2:47 am - 06/11/2012

Sore on Labia. Kinda freaking out.

I had a yeast infection last week, and within a day or so of getting over it, I realized that I still had some stinging / burning around my clitoris. I thought that it was just something related to the yeast infection, but then I realized today that not only does my clitoris sting / itch / burn, but I also have a painful bit on my inner labia that stings especially when I urinate. I also had pneumonia last week, so my immune system was definitely not doing so hot.

I decided to take a look and noticed that there's definitely some sort of sore on my inner labia. I'm pretty much convinced that I have herpes, so I'm kind of freaking out. I was tested in late April (early May?) for chlamydia, gonorrhea, HIV, and had a pap smear, and those were all negative. I haven't had a new sex partner since then.

I'm thinking that this may not have been the first time that I had a sore. I have a vague recollection of this happening before, and having my clitoris hurt like this, but just sort of ignoring it, so if it is an STI, who knows when and from where I picked it up.

I feel awful because I do have a boyfriend right now, but we had a bit of a shaky relationship in recent months, and I slept with a couple of other people. I always thought that if I contracted something from one of those people and passed it on to him that I'd feel awful, but after I got the STI test, I thought I was basically in the clear. My boyfriend and I are long distance, so the last time I had sex with him was when he visited about two weeks ago, and we don't use condoms.

I know one other person who has herpes, and she literally starting shooting heroin after she found out, and recently got out of rehab. So, I feel like I need somebody else who I can talk to about this.

The other crappy thing is that while I just graduated from college, I am still under my parents' health insurance. I tried to search for a gynecologist in the area (I live just outside a major city), and my insurance's website literally says that the closest gynecologist that they cover is 100 miles away. I'm going to call them tomorrow and see if there is somewhere I can go to get this tested ASAP. If that fails, there is a planned parenthood nearby that I can try to go to. I assume I'll have to pay out of pocket there, but I am technically unemployed, so don't they scale the cost according to that?

Any advice / support / anything is very much appreciated.

EDIT: 11 June 2012 - 6:08 PM: I was able to get an appointment with a gynecologist covered by my insurance (turns out there are a bunch around here, I was just not looking right) and she took a look. She looked at the sore and said that it's probably herpes, and that's what she's going to assume. She tried to take a culture, but it may be too late to tell, since the blister has already broken. In addition, she ordered blood tests for herpes 1 and 2. I called my friend who has herpes and it was definitely nice to have somebody I can relate to a bit. I was prescribed acyclovir and lidocane gel. Thanks for the support, everyone.

sweetchild92 11th-Jun-2012 09:29 am (UTC)
You can see if there are low cost/free health clinics around you.

http://www.itsyoursexlife.com/gyt/ <<link where you can put in your zip code, if from the U.S. PP will try and work with you wrt to payment. Their ability to free/low cost health care varies from center to center. Well, the absolute worst case scenario is you have a manageable skin condition that can cause some discomfort. You want to tell the receptionist at whatever clinic you go to that you have a sore you want tested, the sooner the better. Although unfortunately those tests can yield false negatives. Your other option is a blood test to detect for HSV-1 (most commonly oral herpes) and HSV-2 (most commonly genital). It could also be nothing-ingrown hair, maybe? External yeast infection? I'm sure a nurse/dr will be able to help test/determine what is what :)
archangelbeth 11th-Jun-2012 10:37 am (UTC)
STD tests almost never include tests for herpes unless the doctor actually sees a sore, or if you specifically ask (and/or insist). This is because so many people have antibodies to HSV-1 orally (though HSV-1 is quite happy to jump to the genitals in the absence of antibodies from an oral infection), and a blood test can't tell you where you would have outbreaks. (And depending on the age bracket, up to 90% of everyone may have antibodies to HSV (usually HSV-1), meaning they were exposed and probably have an infection somewhere.) A blood test can only say, "Yup, you've got antibodies." And early herpes tests were unreliable, further contributing to a long-standing policy not to test routinely. (What you want to ask for is a Type Specific herpes test, and HerpeSelect is a name I recall as being a decent brand.)

