[Question #2594] For Dr. Handsfield- Herpes or unnecessary worry?

42 months ago
Hello, Just fyi, I ordered a question earlier today but my page exited and I Hope I don't get charged twice...I'm doing this again. I'll give background for context.

In Nov 2015, had unprotected oral sex. No sores but Felt What appears to be genitally focused anxiety, tingling, burning in scrotum, penis, groin, nasuea, fever lasting a few hours, rash on left shoulder, arm, chest., no sores. Tested neg for HSV 2. Symptoms mostly went away after a couple weeks, got Tested a couple weeks later for hsv1 it was positive but I get cold sores, test said wasn't in a state of infection. I might have Felt some tingling during hsv1 test, not Sure, but how Can I know it's genital hsv1 and not Just oral?

Felt similar symptoms a couple more times between March and June each lasting about a week, no sores.

In mid june, had a handjob, no mouth contact, but saliva did contact the head of penis and next day Felt burning and discomfort in head and tip of penis. The head was Red I assumed  from friction. It's always been Red from friction a long time ago but I noticed more redness. I don't recall seeing any sore but possibly some Red Marks the next day or a few days later, not Sure. I don't believe it would have lasted more than a week and definitely not classic sores.  Burning lasted couple weeks, went away and returned a week later, no sores or Marks I remember. Lasted a week or so. 

From Oct 2016-present, I've noticed a Red mark on the head of the penis That seems to occur after sex, but not certain, going away That Same day or a couple days later. Not positive but definitely doesn't last long. I attributed   it to friction because my head is overall Red and had other little Marks too.  I'm also diabetic. However, I read That herpes Can be a small Red spot and not blisters. What are the chances of this? I Hope I've given enough info. Thanks!
42 months ago
Just  to  clarify, the Red spot is tiny and doesn't happen ever time after sex That I've noticed, but I have seen it 2 or 3 times Im the past year. I didn't notice burning, tingling associated with That I remember, but Now I don't know, hopefully Just paranoid...

Also, I neglected to add That the scrotum burn etc I mentioned first returned this past July and included itching all over the genitals, but didn't seem to coincide with the Red mark or spot. I trust this was anxiety as I was worrying about having herpes and transmitting to my partner leading up to it which seems to be What Dr. Handsfield has discussed on prior threads. Please Let me know If I'm offbase. Sorry I I'm giving too much detail,but want to be thorough. Thanks.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
42 months ago
Hi, this is Terri, I answer the herpes questions on this board.  You aren't off base by giving lots of details - it helps us sort out what might or might not be going on with you.  I have to say that nothing you have described in this post sounds anything like genital herpes and your negative test after the first encounter really should help to reassure you about herpes exposure.  The second encounter which involved only masturbation but a little saliva on your penis also presents virtually zero risk for transmission of herpes.  The red spot that appears does not sound like a herpes lesion to me - at all.  I've seen lots and lots of herpes in my 33 year career specializing in herpes and I would rarely, if ever, would  describe herpes as a tiny red spot. 

So you are not off base but I do think you are likely worrying excessively over things that are extremely unlikely to be herpetic.

Terri
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42 months ago
Thank you so much, Terri. Just one follow up as things came to mind that I hope you can address. I neglected to mention that during the first encounter I also experienced what appeared to be swollen lymph glands in my neck that lasted a half day. I trust this is just anxiety.

 The second time I felt burning in the head and tip of the penis, it also burned and hurt to ejaculate. I know there was also added friction to this area due to my involvement in sports, so I hope this isn't a worry?

I appreciate that you didn't see cause for concern in your reply but my lack of knowledge about genital herpes testing leads me to ask if  there is any test that would show a positive test for hsv1 and prove that I'm in a state of infection from feeling burning, tingling, etc and not displaying sores. You said the red mark isn't herpes, but what do you suggest I do to ensure I know I don't have genital hsv1? Since I already get cold sores, blood tests will always show positive but I want to know if the symptoms I felt demonstrate I'm in a state of infection or not, thus showing whether I have it. I can always get another hsv2 test done but do you think this is necessary?  I'll  add that since the saliva incident there have been other encounters since with strangers, most protected, but on 2 encounters, there was penetration without a condom. This all happened before the saliva incident in April-end of May of the same year. Sorry I neglected  to mention this but I didn't think this would factor in, but now I think I'm paranoid.

Anyway, any expert advice you have regarding this new info and about what you recommend  with tests, whether  I need an hsv2  test and can get an accurate  hsv1 test,  would be appreciated. This will be my last post as I trust your opinion. Thanks again for your help.


