[Question #202] Herpes concern

36 months ago
Regretfully, my first 3 sexual encounters were unprotected one nights stands. I was tested across the board (with the exception of HSV tests) after each partner, my only positive result being Chlamydia, contracted from my 2nd partner. I now really kick myself for having been so cavalier about my sexual health at that time. I didn't give my positive Chlamydia result much thought. However, on reflection and in light of symptoms I have been experiencing for quite some time, I suspect I may have contracted HSV2 from the partner who also gave me Chlamydia. 
I slept with this partner around 6/7th October 2012. I began the contraceptive patch not long after the encounter; I can't remember exactly when as this was some time ago! However, I do remember that I was experiencing painful urination in the last days of October for which I retrospectively attributed to the Chlamydia infection (although I now know only around 30% of women experience symptoms with Chlamydia). In early November I developed a slightly itchy all over body rash, swollen eyelids and a fever. I assumed I was having an allergic reaction to the contraceptive patch, but could this have in fact been aseptic meningitis caused by a new HSV2 infection? I may have had a stiff neck and headache along with the rash etc symptoms, but I may be misremembering after reading symptoms of viral meningitis. I had no genital symptoms at this time. In mid December I experienced my first bout of what I thought was thrush. Symptoms included thick, curd like discharge and general itching. I think it cleared up relatively quickly with the use of a pessary; less than a week. My third partner was a few days after the episode of presumed thrush. Tested for all STDs, (except HSV) all clear.
I have now been with my 4th and current partner for just under 3 years. I'm concerned that the recurrent thrush i quite frequently experience, sometimes accompanied by fissures, is in fact HSV2. Additional information: on yasmin, after my 1st episode
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
36 months ago
While it is possible that you have HSV 2, nothing that you've said here makes me concerned in particular about HSV 2.  Yes, herpes can cause painful urination, but so can chlamydia and a urinary tract infection and a simple bacterial UTI is a more likely explanation than HSV 2.  The all over body rash is not consistent with herpes at all.  Most people who have the aseptic meningitis associated with new herpes have symptoms that are quite a bit more remarkable than what you describe, and different, in my experience.  My patients more often have severe headache and sensitivity to light.  Your symptoms of discharge and itching sound far more consistent with a genital yeast infection than herpes.  The discharge associated with herpes tends to me watery and often clear.  I'm wondering if you live here in the US?  If you are concerned about whether you have herpes or not, you can get tested you know, with an IgG antibody test.  Do you think that would help you put your mind at rest, one way or another?

Terri
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36 months ago
I apologise for how long winded that question was! And I appreciate the quick response. I'm in the UK. I've been to my GUM clinic and GP numerous times and unfortunately haven't received much help or information on the matter. I would like to get tested, as the last thing I want is to infect my boyfriend, however I've been turned away for blood tests several times, they'll only swab an active lesion. 
After my first yeast infection, a few months after my suspect partner, I didn't experience another for around 6 months. My second bout of thrush is when I first noticed a vaginal fissure. The following year thrush became more and more of an issue for me and was sometimes accompanied by these aforementioned tears. Could the tears be an atypical presentation? The frequency of these fissures is what's troubling me. However, they are always accompanied by classic yeast symptoms and I have been diagnosed at least once with thrush. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
36 months ago
Certainly a yeast infection that sticks around for a bit can cause fissuring in the genital area - I have seen that often in my practice.  That labial skin is quite thin and if the yeast (thrush) gets growing, it can cause fissuring for sure.  I didn't think you were in the US - first, because you didn't describe getting an antibody test and second because you used the term thrush instead of yeast.  I've had many interactions with folks in the UK and I know that it is difficult to get antibody testing.  But I have seen people be able to do it somehow- not exactly sure how - perhaps through some private system? 

But again, short of that, your symptoms really don't sound like herpes to me.  I know you would feel more reassured with a negative test but I can offer you this opinion if not a test!

Terri
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36 months ago
Thank you very much for your help. I think that the next time these symptoms arise I'll simply go and get swabbed for yeast. I think another positive yeast result alone would ease my mind. I don't think I'll pursue a herpes blood test as I'm quite the hypochondriac, always worrying about sexually transmitted infections, I have to draw the line somewhere! And whilst I recognise only a test can tell me definitively, i'll take an expert's educated guess! Just some follow up questions for clarification if that's ok: 1) Statistically, do you know if the chance of contracting herpes is fairly low for a one time encounter? 2) Do you see many women presenting with herpes as fissures? 3) My boyfriend suffers from infrequent cold sores, I read somewhere that oral herpes sheds around 13-18% of the time, is that correct? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
36 months ago
I don't have an exact statistic on how likely a single encounter is to acquire herpes but it is very low.  Any number would be guessing. 
While I do see fissures that are herpes, normally I see ulcers in the skin that are more rounded than a long crack - I think you are describing a longer crack in the skin
Cold sores are caused by herpes, almost always HSV 1.  And that virus does shed about the amount that you list.  That's correct. 
You take care, Anna, and if other questions arise, please let me know.

Best
Terri
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