Clarity

[EmmyGon]

I woke up one morning after a night of rough dry sex and had soreness of my penis. The pain was coming from inside my penis (urethra) and burned when I urinated. Days later a ulcerated sore was on the left side between the head and the shaft of my penis. The sore did not itch, tingle or burn. I had swollen lymph nodes, stomach pain, testicular pain and a feeling that my rectum was sore.

Are symptoms of herpes similar to the symptoms of prostatitis?
Are these symptoms I will experience with every outbreak?
Is it possible to have both HSV1/2 genitally or do you get one or the other? Will the sores spread from my penis to anus since I feel the pain in my rectum and perineum? If there is a chance or spreading how can I minimize this from happening?

By the way I did test positive for HSV1.

[Terri Warren]

The ulcerated sore is the only thing that really concerns me here, quite honestly, and it concerns me quite a bit. Were you seen to have the lesion swab tested or evaluated by a professional?
It is unlikely that someone would have both types genitally, though I have seen it once or twice.
Herpes sores could show up on the shaft of the penis or the anus or lower belly or thigh. The virus can simply travel along a different branch of that nerve group to get to the surface of the skin – it’s not about spreading it.

So you tested positive for HSV 1 – was that a swab test or a blood antiody test?

Terri

[EmmyGon]

The lesion was not swabbed. It was a blood antibody test. The level was 8.60. I have never had a cold sore. I took urine cultures with both my pcp and urologist and everything came back normal…I did a full panel std test that included HIV and Syphillis. I asked for the HSV Test. Results came back HSV1. The first day after having sex my penis felt sore like I was having sex all day. Then the tip got sore. Then by the end of the day it was extremely sore in the inside and burned when I peed. By day 3 I developed one single sore that was not a cluster and my testicles were sore and my stomach hurt like someone kicked me in the balls. By day 5 the sore scabbed (never crusted). Day 7 the scab fell off and looked ulcerated. Initially I went to my pcp and because all my test came back negative and he referred me to a urologist. The urologist didn’t swab it because it was already scabbed and said he didn’t know what it could be and diagnosed me with prostatitis after doing the anal exam and discovered my prostate was sore to touch and inflamed. By day 2 of taking the meds which was actually day 9 the burning sensation when I pee and soreness went away. What remained was the testicle and anal soreness/pain that has now subsided (day 19)

*Why is the lesion what concerns you?

*Does hsv give symptoms of prostatitis?

*is the feeling I had that felt like someone kicked me in the balls normal. I had very bad stomach pains due to this feeling.

[Terri Warren]

The lesion concerns me because that is the way herpes presents – with a sore.
HSV does not cause prostatitis, no. It also does not cause testicular pain or stomach pains.
Since your HSV 1 index value suggests a well established HSV 1 infection, this lesion could be due to a longer standing HSV 1 genital infection. Or you could have new HSV 2 infection – the antibody testing was done too soon to detect a new infection.

I would recommend that you repeat the HSV 2 antibody test about 10 weeks from the sexual encounter that you describe. If negative, that’s good news. If you have never had a cold sore, there is no way to know if your HSV 1 infection is oral or genital.

Terri

[EmmyGon]

Ok I will wait to test again. Can you tell me if there is a difference in symptoms with HSV1 and HSV2? I’m not understanding how my prostate was inflamed and it burned to pee. How can I keep outbreaks under control if I’m still having outbreaks on valacyclovir? I’m taking 1000mg daily. Should I take 2000mg instead? I’m trying to have a healthy relationship and sex life but that’s hard while have constant outbreaks.

[Terri Warren]

First, we don’t know that you are having herpes outbreaks as the lesion was not swabbed. There is no difference in symptoms between HSV 1 and HSV 2 except if someone has long-standing HSV 1, which you do, then when they acquire HSV 2, they most often do so with minimal symptoms. Which is why I was worried about the sore. Yes, repeat the testing and if negative for HSV 2 when 10-12 weeks have passed, I see no reason for you to go on suppression for your HSV 1 as we don’t even know if it is oral or genital at this point.

Terri

[EmmyGon]

Thank you. My additional question above wasn’t answered. I asked what would you suggest to keep outbreaks under control. I’m taking 1,000mg of valacyclovir. Should I take 2,000mg? My last outbreak begin 4 weeks ago and the scab is still not healed.

[Terri Warren]

Something that lasts 4 weeks is very very unlikely to be HSV, especially since there was only one lesion.
There is no need to increase the dose is 2,000 a day. 1 gram should be adequate.
Terri

[EmmyGon]

I know you said it’s very unlikely but my symptoms have started again….testicular aching and pain in the left side, the same side as the single lesion. You said testicle pain and UTI pain from hsv outbreak is rare? Because it’s happening again.

[Terri Warren]

While anything is possible, I would say again that testicular aching in pain in the left side is not a normal symptom of herpes.

Terri

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