[Question #6218] STI exposure / Herpes worry

15 months ago
I am a married female.  2.5 weeks ago, I had an encounter outside of marriage. He had been tested 6-8 months prior with no exposures after. He did ejaculate unprotected. Within 2-3 days I began to have discharge and discomfort. Odd sensations, tingling of the entire vaginal area, not quite pain but definite discomfort around the whole opening & copious clear watery discharge. No pain on urination. No sores. Went to Gyn, and was diagnosed with BV. Took 5 days Flagyl 500mg and 10 days Doxy 100mg 2xday. No change in discharge or odd feelings after treatment. 
Asked him to clarify his testing. He checked with his Dr - had been Negative on Chlamydia, Gonorrhea, Syphilis and HIV. I asked him if he ever had thought he had anything odd, and he stated no, never. No sores, no tingling. Maybe a bit of painful urination once in a blue moon in his past but never anything that he worried about. I asked him to get a Herpes blood test. He went to his Dr and they did Herpes blood test, apparently for any exposure ever. (I can only assume IgG, but he is naive about this.) He said he comes back negative for any previous exposure.
When I was seen for BV, she sent out for Chl, Gon, and Trich. All Negative. After my course of Flagyl & Doxy I tested for ph with an over the counter kit, and have no elevated ph. I was given 5 days of metronidazole gel also since the discharge continues but have not taken it.
 I went for  check up with my GP and she said she sees nothing, felt like I should trust his blood test results and that my discharge and odd feelings were just anxiety about guilt and bacteria. She prescribed Azithromycin 1g single dose which I took last night. Since we know Chl, Gon, Sy, HIV and then also Trich was tested for, and I have been treated with Doxy, Flagyl, and Azith is there anything else I should be doing now?
I know too soon yet for IgG. Nervous wreck.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
15 months ago
I understand that this encounter was a disconcerting experience for you and worrisome as well.  It's so so great that he had testing done AND that he agreed to do herpes testing as well when you asked him to.  I can't tell you how often it happens the other way - refusing to test. 
While herpes can cause a watery discharge as a result of cells on the cervix being damaged, it is unusual to have that alone with no lesions externally.  Quite unusual.  It is also good that you have been tested for all the pertinent STI's.  It is too early for the herpes IgG, that's correct.
Given that he tests negative for HSV IgG (I guess we don't know for sure if it was for HSV 1 or 2 or both), this should not be a big worry for you. 
When someone has sex with a person outside of their normal partnership, they often recognize every little sensation in the genital area where previously they did not.  That's really normal but can result in you being nervous about these sensations.
To me, this seems like quite a safe encounter.  Are you reassured by all of his negative test results?

Terri
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15 months ago
Well, I am certainly trying to be reassured!! Although I know there are mistakes that can be made, wrong test etc and that the normal IgG is not 100% reliable... He tells me that he has only been with 5 or 6 people in his life, and that yes, he has had unprotected at some point with each of them, because they were all actual relationships except one of them. But when I take all this into consideration, I feel that even if he had contracted something along the way, at least ONE of these other women would have experienced symptoms of something.
I cannot be the only one in the entire situation who would be symptomatic...

I had a total hysterectomy, so I do not have an actual cervix to be reacting, just the vaginal walls. I can  *certainly*  see where just my anxiety and neurotic attitude about this could manifest symptoms of tingling, shooting pains, discomfort and so forth. But I do not think I could manifest discharge just with my craziness?
WHY would the discharge just continue and continue? I have had it for 2.5 weeks straight.  I have been married for a very long time, so my bacterial flora would probably not have included some of the newer Ur/Myco etc but I feel like I have been treated for those now with the doxy and Az, right?  And they should not be a problem, perhaps now the discharge will just begin to taper off?
So you say that watery discharge alone (with odd sensations) is a very strange symptom to be had alone as a manifestation of a primary outbreak?
Would watery discharge due to herpes continue for this length of time? The encounter was on Oct 10 or 11.