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
42 months ago
This is a difficult question.  And lots of people wonder the same thing - if I have cold sores, how do I know if I have genital HSV 1 as well? 
First, we know that after having HSV 1 in one location on your body, it is extremely unlikely you would get it in new location - I saw it one time in 33 yearws of practice specializing in herpes.  The only way to know for certain, other than believing years of experience, is to get any new lesion or symptom in the genital area swab tested to see if it is herpes. 

I don't think you are paranoid, but I don't think you are overworrying about this situation.  There is no test that is going to help you sort out if you have HSV 1 infection genitally, other than swabbing any lesions that might show up. 

If you want to know if you have HSV 2 due to the two unprotected encounters, the IgG test is fine - the western blot is slightly better.
If you have pain with ejaculation, I am hoping that you have been tested for all the other STI's like gonorrhea and chlamydia as well.

Terri
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42 months ago
Sorry, it maybe doesn't matter but for clarity, the original unprotected  oral sex incident  I mentioned before I felt the burning  etc, at the beginning  of my first post, was with a prostitute.  I felt lower abdominal  pain  2 days later and a couple weeks later, the burning  etc. After, I had protected sex with prostitutes 2 times and unprotected  sex twice during one night stands with women I met at a bar. Then the saliva incident occurred after all of this, also with  a prostitute. After the encounter with the saliva, I had protected sex with 2 prostitutes and unprotected sex with a girl I know, and would doubt would be a factor in my concerns. 

To  add more clarity,and be thorough, I'll mention that before everything I've mentioned in my posts, in April 2015, I received oral sex from who I later found out was a prostitute. A couple days later, I experienced lower abdominal pain, but I assume was stress about what happened. I didn't feel any herpes tingling, burning, etc so didn't consider it . I got tested for gonnorrhea and negative.  Since  everything  that's  happened, the most recent std tests I got done was summer  of 2016, I  had a full std  test done and came back negative but didn't test for herpes at the time.

I know all of this sounds bad but after reading my last post, the wording for the timeline appeared confusing and I wanted to give all the detail and not hold back despite the embarrassment. Sorry for posting again, but this IS the last one, I promise :) Thanks, Terri.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
42 months ago
Thanks for the clarifications.  Did you also get tested for the other STI's that I mentioned?  Given that you appear to have had two unprotected sexual encounters with two one night stands you met in bars, I hope that you've had a full panel of STI tests.

Terri
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42 months ago
Sorry Just saw your last response. To answer, Yes I Tested for gonnorrhea and clamidia in 1st week of July 2016, roughly.   I can't  remember exact date but it  might have been a few days later, not Sure. Around there. The saliva incident occurred mid June of 2016. This is where I Started feeling the burning in the tip of the penis. I don't remember feeling pain or burning ejaculating Until late June early July 2016.  The  reason  I'm  worried  about  dates  is  That is  my  negative  test  for gonnorrhea  clamidia ok?  Do you have to wait a certain amount of time to get tested? Should I get Tested again? The burning ejaculating only lasted 2 weeks maximum after I Felt it early July. Urethritis is What  I read and Can be caused from friction which I know has created overall soreness from rubbing  over  the years and has always been sensitive and Can be painful after ejaculating after sex. Being diabetic the tissue and nerves on the tip and head of the penis have been sensitive to pain, rubbing, friction and seems to be heightened after ejaculating. I know gonnorrhea and clamidia Can create Urethritis, too. Herpes, I've read is unlikely to cause this.

Is my std test valid with the timelime amd info I gave?
42 months ago
To clarify, the std test I got InJuly 2016 was a full std test That included syphilis, gonnorrhea, clamidia, Hiv
42 months ago
Forgot to add, is it ok to engage in sex without worry provided the other std tests were negative and with the info I gave you regarding hsv1 and hsv2? You said I Can get an hsv2 test done but not hsv1 but in your opinion I don't have either herpes. So should I wait till I get the hsv2 test or are you Just recommending it to ease my anxiety?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
42 months ago
Yes, the timing of your gonorrhea and chlamydia tests are appropriate. You describe having to unprotected sexual encounters if I am reading that correctly. The testing for HSV-2 would be to eliminate any concern about contracting herpes at these two encounters. Please remember that the sensitivity of the HSV one IgG test is 70% and for HSV-2, about 92%, both compared to the gold standard herpes Western blot.

Terri
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