[Question #2264] Possible HSV symptoms ongoing?

46 months ago
Good Afternoon! About 8 weeks ago I had protected vaginal/penile sex. A few days later, I noticed some irritation on the labia minora and white, creamy discharge. The irritation was on both sides of my inner labia. Just some redness, no pain. Went to the GYNO a week after the sex. No yeast, bv, gon, clamydia. Wanted to try an insert cream (clymadicin?) in case of bacteria, for 7 nights. The redness spread but stayed on my inner labia and felt kind of raw in spots. Gyno didn't see any marks or lesions and did a full pelvic, checked cervix. Was not concerned about herpes. As I am in my 40's, felt this could be peri menopausal. Classified as inflammatory vaginitis and said it could take weeks to clear. Went to Planned Parenthood a few days later. Didn't see any lesions or spots of worry. Went to GP 3 weeks in, again just said it was inflammation, cervix was fine and to keep area clean. Saw gyno 2 more times. She swabbed the entire area (about 2 weeks in) just to make me feel better and no particles found. The cream didn't do much. Had some watery discharge after I finished the cream, which freaked me out. It's now been 8 weeks and while the redness is going away, I do have some spots that feel a little raw and irritated but most of the redness is at the top of the inner labia and my discharge has been a little runnier and maybe yellowish? Could it be bacterial? Would a herpes outbreak last this long if it was atypical? I do get an occasional corner or the mouth cold sore, very rarely, so I am sure I have hsv1. There was no oral sex performed on me. This has never hurt but I do feel twinges on occasion on my vagina and butt and thighs and they cause me to investigate all the time. It's just been a long time and I have read so many posts from people with different symptoms that it has me worried. I will see my GYNO again tomorrow for a follow up but not sure how to move forward. Your thoughts are appreciated. :)
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
A herpes outbreak would definitely not last this long, no, and with all the exams that you've had, surely if it looked at all herpetic, someone would have suggested or done herpes testing. 
You might want to ask if this could be a staph or strep infection.  I've certainly seen women with similar symptoms who end up having a bacterial infection that clears up very nicely with appropriate antibiotics.  You did mention that she did swab the area - not sure if that was a bacterial culture or a herpes culture or something else entirely - perhaps you can clarify this. 
Nothing you've described here makes me concerned about herpes, honestly.  Plus we know that if men with herpes use condoms with intercourse, the risk of herpes transmission is reduced by 95%.  So another reason I think herpes is unlikely.
Please let me know what other questions you might have.

Terri
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46 months ago
Thank you so much Nurse Warren! On my initial visit, my doctor did a bacterial culture which came back negative. When I followed up on the second visit, that is when she did the swab (PCR, I believe it's called) of the entire area and cervix. She told me this is what she would normally do on active lesions or areas that appear symptomatic. This came back negative. I think because it was so soon after sex, that I got it in my head that I was having an atypical outbreak because of the twinges and raw feeling, plus the mirrored inflammation on both sides of my inner labia. I haven't been eating properly at all, nor working out, and my periods have been all over the map and different, so i am sure my hormones are pretty ticked at me. I think part of the problem for me, and I'm sure plenty of others, is google. You read about discharge and cuts and this and that and instantly assume. Just saw my doc again and she took more bacterial swabs to see if maybe an infection was missed or has since developed that is causing the irritation to stick around. Can you leave this message open, in case I have another question? I really appreciate your opinions on this! 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
So you have had a HSV PCR, that's good, and good it was negative.  Perhaps it is hormonal, yes. 
I would be happy to leave this open for a month. If more pops into our head, do let me know!

Terri
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46 months ago
Thanks so much for keeping this open, Nurse Warren. It's been frustrating to say the least with the redness and inflammation. Its at times been uncomfortable and a bit bothersome but hopefully on the, slow, mend. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
I can only imagine. Hope it keeps getting better.

Terri
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44 months ago
Hi Terri! I was so happy to see this post active again. Looks like it was closed after I replied a second time without a question. I just have a couple of questions to move forward. 
1. I know the Igg is accurate for about 92% of infections stemming from HSV2. Do you know why it misses, or can miss, the other 8%? Is this a flaw in the test?
2. I understand that 12 - 16 weeks is recommended to get an accurate result, are there any reasons that might cause someone to take longer than 12 weeks show a positive? I read hsv1 may delay the development of anti bodies but is there other factors that may come into play?
3. I had an IGG drawn at 12.5 weeks. I guess I am just looking for a bit of peace of mind that this is as close to conclusive as I can get with the IGG? 

As you can see from my previous posts, I have had ongoing issues vaginally for months that all started after protected sex. It's been improving, slowly, but I still get occasional twinges and discomfort and still have some redness on the inner labia (and a little bit on the outer labia) and some discharge. My new doc has been wonderful and is now checking for a bunch of things but is confident this isn't STI related. I did the IGG to eliminate the worry because, it just amplifies every feeling down below. She also did a cervical swab that tests for all types of yeast and bacteria and checks for hsv particles. I am not sure what it's called, something new that I've never heard of, but it was one of many tests she is running. 
Thanks so much Terry's!

44 months ago
I'm sorry but I have one add-on question to the above post. 
If the virus is dormant, would it still show on an IGG test? Or is it only when active that is appears, even if there aren't any physical symptoms? Sorry for all the questions. Just trying to wrap my brain around testing and accuracy. Thanks again, Nurse Terri! 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
1. We don't know why it misses 8% compared to western blot- clearly antibody is being made that is being picked up by the blot.
2.  The other big factor is the dosing of antiviral therapy.  Other than that, and possibly a compromised immune system, we don't know why some very few people might take longer to seroconvert.
3.  I understand that you have some ongoing issues, but the good thing is that herpes really doesn't persist like this on an ongoing basis - it comes back periodically and then really goes away.  Yes, I believe that the 12.5 week test is as good as it is going to get with the IgG test.
and Yes, even if the virus was dormant and not causing lesions, it would still show up on an IgG test. 
You are most welcome

Terri
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