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herpes confusion
Dear Dr.H,
The only sexual encounter I have ever had has been mutual masturbation and kissing over a year with somebody that does get cold sores on his lip from time to time. I did catch a cold sore from him but it was inside my mouth. Got a herpeselect test which was positive for hsv1 negative hsv2 all other stds negative. Noticed a cut in my gential area and went to the obgyn who said it was herpes and did a culture which came back negative. But she still says it is herpes. Got a second opinion and the second obgyn says it is just a cut. It is linear and I also had swollen lymph node in my grion and lower abdominal, leg and calf pain (but I have this pain very very often). The cut was about 3/4 an inch and very neatly along the labia almost looks like a split. The masturbation that week was very very rough and often. My questions are:
1- if you can get gential herpes from autoinoculation why not from somebody with a cold sore masturbating you?
2- what are the chances of a culture being wrong if i went as soon as i noticed the cut/sore which still was fresh at the time?
3- can herpes be transmitted through saliva without kissing or oral sex like what if he had saliva on his hand and masturbated me?
4- if i have vaginal herpes could i have spread it to my mouth by tasting my vaginal fluid which is something my boyfriend had me do?
5- do women get cuts like that often? that size?
****MAIN QUESTION 6- do you think i have genital herpes or not and why are two different doctors telling me two different things???
7- if it is not herpes why did it hurt so much when she did the culture?
Thanks so much these conflicting opinions are killing me!
The only sexual encounter I have ever had has been mutual masturbation and kissing over a year with somebody that does get cold sores on his lip from time to time. I did catch a cold sore from him but it was inside my mouth. Got a herpeselect test which was positive for hsv1 negative hsv2 all other stds negative. Noticed a cut in my gential area and went to the obgyn who said it was herpes and did a culture which came back negative. But she still says it is herpes. Got a second opinion and the second obgyn says it is just a cut. It is linear and I also had swollen lymph node in my grion and lower abdominal, leg and calf pain (but I have this pain very very often). The cut was about 3/4 an inch and very neatly along the labia almost looks like a split. The masturbation that week was very very rough and often. My questions are:
1- if you can get gential herpes from autoinoculation why not from somebody with a cold sore masturbating you?
2- what are the chances of a culture being wrong if i went as soon as i noticed the cut/sore which still was fresh at the time?
3- can herpes be transmitted through saliva without kissing or oral sex like what if he had saliva on his hand and masturbated me?
4- if i have vaginal herpes could i have spread it to my mouth by tasting my vaginal fluid which is something my boyfriend had me do?
5- do women get cuts like that often? that size?
****MAIN QUESTION 6- do you think i have genital herpes or not and why are two different doctors telling me two different things???
7- if it is not herpes why did it hurt so much when she did the culture?
Thanks so much these conflicting opinions are killing me!
MEDICAL PROFESSIONAL
For goodness' sake, why didn't you say that in your original question? That the HSV-1 blood test started out negative and later became positive is one of the most important parts of your whole story.
This means you acquired HSV-1 in the past few months. I still cannot say whether HSV-1 explains the sore in your mouth, the genital sore, or both, but both those possibilities are now more likely than I previously thought. That your groin inflammation was on the "wrong" side is atypical for herpes, but lots of aspects of your case are atypical.
I cannot say why one ObG had a different opinion than the other, but it is natural for doctors to disagree about such things. The diagnosis of genital herpes by just looking at a sore is not very precise; even top herpes experts make mistakes. That's why laboratory tests are necessary.
None of this changes my advice above about what you can do to possibly confirm the diagnosis of genital herpes. Please re-read those replies above.
This means you acquired HSV-1 in the past few months. I still cannot say whether HSV-1 explains the sore in your mouth, the genital sore, or both, but both those possibilities are now more likely than I previously thought. That your groin inflammation was on the "wrong" side is atypical for herpes, but lots of aspects of your case are atypical.
I cannot say why one ObG had a different opinion than the other, but it is natural for doctors to disagree about such things. The diagnosis of genital herpes by just looking at a sore is not very precise; even top herpes experts make mistakes. That's why laboratory tests are necessary.
None of this changes my advice above about what you can do to possibly confirm the diagnosis of genital herpes. Please re-read those replies above.
A related discussion, Worried if a friend has Herpes.Or any other std. was started.
MEDICAL PROFESSIONAL
Good grief. Another piece of critical information you withheld from all this discussion! How much easier all this would have been if you had originally said you had oral herpes proved by culture, confirmed by conversion of your HSV-1 blood test from negative to positive, and a later genital ulcer that was culture negative for HSV.
