[Question #8276] Symptoms

46 months ago

Thanks for your help. For about 7 day i had a issue, slight burning/ nagging pain in my penis. I started to drink lots of water and it has resolved. A day after I found an area in my public area that is red and sore. Maybe an ingrown hair. Only sore if I touch/apply pressure. Does this sounds like the first episode of Genital herpes? My only sexual encounters were oral sex unprotected for 15 mins (received) 120 days prior to the issue and then sex with a regular partner.

Edward W. Hook M.D.

46 months ago

Welcome to our forum and thanks for your question. I happened to be on the site at about the time your question arrived so you are receiving a reply more quickly than his typical. Follow ups may take longer. I’ll be glad to comment. You describe two different sorts of symptoms. Neither is suggestive of an STI of any sort. Let me elaborate.

1. First, the interval since your last exposure outside of sexual contact with your regular partner (4 months) is far beyond the interval which typically occurs between exposure and the onset of STI symptoms.

2. Few STI’s are acquired from receipt of oral sex. Gonorrhea or non gonococcal urethritis (NGU) sometimes occur following receipt of fellatio but both of these illnesses proceed to cause symptoms in the majority of persons within 4 to 10 days following exposure. Occasionally among persons who have never had HSV-1 (cold sores) receipt of oral sex can occasionally cause genital herpes. These infections typically occur within 8 to 10 days following exposure at are not characterized by redness but with small fluid filled blisters occurring on the shaft the penis in the vast majority of persons.

3. Increased fluid intake would not be expected to resolve the discomfort on urination which sometimes is present in persons with gonorrhea or NGU. Further, this discomfort is most typically present during urination not between urination.

4. The redness you describe in your pubic region does not bring to mind any specific STI’s. Folliculitis (infection of the hair follicles) is relatively common in this area. It typically resolves over a few days with soap and water.

Unless there is a reason to be concerned that your regular partner may have other partners, nothing you have described suggests any reason for concern for STI’s or any medical need for testing. On occasion some of our clients choose to seek testing for the peace of mind it provides and that would be fine although, should you choose to test, I urge you to not pursue blood tests for herpes as these tests are notoriously unreliable in this situation. EWH

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46 months ago

My regular partner takes a suppressive for 2. And we have never had sex when outbreaks are happening. This is what made me think herpes. The last time we had sex prior to this happening to me was about 5 weeks ago. How does this change your thoughts. Should reach out to my oral sex encounter from months ago and let the know what has happened to me?

Edward W. Hook M.D.

46 months ago

This really still does not suggest herpes. The location would be an unusual place for herpes outbreak, your partner’s use of suppression reduces your risk of acquisition by more than 50% over the already very low rate, and the timing is still well be on the more typical 8 to 10 days following an encounter. I see no reason for you to reach out to your oral sex encounter. FYI, even if you did have general HSV-2, this virus rarely and fix the oral cavity and your partners risk for acquisition would be vanishingly low.

That your partner has proven HSV-2 and you are concerned over the possibility of infection does lead me to change my recommendation about a blood test for herpes however. One of the few places where serological testing with currently available tests is useful is for evaluation of persons whose regular partners are known to have HSV-2. On occasion HSV-2 infection can be acquired asymptomatically. If you found that you already have the infection this would address an important concern for you. On the other hand, if the test is negative, you will continue to take the precautions you already take. EWH

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