Additional Symptoms/Side Effects

[Questions0189]

Hello,

Thank you for this forum – I haven’t gotten very comprehensive information from other physicians so I was hoping you’d be able to clarify a couple things for me.

A bit of background – I contracted herpes about 7 years ago with my first-ever sexual partner. I have been in a monogamous relationship with him since then and have had no other sexual partners, oral or otherwise. My boyfriend had previous sexual partners but never had any symptoms of herpes and was unaware that he had contracted it and passed it to me until I was diagnosed and told him.

My question is related to the other symptoms/side effects of herpes. I have found that I don’t really get full “outbreaks” anymore (i.e. pimple-like outbreaks on my vagina) and when I am not having sex with my boyfriend, I don’t have any side effects at all (unless I’m sick with a flu or a cold). However, beginning a day or so after we have sex (oral, vaginal or anal), I typically start to get itching, redness, and more vaginal discharge (usually white and thick), and sometimes it looks like I have small “cuts” in the folds between my inner and outer labia. These symptoms are usually a lot worse when my boyfriend ejaculates inside me, and not as bad if he doesn’t. I’m wondering if this is typical or if you have seen this type of reaction before? I’m not sure why, after this long, I’m still having worse symptoms, specifically after sex.

Also, I take Valtrex for these symptoms and I was wondering how much I should be taking. I’ve tried both ways: preventative (i.e. 500mg twice per day, everyday) and responsive (i.e. only when I start feeling the itching). When I take it preventatively, I don’t find it to be as effective. I still get the itching and it takes longer to go away. I found that when I take it more responsively, it is more effective but I have to take more – three 500mgs, once per day for three days and my symptoms are usually gone. I wonder if I’m taking the Valtrex incorrectly, or if you have any suggestions about what my dosage should be? My current physician seems to think that my dosage should only be increased if I meet the threshold of “minimum outbreaks per year” for whichever level, but since I don’t really get full-on outbreaks anymore, it’s difficult to explain this to her.

Thank you again.

[Terri Warren]

First, do you know if you have HSV 1 or HSV 2?
I do wonder if the symptoms that you are having after sex are really related to herpes or not. Have you had someone swab test these “cuts” to see if they are actually herpes? They honestly don’t sound like it and the fact that preventative therapy is not working well for you suggests that it isn’t herpes. Also, ejaculation should have nothing to do with having a herpes outbreak. I’m wondering if you are sensitive to something about your boyfriends’ semen? That does happen to my patients sometimes. I think it is important to note that not everything that happens in the genitals of people who have herpes is herpes.

I’m wondering if you could tell me a little bit more about how you were diagnosed with herpes. Was it a swab test or a blood test or a visual exam only? Was your boyfriend is subsequently tested to determine that he did indeed have herpes?

Thank you for answering those questions

Terri

[Questions0189]

When I was first diagnosed, I was told it was HSV 1 and that it presented genitally (FYI I have never had a cold sore on my face). I had a visual exam and subsequently a swab test. My boyfriend has not been tested, and when I asked my physician about this, I was told it would be quite difficult to diagnose in him because he had never had an outbreak or sore.

The initial outbreak (which led to my diagnosis) was pretty “classic” in that I had many pimple-like outbreaks which looked exactly like herpes sores between my anus and vagina, and on my inner labia and clitoral hood.

Wondering about your thought that I might have a sensitivity to his semen – what types of tests might I ask for to determine this?

[Terri Warren]

I am not aware of any test to know if you are sensitive to his semen – I think most people who are aware of this just see a temporal relationship between the irritation and having semen on their skin.

So are you saying that a swab test was done when you were diagnosed and it was positive for HSV 1? If yes, then I seriously seriously doubt that all these symptoms are related to your herpes diagnosis. HSV 1 recurs quite infrequently in the genital area – on average, about once every other year.

Your boyfriend could have an antibody test done – he does not need to have an outbreak to have that happen.

Terri

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