Does your boyfriend have cold sores? Cold sores are oral herpes -- which can, as I said above, happily jump to the genitals during oral sex, or even from saliva if a hand goes from mouth to genitals. (A memo that I didn't get till after I was married, gah! Fortunately, my spouse thinks he also had cold sores as a kid, and has never had an outbreak in either set of mucous membranes that we can tell.) Further, it can do so even when there's not a visible outbreak; asymptomatic shedding (oral or genital) happens on an average of 5% of the time.

It's also not impossible that it's just a yeast infection lesion.

However, just getting it swabbed may or may not tell you anything; if you don't catch the virus before your immune system does, it may not be shedding enough infectious viral particles for the swab to pick anything up. I'd make sure to insist on a blood test as well.

The thing to remember is that even if you have genital herpes? It's just cold sores, except what it gains in potential discomfort from peeing, it loses on the ability to show up on your driver's license for a few years in a row. (Okay, I am indeed making a bit light of the fact that, for some people, genital outbreaks are really awful. But, statistically speaking, most people have few outbreaks, and they are not much more painful than my oral ones.) Further, HSV responds well -- in my experience -- to anti-virals. Get Acyclovir, not Valacylcovir (generic Valtrex), since the latter tends to be more expensive (yes, even the generic!!), in my experience. You can go on a suppressive dose and be much, much less likely to shed infectious viral particles, or -- depending on your partner's HSV-status (he may be positive for it!) and risk-tolerance -- only take a dose if you get an outbreak. (I do the latter.)

Heroin is... definitely an overreaction in most cases I can think of, save perhaps that she was having an extremely painful outbreak and not being given anti-virals or painkillers. (In which case, her doctors should be smacked hard.)

You do need to be able to tell your doctors, if you ever have a baby, because herpes can get into the eyes and is very dangerous to a newborn; if you don't have a c-section, it might be a good idea to be on a suppressive dose of anti-virals for some days prior to birth. That's one area where genital herpes is more annoying than oral herpes.

But you probably know lots of people with herpes. Some of them may not know it. Some of them have oral herpes. Some of them are just going about their lives. It's just a virus, it doesn't deserve the stigma that people tend to put on Anything To Do With The Genitals, and you can get through this without resorting to illegal drugs.

*offers hugs*
sweetchild92 11th-Jun-2012 11:54 am (UTC)
ooo, so it's still possible to have a vaginal birth with genital herpes?
jennifer0246 11th-Jun-2012 04:35 pm (UTC)
Absolutely. Some medical providers may recommend suppressive medication at the end of pregnancy, or may recommend covering lesions if they are present at onset of labor/birth, but vaginal birth is completely possible.
sweetchild92 12th-Jun-2012 06:14 am (UTC)
ty!! Even as someone who will probably remain childfree, I have to say the only thing that would truly upset me when thinking about the possibility of ever contracting genital herpes was thinking that ruled out a vaginal birth. This makes me so happy lol.
korppi_ravn 11th-Jun-2012 12:23 pm (UTC)
Sometimes, I think I love you a little bit after reading your comments.

Just a quick question; my SO occasionally get cold sores. I've never had one, and it doesn't seem like he's infected me so far; should I still maybe be careful about letting him go down on me while he's got an outbreak? I'm prone to YI's, and I really don't want to deal with another thing down there, like herpes. I have no idea how to breach this subject with him though.
archangelbeth 11th-Jun-2012 07:32 pm (UTC)
Honestly? He should NEVER go down on you unprotected when he's got an outbreak, if at all possible. Even if you have antibodies, if your immune system is compromised, it is possible to become infected in both locations. (There's been at least one post on VP that I recall where someone auto-infected, from touching mouth and then genitals.) While it may be within y'all's risk tolerance to have unprotected oral sex when he doesn't have an outbreak, even though there is asymptomatic shedding as a potential, when there's an outbreak (and often up to a week before an outbreak), there is definitely viral shedding going on.

It is also up to your comfort level whether you would be okay with him using a dental dam or (non-microwave-specific) plastic wrap, during an outbreak.

That said, I have given my spouse oral sex and then looked in the mirror a few hours later and realized with horror that my lip was puffy, so that can happen -- but again, we are going on the assumption that he has antibodies, and thus far he's had no outbreaks...