I did not say you cannot have both oral and genital infection. Certainly that is possible. That your oral lesion was proved to be herpes increases the chance the genital lesion also was due to herpes. You might have auto-inoculated yourself.
That ends this thread. I'm worn out. I won't have any more comments.
I did not say you cannot have both oral and genital infection. Certainly that is possible. That your oral lesion was proved to be herpes increases the chance the genital lesion also was due to herpes. You might have auto-inoculated yourself.
That ends this thread. I'm worn out. I won't have any more comments.
Got back a culture from an oral sore and it is positive for hsv. Does this mean i don't have a genital infection since you said on another thread you cannot have both? Also, is two months post exposure to hsv enough time to build up antibodies to prevent autoinoculation?
Thanks again.
Thanks again.
I was tested before this encounter and the herpeselect igg was negative for type1. Also, there may have been a sore in may but the pain was not severe enough for me to have even looked down there. The pain this month was. Does this change your opinion about whether or not I have gential herpes? also, you did not answer why one obgyn says genital herpes and the other says it is not? also, i forgot to mention that the pain and swelling was severe on my right side but the cut/sore was on my left side.
Thanks again.
Thanks again.
MEDICAL PROFESSIONAL
I'm now even more doubtul that you had genital herpes. Herpes is not a likely cause for a single sore in the mouth, no matter how painful. And the genital pain in may almost certainly wasn't herpes either, since apparently there were no sores. The blood test could well be positive since childhood; I'll bet it would have been positive no matter when the test was done.
"so it is possible to get herpes from mutual masturbation?????" I already answered that as best I can. It is theoretically possible but very rare. It might not occur at all. I have never seen a case.
I suggest you follow the advice I outlined above, about finding a provider who does the HSV PCR test (you might need to seek out an infectious diseases specialist or an ObG who subspecializes in infectious diseases), and seeing that provider within 1-2 days in the event a new genital sore appears. In the meantime, in my opinion it is unlikely you have genital herpes.
"so it is possible to get herpes from mutual masturbation?????" I already answered that as best I can. It is theoretically possible but very rare. It might not occur at all. I have never seen a case.
I suggest you follow the advice I outlined above, about finding a provider who does the HSV PCR test (you might need to seek out an infectious diseases specialist or an ObG who subspecializes in infectious diseases), and seeing that provider within 1-2 days in the event a new genital sore appears. In the meantime, in my opinion it is unlikely you have genital herpes.
september
MEDICAL PROFESSIONAL
And when was the blood test that showed positive for HSV-1 taken?
forgot to mention the masturbation and kissing has been ongoing every few months for the past year
By two doctors i mean two different obgyns gave me different opinions. My regular one said no herpes and another one said it is herpes. That is the confusion.
May- genital pain no sore
July- primary oral sore (very obvious large painful)
November - first genital sore or cut
so it is possible to get herpes from mutual masturbation?????
Thanks again.
May- genital pain no sore
July- primary oral sore (very obvious large painful)
November - first genital sore or cut
so it is possible to get herpes from mutual masturbation?????
Thanks again.
MEDICAL PROFESSIONAL
The opinion of a health care provider who diagnoses genital herpes has to be respected, especially if the provider is experienced in recognizing herpes, as most gynecologists are. However, it is extremely rare for someone to acquire HSV or any other infection through mutual masturbation, and people don't get HSV from public toilets and that sort of thing. In addition, your description of the cut-like labial sore doesn't sound much like herpes. If the sore developed exactly where you were injured during the masturbation event, then probably that was the cause.
Even when herpes is present and the culture is done on a fresh lesion, culture often misses the virus. That test result doesn't help one way or the other. Half of all adults in the US (more in many other countries) have positive blood tests for HSV-1, mostly due to childhood oral infection (often without known symptoms of oral herpes, so that test result says nothing about the cause of the genital sore. You don't say exactly when the blood test was done, but if it was within a couple weeks following the mutual masturbation event, then that's not where you caught it, since it takes a few weeks for the blood test to become positive.
If you had a brand new oral HSV infection, auto-inoculation to your own genital area could be possible -- in other words, if the oral and genital lesion were within a few days of either other. But beyond the first few weeks, autoinoculation is very rare, if it occurs at all.
Finally, for the sake of argument, let's assume you are a very unlucky person who actually caught genital HSV-1 from the mutual masturbation event or autoinoculation. If so, you probably will have only 1 or 2 recurrent outbreaks, perhaps none at all; you probably will not have significant asymptomatic shedding of the virus; and therefore probably there won't be high risk of transmitting it to a sex partner. For these reasons, genital herpes due to HSV-1 isn't usually a big deal -- very different than HSV-2.
