[Question #6906] No Visual Symptoms

11 months ago

2 months ago, I had unprotected sex twice with a woman, who informed me that she had contracted HSV-1 and HSV-2, over 20 yrs ago, and has had infrequent (about once per year) outbreaks since then. She claims she was not having an outbreak during our encounters, and that no one has ever caught it from her.

Since then, I’ve noticed faint itching and "buzzing" in the head of my penis and testicles, occasionally in the tops of my thighs, and a feeling of "heat," as if the temperature down there is a few degrees too high. But, these sensations are very faint. The itching isn't like poison ivy, where I have to restrain myself from scratching. And the higher temp is just an internal sensation. It’s not hot to the touch of my hand. I have no lesions, blisters, or any visual symptoms, and I check daily.

My concern is that I've possibly contracted the virus, am asymptomatic, that these subtle sensations are indications (pronome?) and that I might transmit it to my next partner, even though I've had no visual symptoms. But, it's also possible I’m just being paranoid, and that if the woman I slept with never told me she had herpes, I wouldn't even notice these subtle sensations, and herpes would never have crossed my mind. I want to get a test, if the results are negative, to ease my mind, but I’m scared to death they might come back positive, and I should just let “sleeping dogs lie.” How likely is it that these subtle sensations indicate that I have the virus, and should get tested?



Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
11 months ago
While it is possible that you acquired herpes without symptoms, I honestly don't think that's what is going on here.  The risk of contracting herpes from someone who has had HSV 2 for 20 years and has infrequent recurrences, is highly unlikely, all by itself.  The sensations that you describe here are really not consistent with herpes.  Could people with herpes have itching?  Absolutely they could but this could be present more commonly with fungal conditions of the genital area.  You've had no symptoms, which is also good.  I think it's possible that the information that she has herpes is playing with your head and causing you to over-observe your body sensations.

Terri
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11 months ago
Hi Terri. You say "The sensations that you describe here are really not consistent with herpes." Can you tell me specifically, can each of the following be symptoms of herpes and/or pronome, yes or no? I continue to have zero visual symptoms.

1) Slight soreness in the tops of thighs (btw the top of knee and pants pocket)
2) Sensation of a higher temperature in the head of penis, and testicles.
3) Slight itching in the head of penis and testicles (This has mostly gone away with Lotrimin daily cream)
4) Slight irritation at the entrance of urethra, when beginning to urinate.

Again, I started noticing these things shortly after I had sex with the woman who confessed to me that she carries the HSV-1 and HSV-2 virus. I understand what you are saying, that this might be somewhat psychosomatic, but I don't think I am imagining these sensations. They all give me the feeling (at least psychologically) that some foreign invader has entered my system, that wasn't there before.

Finally, can you explain the semantics of "I have herpes?" The CDC web site says "Most people with the virus don’t have symptoms." Let's say, hypothetically, that I get a Western blot test, and it comes back positive, and let's say I never have a visual outbreak for the rest of my life, do I still "have herpes?" 

In that scenario, can I still infect someone else, and they have bad breakouts, lesions, painful sores, etc, even if I never have outbreaks for the rest of my life? I'm considering getting the Western blot test, but if it comes back positive, and I never have an outbreak for the rest of my life, what good does this do me, or any of my future partners, other than cause shame, rejection and fear, if they are not really at risk?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
11 months ago
Could a person who has herpes have any of these symptoms?  Yes, they could, that is possible, but so could anyone with many other conditions.
If you got a western blot and it came back positive for HSV 2, you would be both infected and potentially infectious to others.  A herpes infection does not depend on symptoms to be real.
And yes, the disease presentation could be different in you than in people that you might infect if you actually did have herpes.  The reason to know would be to be able to do all you could to protect future partners - daily antiviral medicine, condom use with every intercourse, and notification of partners so they have a choice about whether to take a risk of getting herpes themselves.  If someone is infected but has no symptoms, they still give off the virus on days when no symptoms are present.  Perhaps that is your confusion here?

Terri
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11 months ago
But you said "The sensations that you describe here are really not consistent with herpes." Can you please elaborate on that?

Also, the CDC does NOT recommend I get tested, because I don't have any outbreaks. But you are suggesting that I should get tested? 

"CDC recommends herpes testing for people who have genital symptoms for herpes to confirm that they are infected. These events are called “having an outbreak,” and they appear as blisters on or around the genitals, rectum, or mouth. The CDC does not recommend herpes testing for people without symptoms. Without knowing the benefits of testing, the risk of shaming and stigmatizing people outweighs the potential benefits. For these reasons, testing everyone for herpes is not recommended at this time."

https://www.cdc.gov/std/herpes/screening.htm

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
11 months ago
If you look further you will find that the CDC also says, "herpes antibody testing should be considered in those seeking a full STD screening"
These sensations that you describe, without any lesions, cannot tell you that you have herpes or even that herpes is likely.  Of the people who come to me to test with the herpes western blot and have only these symptoms, or symptoms like those that you describe, at least 90% test negative - maybe higher.  That's is what I meant.

If YOU consider that these may be symptoms of herpes, then be using your definition, you would fit the testing criteria listed above, right? 

And I would also add that I don't necessarily agree with what the CDC says about testing.  We DO know the benefits of knowing you have herpes - you can do something about transmission - using condoms with every intercourse, taking daily antiviral medicine to reduce transmission, telling partners so they can make a reasonable decision about potentially exposing themselves to infection.  I'm not suggesting testing EVERYONE for herpes. 

Do I think you have herpes based on the symptoms you describe?  No, but that's just an opinion.  I don't really know.  This has obviously been worrying you for a while.  I hope you can reach a decision about testing that works for you.  To some degree, these are individual decisions and different people make them differently.

Terri
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