Should I do further testing?

[Pinklady]

I am recently divorced 37 year old woman who had shingles at 21 and has had Oral herpes since about then as well. My first sexual encounter after my ex husband was someone performing oral sex on me numerous times over a weekend. On Monday I had pain and noticed 3 small red bumps on top of my clitoris. I was def in pain and went to the gyno Wednesday, 5/13. She visibly diagnosed as genital herpes. Swab came back negative for HSV but positive for yeast. I was put on valtrex and diflucan. I wasn’t feeling right though, had tingles, itching in the genial area and discharge which seemed more than normal and also had. Fever one day which was rare for me. I went to my PCP and got a blood test on 6/4. HSV 1 igg 19 and nothing for HSV 2. Got another blood test on 7/8 and similar results. Still feeling not myself I went back for a final blood test On 8/11. HSV 1 igg increase to 23 but still nothing hsv2. Both my 2nd gyno and PCP are convinced I don’t have it but the first gyno seemed sure. So now I am too scared to have sexual activity of any sort being so unsure. I have not had any visible symptoms the last few months though last week I had a pimple lime item on the back of my mid thigh. Was an odd spot and was traveling so didn’t have a chance to get a swab but do have continued tingling and itching At times. I must check down there 5 times a day for sores. I guess I have 2 questions, should I get another blood test and could it be possible I had HSV 1 in genitals though I have had it for so long on my mouth? My doc and everything I read says no. Thanks in advance as this is really stressing me beyond belief.

[Terri Warren]

When you say that you have had oral herpes since you were 21, can you describe your oral herpes for me? Location, character of lesions, duration of outbreaks?

At what point in relationship to the receiving oral sex did you have the first testing done?

It is highly unusual to acquire HSV 1 in a new location after having a well established infection in a different location. I have seen it or heard about it twice now in 33 years. That is still very unlikely, right?

Do you know if the doctor did a PCR or a culture from the red dots?
Do you know that HSV 1 status of that partner?
How long did they take to heal?
Remember that the majority of the US population already has HSV 1 and IF you have HSV 1 genitally you will shed virus infrequently.
let me know the answers to these questions please.

Terri

[Pinklady]

For HSV 1 I have had sores always on my face usually on my upper left hand side of my lip. I finally have a better handle on them but I would look like I had clown lips with one huge sore lasting about 2 weeks.

I received oral sex for first time on 5/8 and again is was my first partner in over 10 years and it was about a year and a half after I was with my ex husband. I didn’t feel any sort of symptoms until 5/11 and had a swab done on 5/13.

I believe the doctor did a culture but if important to know for sure I can find out.
He said he never had a cold sore and has been tested for everything and negative but we all know HSV has to be specifically requested which I am not sure it was and we have not spoken in awhile.
Healed in a few days so was there from Monday to Friday.

[Terri Warren]

Sounds like you are correct – typical cold sores.
Statistically, with a negative swab test and history of cold sores, I think they were not HSV 1 but can’t be 100% certain about that. But the truth is, even if it is HSV 1, which I doubt (I would not think that lesions on the clitoris would look like red dots but rather ulcers), you are more infectious from your mouth, giving oral sex, than you would be from your genitals if you had HSV 1.

There may never be a clear answer here as HSV 1 genital infection recurs infrequently but if you do get another, please get another swab test and try to be certain it is PCR vs. culture as PCR is far more sensitive. And let me know about it, if you wouldn’t mind

Terri

[Pinklady]

Hi Terri, I know this post is older but believe I still have 1 question left. So I still have not been able to be diagnosed (except the visual) but I am about 90% sure I have HSV 1 oral and genital at this point. I have been to numerous doctors with many different tests including about 10 blood tests and swabs. The blood tests don’t show any HSV 2 and none of the swabs have come back positive for either HSV 1 or 2. Anyway I do still believe I have the genital HSV 1 as I have a lot of the symptoms, such as tingling, itchy, and I typically get bumps or pimples on my butt cheeks and back upper thighs. I have not anything similar to what would have been the first outbreak though where the red bumps/sores were actually on my vagina. I have been trying acupuncture to try to help with my immunity and symptoms but I would say if I am right I am having mild outbreaks at least twice a month if not more which I really didn’t think was common in HSV 1 and instead of getting better in the past year it feels as though it is getting worse. I have been trying many holistic things such as activated charcoal as well. I have 2 questions to be honest. Do you have any recommendations of an ob/gyn in the NYC tri-state area with more experience in this disease or would you recommend seeing another type of doctor (infectious disease)? Second question is I was always reluctant to go on medication as I wasn’t really sure I had the disease or not but would you recommend going on valtrex daily at this point? It has been a tough year with this and my mental health and stress levels are through the roof as this seems to be getting worse. Any help is greatly appreciated. Thanks again!

[Terri Warren]

I don’t see a downside of going on Valtrex, knowing that you may not need it. If it helps you mentally, then I don’t see why you shouldn’t take it. How about Buffalo, is that too far? I know a good OB up there who knows about herpes.

Terri

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