For how to broach the topic? Perhaps say, "Hey, I just read on this community website that cold sores are the herpes virus, and even though people think HSV-1 only affects the mouth, it can jump to the genitals as well. You're still my sweetie, but no going down on me when you've got a cold sore, hon!"

If he tries to get you to do things against your comfort level, well, BAD BOYFRIEND, NO NAKED TIME!

You may also, however, wish to get your antibodies checked -- and his! If you both have antibodies to the same strain, then that may affect what your comfort levels are for receiving oral sex.

(And I do try to have good comments! I'm glad they're helpful!)
korppi_ravn 12th-Jun-2012 11:35 am (UTC)
Thanks so much for the articulated and detailed response! I'll definitely have a conversation with him about this, as it would suck if I got genital herpes, since it puts him at risk of getting it too! Luckily we're open with each other, so it shouldn't be too much of a problem, hopefully.
ghostyacct 11th-Jun-2012 10:22 pm (UTC)
Thanks for the helpful reply. As I said in the edit to my post above, the gynecologist today said that she's assuming it's herpes. So that's that. I have herpes. I don't know where I got it, and I can't talk to my boyfriend until Wednesday or so since he's in the military. I feel pretty awful that I may have exposed him. Now that I think about it, he said the he may have started getting cold sores, but only after he started dating me. I think that I may have had oral cold sores as well, but only in my mouth. I'm not really sure, though. Is it possible that I spread the infection to him orally, then he gave it to me genitally?

I also still can't believe that this happened to me, and I'm upset that I didn't do more to prevent it. I definitely was crying in the doctor's office when I found out and trying not to have a complete breakdown. I have so many health issues as it is, so I hate that I have to deal with something else. I also grew up in a pretty sex-negative, religious household and only had abstinence only education. I always cursed abstinence-only education because it gave me some pretty negative ideas about sexuality, but now I just wish I listened to them a little more. ugh.

Also, I'm confused what you meant when you said, "It's just cold sores, except what it gains in potential discomfort from peeing, it loses on the ability to show up on your driver's license for a few years in a row."

Edited at 2012-06-11 10:25 pm (UTC)
korppi_ravn 12th-Jun-2012 11:23 am (UTC)
Re: the last part, what I think she means is that while yeah, genital herpes may be annoying and it may hurt while you pee, it won't be like the cold sores on your mouth that could pop up just as you're going to be having your picture taken (like for your driver's license.) :)
sweetchild92 12th-Jun-2012 11:59 am (UTC)
im willing to bet good money that this happens to me when I get to take my long awaited for new picture for my renewal lol
ghostyacct 12th-Jun-2012 04:48 pm (UTC)
ohhhhh alright I get it. Thanks.
archangelbeth 13th-Jun-2012 11:45 pm (UTC)
Is it possible that I spread the infection to him orally, then he gave it to me genitally?

It is not at all impossible! Unlikely, yes, as your antibodies should have protected you, but if your immune system was in an unhappy place, it's not impossible that the virus could have raced up a pelvic nerve and found refuge in the spine before your immune system killed it. It is also, sadly, possible that you might have been exposed both orally and genitally at some point in the past (e.g., kissing and receiving oral sex from a partner who was shedding contagious viral particles), and therefore got an infection in both locations at the same time, before your immune system could do anything about it.

It's also possible that your boyfriend might have had cold sores already, and is just getting them triggered; there is at least one study I dug up (though I'd have to do a more intensive search to dig it up again) that suggested partners who both had HSV would tend to have breakouts together. I believe the speculation/assumption was that the additional viral load from the partner temporarily overwhelmed the immune system's defenses and allowed an outbreak to occur. (But it could also be that shared stress lowered the immune system's defenses in each partner at roughly the same time; correlation does not equal causation and all that.)

And yes, what korppi_ravn said: oral herpes can show up as a large, visible, and somewhat unsightly scabby blotch on driver's license pictures (I think it was three years in a row I got an outbreak right on picture day!), as well as be uncomfortable. Genital herpes can be painful, but at least it's not on a photograph you have to show to everyone for the next year. O:(

Talk to your doctor about suppressive treatment and whether it's a useful thing (and if your insurance will cover it), and I'd suggest getting your vitamin D levels tested, just in case. Vitamin D, for me, really helped my immune system a lot, and it's your immune system that keeps the virus besieged in your spine instead of running down the nerves to the surface to try to colonize new mucous membranes.

