn't cause you to be unhealthy and as far as "clean" goes, this infection doesn't make you "dirty", it makes you infected with a very manageable skin condition that is unfortunately highly and irrationally stigmatized.  But you don't have the buy the stigma.  Yes,this was acquired through a sexual contact and that's a big part of the stigma, but you will be faithful to your new partner in the future,yes? And she knows you have had sex with other women in your lifetime, yes?  Everyone brings things to relationships - some of it wonderful, somethings not so wonderful, part of your not wonderful might be herpes, I'm sure she has some not wonderful too, though you may not have seen it yet.  We come as total packages with all sorts of characteristics.  Let's first see what the doctor and testing shows.  I would like you to look at a website called herpes opportunity.  If it turns out you have herpes, this site will be very useful to you. If you don't, you will know more about this common infection.   Then when you can, get back to me with the results of your visit.  And don't pick at the bumps before you do in!  You might also request an IgG test for HSV 1 and 2 - that is a blood test. If the swab is negative, the blood test may help clarify the situation

Terri
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54 months ago
My appointment is scheduled for Monday at 8:15am. I will be sure to ask for each test you suggested. Thank you for those suggestions!

I'm also hopeful that if I do have herpes, that it's HSV-1. However, I'm still a bit lost as to the difference between the two. Based on my understanding, HSV-1 more commonly appears around the mouth (cold sores). To my knowledge and memory I can't remember having a cold sore ever in the past. HSV-2, from my knowledge, most commonly appears on the genitals and thus comes with the more negative stigma. I guess my question is, does HSV 1 have the same or similar symptoms as HSV 2 when seen or discovered on the genitals? Is it just less frequent and severe? Less likely to be spread to a partner? Can my sex life be better and more normal/free w/ HSV 1 vs HSV 2?

I'm obviously very concerned about my girlfriend's reaction. She's a sweetheart who cares about me for sure. No matter how I deliver the message though, this will be difficult for her to hear.  I have no problem believing she will be forgiving and understanding. However, I still fear that her ability to commit long term to me would be very difficult for her. She has every right to consider her own health and the health of her future children above all else. I honestly could not fault her for moving on from me. 

I can't help but feel that dating a virgin complicates this situation in a different way from what Ive commonly read about w/ discussing herpes w/ a partner you're sexually active with. There's not as much common ground and/or similar experience levels. 

Thanks for your feedback and help! I will be in touch after my appointment on Monday or once I receive my results. 


54 months ago
Also, I meant to address this in my previous reply...

You are correct, the first set of bumps were not visualized by a doctor. I did end up getting a physical about a year later and explained the incident and my concerns. He said not to worry as there haven't been any signs or symptoms since. Of course that was a few months ago before this latest incident. 

I also meant to say earlier that I absolutely plan to be faithful to my girlfriend now and moving forward.  She is aware that I have been with other women previously. 

If I do have herpes I'm confident I will eventually get past the shock and confusion I feel now, but my chief concern will be for my girlfriend/wife and potential children. If I can ensure that they remain healthy and herpes free, I'll feel so much better. 

Is it possible it could be folliculitis? I do have small hairs on the lower part of my penis around the area and I did recently trim my pubic region. Are there any other similar symptoms from other causes that it could be? Just trying to be optimistic.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
54 months ago
I do worry that Monday will be too late to give you an accurate swab test - any way you could be seen this weekend? 
The older the lesion,the less virus will be present and thus the less chance that you will get an accurate diagnosis if this is herpes.  You will then need to rely upon an IgG test to find out if this is herpes. If you are positive for HSV 2 at an index value of 3.5 or greater, then you have the answer about these genital lesions. However, if you are positive for HSV 1 only, you cannot know if this is oral infection that is asymptomatic or these genital lesions.  That's why the swab test is so important - it can tell you location of HSV 1, if that's what is going on here.  Yes, HSV 1 genitally is a far milder infection for most everyone than HSV 2.   Who knows,you current partner might even have HSV 1 from some childhood experience with an adult with a cold sore.
And yes, it is always possible this is folliculitis.

Terri
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54 months ago
Hello again,

I was able to meet with my doctor on Monday morning and get tested. Talking with him and understanding more about HSV2 vs HSV1 and what my options are, both for my health and for my sex life, have made me feel much better.

Unfortunately, I did test positive for HSV2 with and index of 5.6. I was negative on chlamydia, gonorrhea as well as HSV1.

Although I realize that HSV1 is less severe in most cases, and obviously much less stigmatized, I'm actually relieved I don't have it (at least based on these results and never having a cold sore before). According to my doctor, because I have HSV2, it is highly unlikely that I would obtain HSV1 at this point. Furthermore, it is also highly unlikely that I could transmit HSV2 to my girlfriend/wife through oral sex, which makes me feel much better about our sexual freedom. I also was worried and insecure about having spread HSV1 to my girlfriend or loved ones already through kissing, sharing a drink, etc.. That seems unlikely now and I am relieved.

My doc assured me that with a healthy diet and exercise, taking my medication daily (Valtrex) and obviously not having sex during a breakout, that the chances of transmitting this to my girlfriend/wife, although possible, is very low. If I wear a condom the chances become even lower.

I'm obviously still disappointed in myself and there is still the unfortunate conversation with my girlfriend that needs to take place, but I do feel better, more informed and more confident about my options moving forward.

Thanks again for your help and advice. Please feel free to follow up with any additional thoughts, concerns, advice or tips. I would greatly appreciate it! 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
54 months ago
Well, not unexpected result unfortunately, but it sounds like your head is in a better place.  If you have sex about twice per week, with no outbreak, on daily medicine and without condoms, the risk of infecting your partner is about 5% per year - if you use condoms, it drops even lower, as you already know - condom use reduces the transmission risk by about 95%, which is huge.  And your choice to use condoms or not doesn't have to be forever - you could start using them and then stop using them at some point if your partner feels more comfortable with risk.  I hope the discussion with your partner goes very well!
Terri
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