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Hello Terri. About 5 weeks ago I had condom protected sex twice in one night with a woman who told me she had herpes. She told me she contracted it ten years prior from someone who performed oral sex on her, which makes me think she has HSV 1 genitally. I’m pretty sure I’ve had cold sores in the past. She said she was not experiencing symptoms at the time we had sex, and only had outbreaks maybe once a year. She also said she experienced outbreaks on the “outside”, and during her first outbreak thought it was razor burn. Don’t know if my skin would have been in contact with that area if I was wearing a condom. A few days later I noticed a small discolouration or lesion on the right-side-tip of my penis which was PCR swab tested negative at my local STI clinic, however this was about 5 days after I noticed the discolouration. It wasn’t painful and didn’t weep or have any redness or anything like what I’ve read are “classic” herpes sores. Clinician felt that it was not herpes when he first looked at it. I tested negative for all other STI’s as well. My current concern is the intermittent but almost daily soreness, heaviness in testicles, tingling and warm and cool sensations I’ve been getting in my groin and around my right thigh and right testicle starting about 5 days after the sexual encounter. Seems to migrate around the general groin area. A dull ache that is not excruciating or anything, but just lets me know it’s there. Most days it’s pretty mild, but some days it gets stronger. I want to say it feels like nerves because of the heat that sometimes radiates there and the general oddness of it. One day it’s in the testicle, next day it’s in the right thigh, next day it’s kind of all over, etc. I’m a pretty physically active guy and feel like this is not related to any kind of physical trauma or injury. I still do my gym workouts and runs no problem. My doctor ordered a urine test which I went for last week. Haven’t heard back from him yet. Usually if I don’t, it means there was nothing found. I went to a walk-in clinic last week after an evening of more intense soreness and the doctor there checked my testicles, found nothing, and didn’t feel like any further tests like an ultrasound were needed. She said my lymph nodes in my groin were a little swollen and followed that with saying swollen lymph nodes are very “non-specific” so I suppose that means they could swell for many reasons. I haven’t had any other symptoms typical of herpes. No flu, only a small cold which I attribute to the time of year and my sleeping with the window open. No blisters, nothing else hurts. I just can’t get over the timing of my “risky” behavior and the way my groin feels as being somehow connected. Since I’ve visited 3 different medical professionals who’ve all told me that I could wait and do a blood antibody test, I’m not sure what else to do other than wait three more months to test and hope the pain just goes away. However just waiting around is a hard thing to do especially when you’re in pain, and I don’t want to have any regrets for not taking more action. Needless to say, my January has not been the most fun. Anyway, my questions are:
1) Is it a pretty safe bet that she has genital HSV 1 because of having contracted it from oral sex being performed on her? I’m not really in contact with her anymore, and I’m trying to avoid an awkward call asking what type of strain she has after not having spoken in 5 weeks. If necessary I would do that though.
2) Does this type of groin soreness sound like herpes to you? Do you see this type of groin soreness in the absence of “classic” herpes symptoms such as sores and blisters, resulting in a herpes diagnosis often?
3) Does this sound like a prodrome symptom to you? Can prodrome symptoms go on for weeks or months before an outbreak of blisters occurs, or is it less likely to be herpes the longer the pain/so-called-prodrome lasts?
4) What is the ratio of people with herpes who are asymptomatic to those who have symptoms? Do most people who know they have herpes exhibit no symptoms?
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1) Is it a pretty safe bet that she has genital HSV 1 because of having contracted it from oral sex being performed on her? I’m not really in contact with her anymore, and I’m trying to avoid an awkward call asking what type of strain she has after not having spoken in 5 weeks. If necessary I would do that though.
Yes, I would say it is quite a sure bet that if she contracted herpes from receiving oral sex that it is HSV 1. I don’t think you need to ask her.
2) Does this type of groin soreness sound like herpes to you? Do you see this type of groin soreness in the absence of “classic” herpes symptoms such as sores and blisters, resulting in a herpes diagnosis often?
No, we really don’t see the kind of symptoms that you are describing as a first infection with herpes in the absence of sores.
3) Does this sound like a prodrome symptom to you? Can prodrome symptoms go on for weeks or months before an outbreak of blisters occurs, or is it less likely to be herpes the longer the pain/so-called-prodrome lasts?
No, this sounds nothing like prodrome to me. This is lasting very long for prodrome. Normally, we see prodrome for a couple of days, rarely much longer.
4) What is the ratio of people with herpes who are asymptomatic to those who have symptoms? Do most people who know they have herpes exhibit no symptoms?
For HSV 2, of those infected, 80% are unaware and That they are infected so it is very common to have herpes but be unaware of having symptoms associated with that disease.
I think it is important for you to know that the likelihood of contracting HSV 1 when you already have a history of cold sores is very very small. The immune response that you have developed on your own will protect you from getting infected at the new location. In all my years of practice I have only seen one instance where a patient with a known history of cold sores acquiring HSV one genitally and even in that instance I think the history of cold sores was questionable. If indeed this person you had sex with has HSV 1 genitally then I think you do not need to worry about contracting that infection your self genitally.
Please feel free to ask me more questions about your situation as you feel the need.
Terri
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1. If I never get a herpes lesion on my genitals yet test positive for herpes antibody (1 or 2), how can I ever know if I have genital herpes? I feel like I need to get a herpes sore to know for sure because the girl I slept with 6 months ago said she got genital herpes from oral sex, so presumably HSV 1. And if I never get a sore, I could still have it without knowing.
You can only know if you have HSV 2 if you have either a type specific antibody test OR a lesion that swabs test positive for HSV 2. If you already have ever in your life had a cold sore you are not susceptible to her HSV 1 infection.
2. Does herpes medicine help simply with getting rid of blisters or is there any pain or prodrone killing quality? Like if I took some and my pain went away, would that probably mean I had genital herpes all along?
No, I don’t think that is a reasonable assumption. That could be coincidence. I do not advise that.
3. Do you have any experience with chronic orchitis or orchialgia and how to deal with them? These were briefly mentioned as possible reasons for my pain.
I don’t have experience with chronic testicular pain, no. My only experience is with acute testicular pian
4. Do you know of any other types of tests that might help determine the source of my pain other than ultrasound? Or any type of medicine that might be beneficial other than Tylenol or advil?
You are truly out of my scope of practice here. I’m assuming you’ve had at least one ultrasound – did they consider any other type of imaging?
Terri
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