[Question #2054] hsv discharge or IUD

47 months ago
Hi, 

13 days ago I had protected vaginal sex and since then have been experiencing assorted "symptoms" that I am having a hard time discerning as anxiety or not.  The most noticeable of which was sensitivity to light and body aches, but this was followed by a cough so this may have been some sort of cold.  I thought I noticed some lines/bumps (which I posted about) but they all resolved quickly and never turned into lesions.  I just realized that I have had one tiny (1 mm or less) pink bump in my pubic hair area about one inch above my clitoris for about a week, and its a little shiny.  Yesterday it seemed dry and like a bump with the top shaved off.  Yesterday I also noticed a yellow bump of similar size about an inch away.  Maybe these are folliculitis but I have also read about very mild herpes cases?

For the past week or so I have been noticing a very sour/foul discharge odor, and at one point it seemed pretty watery.  Over the past several months I have had bleeding during/after sex which I have seen a dr about (they said it was due to a misplaced iud).  This seemed to have resolved over the past month with the insertion of a new iud, but two days ago I had sex and there was blood again (this time it was pink, rather than the brownish color I had been noticing before).  I was wondering: what is the likelihood of a primary herpes infection that is only internally present if a condom is used?  If such an infection were to occur, is it possible that there would be no other symptoms besides the bleeding and foul odor?  Or could the two tiny bumps be an external presentation of an otherwise totally internal infection?

All prior hsv 1/2 igg tests neg.

Thank you
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
47 months ago
Was the condom used for the entire time you were having intercourse?  If yes, even if your partner had herpes, which I am assuming you don't know, the condom would have reduced the transmission rate hugely - more than 95%- as the main site of viral shedding in the male is the penile shaft. 
Nothing you have mentioned worries me except one statement where you said you had a bump that looked like the top had been shaved off?  Was it ulcerated, is that what you meant?  Herpes does not cause a foul odor, but if you have that, you should be seen, especially if you are now having spotting with intercourse.  Herpes does not cause bleeding either.  I seriously doubt any of this is herpes.

Terri
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47 months ago
I do not know if the condom was used the entire time, unfortunately I can't remember the incident.  The person informed me it was.
I am confused because I have read that cervicitis is a common symptom of herpes?  Could the bleeding and discharge/odor be from herpetic cervicitis?  I am feeling sort of a twinge type feeling on the inside.
What I was referring to before was not ulcerative.  It was a small pink bump that at one point might have had a pimple type look to it, and then dried out.
Now it kind of feels like my entire vagina is swollen.  I did have anal pain today but I suspect that was heat rash.  I am reticent to continue visually inspecting these areas as every little thing I find looks like "herpes," so it's possible the pain today could have been from some sort of blisters or ulcers?  Could symptoms show up anally if the person manually stimulated the area during vaginal sex?  It has been 14 days post exposure. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
47 months ago
People with brand new herpes often have cervical involvement, yes, but most often that is accompanied by external genital lesions as well.  I have not seen bleeding with herpes of the cervix, no.  I'm glad to hear the lesion was not ulcerative - that's very good news.  A person could have anal lesions, yes, but normally- not always but normally - we would see labial lesions first in women - recurrences can certainly be anal without an actual anal exposure.

Honestly, if the condom stayed on the entire time, I think herpes is very unlikely here!  Have you ever in your life had a herpes antibody test to know that you were actually negative prior to this incident? And have you asked the man if he has tested and if not, to please test?  If he is negative and your baseline test is negative, you would really have nothing to worry about

Terri
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47 months ago
Thanks for the response, I don't want to waste one of my follow up questions but you asked about testing and I just wanted to clarify that like I said in the first post I recently tested neg for hsv 1&2 igg/igm, and have been tested many times before that. Very careful normally, always have partners tested and no previous symptoms, very certain I was negative prior to this. Not in a position where I can really ask this person to be tested.  I just keep noticing this sort of twinge cramp and im worried about internal herpes.  I'm just worried because you read so many people online who say their primary ob was internal only with similar symptoms as mine. How can the risk be so low if so many people claim to aquire it this way with a condom and have internal only symptoms? 
I know the igm test is apparently worthless, but is it only considered worthless with the assumption that someone doesnt already know their hsv status? If I was to get an igm test at day 16 is a negative result likely to be reliable?  I read that igm antibodies typically appear after approx ten days, so it seems worthwhile? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
47 months ago
The question is  this - if the lesions are only internal, how do people know they have herpes?  I don't think people are examining their cervix for lesions with a speculum?  And I don't believe for a moment that people are acquiring herpes on their cervix from an encounter with a male using condoms the entire time - it just makes no scientific sense.  It's very hard to sort out what is real and what isn't on the internet - I feel badly for someone who seeks out these opinions because you have no idea who is scamming readers and who isn't. 

With the IgM test - I have had at least 7 out of 10 people who test positive by IgM who never seroconvert to positive by IgG, which is the test which has been studied well and completely.  A negative IgM test at day 16 is not a reliable indicator that you don't have herpes, no.  And a positive has such a huge chance of being a false positive, I wouldn't recommend it - you will be worried if you get a positive and even with negative subsequent IgG tests, it will be hard for you to believe that you are not infected if your IgM is positive, even with negative IgGs following. 

Sorry, I didn't go back to your other post to get the info about previous testing for you.

We know that condoms reduce the risk of acquiring HSV by more than 95% and we don't even know this person has herpes!    I really think the odds are on your side here.

Terri
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