[Question #6817] Help Relieve My Herpes Anxiety!

12 months ago
I have a bit of an odd question here to Dr. Handsfield, or any expert who can input! recently I got a bit of redness down in the genital area and itching, nothing that looks like bumps or what would look like herpes, but I seem to be paranoid whenever I get itchiness down there.

Back track to May last year, a week after one particular encounter with a man, I got a big rash, redness, itchiness, strange discharge, pimple-like bumps on the labia, pain while urinating. The lot. Of course then I started my research and thought it could have only been one thing... herpes.

The doctor I went to first in a bit of a panic said it looked nothing like it, that it was probably thrush so gave me some cream for that and sent me on my way.

Of course I still wasn't happy so I wanted to get tested only a month after in June, so I did at a walk in clinic where I got a test called NADALĀ® Herpes-Simplex-Virus 1 IgG/IgM Test Cassette and another of the same for type 2 and tested negative.

My first question would be how accurate are the rapid tests? I got my result within 10 minutes of the nurse drawing blood.

Time goes by and I found myself getting itchy again and read that the blood tests need time before they reach a more accurate status. So in October, I went back to the same place, negative again.

I ordered an IgG test online from a site called Let's Get Checked where I took my own blood and negative.

I did that one more time for the final time in December... negative.

And yet here I am still thinking every itching and redness down there is still some form of herpes! I asked the man I was with too who said he never had coldsores. The type most likely missed on the IgG is HSV1 so thinking if it was anything at all, it would be HSV1.

But I'm at a loss, I haven't had any outbreaks like the first, I know the recurrent ones aren't half as bad as what an initial outbreak would be, but I never noticed any strange bumps down there since.

The redness I got just yesterday has these tiny shiny flat patches but I don't think that's anything like herpes would be... plus I'm aware of how rare HSV1 outbreaks on average.

So please help put my mind at rest here a bit, even though I'm testing negative, 4 times! I still feel I'm hiding something or have something to disclose. I also know that HSV1 is rare to transmit from genital to genital anyway, so I shouldn't be anxious about this, but I am.

At the moment I just don't have the money or facilities to do a Western Blot so I need to try to be reassured with the tests I've done already!

If I do have symptoms like bumps again, I will get them swabbed. I just don't think I have had anything reminiscent to herpes yet.

Would someone know if they were having an outbreak if they got one - what are the symptoms to a gHSV1 outbreak?

Also, the reason I am wishing for Dr. Handsfield to answer this is because I read a great article on The Hairpin website where the writer spoke to him regarding her herpes status and Dr. Handsfield and another doctor told her that she could move on, even with the margin of error in the IgG. I read that back for some hope just to relieve myself a bit!

Thanks for your time
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
12 months ago
I'm not familiar with that particular test so I can't give you the information about how sensitive it is - how many cases it actually picks up.  Tiny shiny flat patches sound nothing at all like herpes to me. 
You are aware of the limitations of the IgG test, regardless of how many times you take it.  It misses 30% of HSV 1 infections compared to the western blot. 
So let's take your situation from where it is now.  You can't afford the blot so that's out.  You know that HSV 1 genital infection is rarely transmitted via intercourse, right?  I think you said you knew that.  You agree that if you get the bumps again, you will get swab tested, so you have a plan for the future.  The symptoms of HSV 1 genitally are sores, sometimes pain with urination, sometimes a clear watery discharge, sometimes swollen lymph nodes.  If you have the sores, you should be swab tested right away.  If you have only other symptoms, I doubt someone will swab test you. 
So given all of that, your best option is off the table so you are left to deal with this with the information that you have.  I would suggest that you ask your future partners to use condoms for a while.  If you the first symptoms you had almost a year ago were actually HSV 1, you are now shedding virus quite infrequently.  And in another year, on average, you will be shedding virus on only four days out of the year.  You have to work with what you have and what you are able to do.  Given the poor performance of the test, it doesn't feel right to reassure you, especially with the symptoms that you described, but a more honest approach would be to envision, what if you do have HSV 1 genitally?   And that picture, without false reassurance, looks quite good for you, in my opinion.

Terri Warren
12 months ago
This is a test to try the respond feature---
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
12 months ago
And I think we are OK now