[Question #6511] Herpes likelihood?

13 months ago
Hey there, I’ll preface this by saying I’ve struggled for a couple years now with OCD over STIs.. for reasons honestly unbeknownst to me. I’ve only had sex maybe 20 times in my life, most with trusted partners. I haven’t been with anyone in about 6 months, but a thought popped in my head I can’t seem to shake. About 3 months ago I had some bleeding and pain after bowel movements, went to the doc and diagnosed hematoma with a small tear in the midline(I was having big hard stools) , I can’t remember how long before this, maybe 2 years, I had a very large hard stool that caused an anal fissure, and I think a couple months ago I maybe re injured it. I’m freaking myself out that this was in fact herpes (I’m straight and have never done anything sexual involving my anus) there were never any blisters and constant pain/itch (only felt like a cut when pooping) I’ve never been with anyone with a known hsv2 infection, my primary doctor said she seriously doubts herpes as I’ve gone in just to ask about this, with no symptoms. (Both the times the symptoms went away by increased fiber and like 2 days of stool softener. So you think this was herpes all along? 
13 months ago
To clarify: I inspected the area both time, nothing ever seen really with the naked eye, just like a small paper cut right after the worst BM a couple months ago. Doctor looked at it as well, didn’t say anything concerning, but I didn’t specifically ask :(
13 months ago
The internet is just freaking me out :( I’m reading “genital herpes disguising itself as anal fissure” 
13 months ago
25 Male, sorry! 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
13 months ago
There is just no reason at all to suspect that the anal fissure is indeed a herpes infection.  I think it would be wise, to reassure yourself, to go into see your doctor if you get this symptom again.  The fact that you can tie hard stools to a recurrence of symptoms if very reassuring indeed!  If it would help you to have a herpes antibody test to get greater reassurance about this worry, you should get an IgG test (never IgM) or a herpes western blot which is the best test available.  But again, nothing in what you have written worries me at all that these symptoms represent a genital herpes infection.   Please let me know what other questions you may have

Terri
---
13 months ago
Thanks Terri, I’ve been a browser for a while, I appreciate what you guys do. I have 2 questions in follow up
1) I know you said I shouldn’t worry but my OCD just can’t seem to let things go. I know that of course it’s not impossible, but is it unlikely to have anal herpes without any history of sexual contact there? Would it be more likely to show up where there is contact? And also would it be likely that anal herpes would show classic symptoms(blisters/multiple lesions etc) 

2) do you have any advice as far as mental health goes into relation to STD phobia (besides the obvious of getting tested after every encounter/getting all partners fully tested).  I obsess a bit over hpv as well.. I check myself a lot etc. I’ve considered talking to a therapist, but I’m just not sure (I don’t want me saying I have OCD to detract from the validity of my question.. it is a legitimate concern of mine, after reading online.. it’s just hard to find concrete info on anal fissure/herpes.. how common it is in low risk hetero contact etc) thanks so much again for all you do. I think this will be my final reply 
13 months ago
Also I don’t specifically remember a hard stool the first time the fissure occurred.. but I do remember eating a huge bag of cashews the night before and it felt like I hadn’t digested them all and perhaps it cut me? If that’s possible. It was a while back I don’t fully remember, just giving you all the info , thanks!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
13 months ago
1) I know you said I shouldn’t worry but my OCD just can’t seem to let things go. I know that of course it’s not impossible, but is it unlikely to have anal herpes without any history of sexual contact there? Would it be more likely to show up where there is contact? And also would it be likely that anal herpes would show classic symptoms(blisters/multiple lesions etc)

It is unlikely that without a history of direct anal contact, someone would show up with anal herpes as a first infection. If it was brand new herpes, yes, blisters, et4c..  People who have genital herpes CAN get outbreaks at the rectum with no contact there, yes.

2) do you have any advice as far as mental health goes into relation to STD phobia (besides the obvious of getting tested after every encounter/getting all partners fully tested).  I obsess a bit over hpv as well.. I check myself a lot etc. I’ve considered talking to a therapist, but I’m just not sure (I don’t want me saying I have OCD to detract from the validity of my question.. it is a legitimate concern of mine, after reading online.. it’s just hard to find concrete info on anal fissure/herpes.. how common it is in low risk hetero contact etc) thanks so much again for all you do. I think this will be my final reply

How often were you sexual contacts condom protected?  About 1 in 7 people have HSV 2 so not that common -less so than it was previously, by a bit. 
I don't think the cashews would like have made it out intact enough to scratch you.

For now, I would suggest that you get the western blot to be sure you don't have herpes and then have sex only with people who have agreed to be tested prior to having sex.  If I were single right now, that's exactly what I would do (and did when I was single many moons ago).  It is not an unreasonable ask.

Terri
---
---