[Question #436] A-typical HSV 2 symptoms

34 months ago

I’m 47 year old active, fit, woman. I’ve had 3 partners in life, one my ex husband of 23 years, 2 since divorcing.  Seven months ago I tested positive (IGG)for Herpes type 2/negative for type 1. I just got retested with the exact same results.  I’d been with a man who 2 days after intercourse he developed  a cold sore (not a new thing for him).  I was experiencing sensitivity in genital area (no sores or visible problems), I panicked and unfortunately got tested. The positive results were surprising to me and GYN since symptoms weren’t  classic for Herpes.  I continue to have these symptoms (7 months now) although they’ve  improved somewhat over the months.  Symptoms are: intermittent (can go days without) skin sensitivity in genital area, mostly around anus, perineum, and bottom of outer labia.  Sometimes the feeling of sores, but there is nothing.  I’ve been examined with normal results numerous times at GYN visits. Feels better without underwear when home, some days better with pantyliner, can have no discomfort one minute, then it comes on.  It makes no sense. When this first started I also had the feeling of inflammation of the labia minora and any clothing was very uncomfortable, I no longer have that problem.  I’ve tried steroid creams, 1 month on an anti viral, tested for bacterial infection (negative), nerve medication for  1 month,  changed soaps, detergents, toilet paper,  went off BCP’s thinking maybe a hormonal problem.  Only time has given improvement but not full relief.  Also, I seem to get hemorrhoids more frequently than before.  My GYN and Internal Medicine doctors don’t think these symptoms are related to Herpes but they do not know what it is.  Doctor is suggesting going back on Valacyclovir for 2 months.  She says if symptoms go away that would indicate they’re related to Herpes and if they don’t, not related. Question is, does it seem possible these are herpes related symptoms?  I don’t like medications and am concerned about taking an antiviral when I’m not, nor have I ever had, outbreaks. I’m concerned the medicine will cause me to start having outbreaks.


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
33 months ago
It is very important for me to know the number associated with the positive result, Maria.  Can you get that for me?  It is called an index value. 
I would agree that skin sensitivity by itself is not necessarily herpes but knowing the index value can help me give you thoughts about needing or not needing confirmatory testing.

I would strongly advise again steroids in the genital area.  That can thin the skin and make all sorts of new problems.

Terri
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33 months ago

The test I had done in June 2015 read Herpes 2 Ab.(IgG) >8.0/Herpes Simp 1/2 (IgM) 1.16------The test I had done a couple weeks ago reads HSV-2 IgG >5.00/Herpes Simplex IgM 1.51 (supposedly this was a western blot test)

A couple other things that may be helpful...I forgot to mention that for the past year or so I will occasionally get a weird feeling in genital/anal area, lasts for about 60 seconds...a kinda hot/cold feeling in area about size of dime at most.  Always thought it was a nerve thing, maybe a pinched nerve as I do have some lumbar herniation and am very active as a personal trainer.  Those sensations have come and gone and mostly gone for the past few months.

Also, the skin sensitivity is very hard to explain...sometimes just feels like an irritation to clothing, sometimes really feels like I might have raw skin or sores, but I inspect myself constantly with a magnifying mirror, occasionally a little 'redness' but nothing more. I can have a day where an area feels really irritated and next day its gone.

I have wondered if it's possible these symptoms could be some kind of nerve (pudendal nerve-?) issue given the inconsistency of symptoms.  And although I cannot say for absolute sure it seems like symptoms may be slightly worse for week or 2 before starting period.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
33 months ago
It looks like you had a type specific IgG test done and your index value was 8.0 which is high and is very likely to be confirmed if you had a confirmatory test done.  This is NOT a western blot.  The western blot does not give a numeric value.  The weird feeling in the vagina and the skin sensitivity may or may not have anything to do with herpes - very hard to say.  Not everything that happens in the genitals of person who has herpes IS herpes.  Remember that herpes outbreaks can occur anywhere in the boxer shorts area, so be observing there for any lesions.
If you have a sex partner who is negative for HSV 2, I think you taking daily antiviral therapy is a very reasonable thing to do.  It is quite benign and reduces transmission by almost 50%.  it is only active in the presence of virus. 

Terri
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33 months ago
thank you.  So IF these are herpes related symptoms does that mean I am contagious?  Also, could the antiviral meds cause me to start having outbreaks?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
33 months ago
The purpose of the antiviral medicine is to PREVENT outbreaks.  If these are herpes related symptoms then yes, you could be contagious during those times. 

Terri
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