Now to the specific questions:
1,3) These are the same question with different wording. It is theoretically possible. It just doesn't happen much. In 30+ years in a busy STD clinic, to my knowledge I have never seen a case of genital herpes that wasn't caught by vaginal or oral sex.
2) At least half of all culture tests are negative, even when done on fresh herpes lesions.
4) Probably not. As I said above, autoinoculation occurs only during the initial HSV infection. People with longstanding or recurrent infection typically do not autoinoculate from, say, an oral lesion to the genitals or vice versa.
5) There is no way to answer whether women "get cuts like that". Obviously a cut is possible if the injury is severe enough.
6) Your question only mentions your gynecologist, so I'm not sure what 2 doctors you mean. If you mean me as the second, I have explained the reasons I am skeptical you have genital herpes.
7) Herpes isn't the only thing that causes painful genital lesions. A fresh cut also would hurt a lot with vigorous swabbing.
What to do now? First, clarify exactly the timing or your oral sore (including how long after the mutual masturbation event), your genital sore, and your HSV-1 test; perhaps that will help me give better advice. Second, talk again with your gyn about how certain she is about herpes as the cause of your genital lesion. What makes her so certain, especially given your sexual history? Third, be on the alert for a new genital sore. If that happens, see your gyn right away for another culture within 1-2 days of onset. Even better, find a provider who can do a PCR test for HSV, which detects the virus more effectively than culture.
But in the meantime, don't be too worried about this. As I said, even if the genital lesion was herpes, most likely you won't have frequent recurrent outbreaks and probably will not be at high risk for transmitting it to a future sex partner.
I hope this helps. Best wishes-- HHH, MD
Even when herpes is present and the culture is done on a fresh lesion, culture often misses the virus. That test result doesn't help one way or the other. Half of all adults in the US (more in many other countries) have positive blood tests for HSV-1, mostly due to childhood oral infection (often without known symptoms of oral herpes, so that test result says nothing about the cause of the genital sore. You don't say exactly when the blood test was done, but if it was within a couple weeks following the mutual masturbation event, then that's not where you caught it, since it takes a few weeks for the blood test to become positive.
If you had a brand new oral HSV infection, auto-inoculation to your own genital area could be possible -- in other words, if the oral and genital lesion were within a few days of either other. But beyond the first few weeks, autoinoculation is very rare, if it occurs at all.
Finally, for the sake of argument, let's assume you are a very unlucky person who actually caught genital HSV-1 from the mutual masturbation event or autoinoculation. If so, you probably will have only 1 or 2 recurrent outbreaks, perhaps none at all; you probably will not have significant asymptomatic shedding of the virus; and therefore probably there won't be high risk of transmitting it to a sex partner. For these reasons, genital herpes due to HSV-1 isn't usually a big deal -- very different than HSV-2.
Now to the specific questions:
1,3) These are the same question with different wording. It is theoretically possible. It just doesn't happen much. In 30+ years in a busy STD clinic, to my knowledge I have never seen a case of genital herpes that wasn't caught by vaginal or oral sex.
2) At least half of all culture tests are negative, even when done on fresh herpes lesions.
4) Probably not. As I said above, autoinoculation occurs only during the initial HSV infection. People with longstanding or recurrent infection typically do not autoinoculate from, say, an oral lesion to the genitals or vice versa.
5) There is no way to answer whether women "get cuts like that". Obviously a cut is possible if the injury is severe enough.
6) Your question only mentions your gynecologist, so I'm not sure what 2 doctors you mean. If you mean me as the second, I have explained the reasons I am skeptical you have genital herpes.
7) Herpes isn't the only thing that causes painful genital lesions. A fresh cut also would hurt a lot with vigorous swabbing.
What to do now? First, clarify exactly the timing or your oral sore (including how long after the mutual masturbation event), your genital sore, and your HSV-1 test; perhaps that will help me give better advice. Second, talk again with your gyn about how certain she is about herpes as the cause of your genital lesion. What makes her so certain, especially given your sexual history? Third, be on the alert for a new genital sore. If that happens, see your gyn right away for another culture within 1-2 days of onset. Even better, find a provider who can do a PCR test for HSV, which detects the virus more effectively than culture.
But in the meantime, don't be too worried about this. As I said, even if the genital lesion was herpes, most likely you won't have frequent recurrent outbreaks and probably will not be at high risk for transmitting it to a future sex partner.
I hope this helps. Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