I hope to someday just believe that his test was fine, and that I am unaffected. He reassures me that neither he nor any of his partners have ever noticed anything at all. That I have nothing to worry about. All the normal STI were negative. His Herpes test was negative. 
I also have Ulcerative Colitis, so having an autoimmune disease, I generally get really sick with whatever I come down with, flu or bronchitis, etc.
So knowing ME, I should certainly think that if I WERE to have a primary outbreak, it would be EXTREMELY noticeable with lesions and sickness and fever and so forth... So I try to reassure myself with this as well. 

I do believe I can likely chalk a lot of the "feelings/sensations" to my over active anxiety and worry about the entire situation and risk.
I just do not know how to reconcile the discharge. Or what to do about it!


15 months ago
Continuing that thought toward the discharge being the problem, more info:

I paid particular attention yesterday & overnight to the discharge. It seems very thin, and tends to coat the entire genital area including back to rectum with even moistness.  I think the whole area looks a bit red.

Perhaps the discharge is more likely m gen and wouldn't have been cured with the 1g of Az ? More Az or a different med altogether?

If I can think by your suggestion that it's unusual/ unlikely to be a pre-cursor to an HSV breakout, then it must be bacterial - something that my smaller city won't test for. I'm about ready to order animal antibiotics online! I can't sleep, can't concentrate, just in constant panic mode.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
15 months ago
I'm not sure what this could be honestly.  But a discharge that lasts this long with no lesions and your partner with a negative test sounds absolutely nothing like herpes to me.  I'm wondering if a repeat visit to your doc would be useful.  They gave you metronidazole gel also - was there a reason for that or just something to reassure you they were covering everything?  did they do a swab and look under the microscope while you were there?  M Gen would likely be treated with the Doxy and/or Azithro - I wouldn't worry about that.  And don't take animal antibiotics.  LOL.  I'm so sorry not to have better answers for you!

Terri
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15 months ago
They did do a wet mount when I was at Gyn, she said she saw bacteria, which was why she said I had BV and gave the 7 day course of Flagyl. When that was completed, and I *still* had discharge, I called back to let them know it was still present, so they gave me the gel scrip.
Deep down I didn't really feel like it actually *was* BV,  thinking that BV would have obvious smell and elevated ph, and so did the over the counter ph test, which was normal.  As such, I did not do the metronidazole gel after the course of oral Flagyl. But I do have it at home.
I began female well-health probiotics to try to make sure my balance was ok.
My Gyn moved out of state this week, so now I do not have one. And having had a hysterectomy, I probably have no reason to find a new one other than this terribly stupid situation I am in presently.

Immediately after the encounter, I did go home and wash my genitals with Hibiclens. Other than that, to my knowledge, I was not really disconcerted or anxious about the situation.  The discharge and soreness which began 2 days later was what began all the anxiety and panic.
I am right in thinking that my anxiety could account for the sensations etc which I am constantly feeling *now* but also correct in thinking that the original soreness and discharge would not be brought about by anxiety I didn't even have.
Anxiety itself cannot manufacture discharge, correct?
So, there is something actually at play here.  I'm worried to transmit to my spouse!
I am beginning to feel better about the HSV due to your counsel. You do not suggest testing later in this instance?

10 days on Doxy 100mg 2x day, and just one dose Azithromycin of 2-500mg tabs would be enough to cure any M Gen infection?
Is there anything else which would cause discharge in this manner?
I think the Drs both already thought I am not in need of any further testing and that I just should dismiss the discharge. But I don't feel like that is a safe option! 







Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
15 months ago
Anxiety does not produce discharge, you are absolutely correct.  Something else is going on here but I cannot tell what from here.
I think the meds you took would take care of MGen if you had that, yes.
I don't know how additional testing would help you, honestly. 
In terms of the diagnosis of BV, they don't exactly see bacteria but rather skin cells that are covered in bacteria called clue cells.
I wish you would see your doctor once more and call it good.  What else can you possibly do?

Terri
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