Please, do try to forgive yourself! As I said, I was married for years before I got the memo that cold sores were oral herpes, and potentially contagious to someone else's genitals! And I didn't come from a particularly sex-negative background, either; just... no one mentioned it. It's entirely possible that the only reason I didn't give my spouse genital HSV-1 is luck that he already had antibodies. (And, frankly? I would still curse that abstinence-only education, because there are precautions that can be taken to minimize the risk without totally denying your physical urges.)

*sends an offer of hugs, if they'll help*
corinthia_moon 11th-Jun-2012 03:18 pm (UTC)
Okay, shooting up heroin when you find out you have herpes is a VERY EXTREME reaction, and I honestly think that someone who does that has a whole host of other issues going on besides the diagnosis.

There's a very high percentage of adults with herpes, and getting diagnosed with it is not the end of the world. However, a sore can mean a lot of things, and it doesn't necessarily mean you have herpes. It can be a pimple, an ingrown hair, or possibly even a spot of irritated skin caused by the yeast infection. So: do what you can to get tested, Planned Parenthood has a sliding scale.
sweetchild92 12th-Jun-2012 06:07 am (UTC)
I think what I gathered is that the woman who did that was already struggling with an addiction, and then the stress of finding out led to a relapse
ghostyacct 12th-Jun-2012 06:32 am (UTC)
Yeah, she has had problems with addiction, but according to her, finding out that she had herpes is what drove her to start shooting heroin, which really was sort of..the final frontier. She got into rehab soon after (as a result of her parents finding a needle), and is in NA, but she relapsed as recently as during this past week. I called her today, because the gynecologist told me that I have herpes and she's the only one I can talk to who can relate.
sweetchild92 12th-Jun-2012 08:07 am (UTC)
That's a shame, because it really is a skin condition at most...and responds to treatment much better than my acne ever will *sigh*

Hope you're doing ok! Anything we can do/provide u with?
ghostyacct 12th-Jun-2012 06:16 pm (UTC)
Yeah, I don't know. I have a million questions that I'm writing down to ask my doctor when she calls me with the blood test results. I'm definitely upset, and I'm dreading having to tell my boyfriend. He's in the military, so I have to wait to talk to him. I've even dreamt about it the past two nights. I guess all I want is just general advice. What do I need to know? I'm not sure where to begin.
ghostyacct 17th-Jun-2012 08:26 am (UTC)
One random question! I've recently started getting Brazilian waxes. Most recently, I got waxed at a pretty sketchy, but extremely affordable salon (we're talking $28 vs $60). Now, she definitely used tweezers that may or may not have been sanitized, though I'm confident the wax is sanitary.

Is waxing an issue with herpes? I assume if I'm having an outbreak it's a bad idea for a number of reasons, but if I'm not, am I in the clear? Should I find a place that's more sanitary?
sweetchild92 17th-Jun-2012 08:49 am (UTC)
I've never heard of anything wrt to herpes and waxing, I wish I had better info for u! I don't think it would even be an issue if there's no outbreak, but if it seems sketchy then for your sake I'd look around at other places/prices.

If you were to make a post asking this, I know ppl would have better info, but that's ttly up to you! I can look it up, I just won't be able to get to my computer until who knows when tomorrow evening lol.
archangelbeth 13th-Jun-2012 11:48 pm (UTC)
http://www.herpes.com/hsv1-2.html is a site I found fairly informative! If there's anything you need translated out of medical jargon, just ask.
ghostyacct 17th-Jun-2012 09:00 am (UTC)
This is pretty interesting. On the CDC's website, they say, "Genital HSV-1 outbreaks recur less regularly than genital HSV-2 outbreaks," but this site goes more in-depth into the difference, which I was curious about since I haven't found out which strain I have yet. I'm thinking that it's possible that I have HSV-1 in my genitals since I've only had one sore, if this information is reliable, as this site says, "A third factor influencing the frequency of HSV -1 and 2 outbreaks is whether the virus is established in its site of preference. While HSV can infect both genital and oral areas, both types cause milder infections when they are away from "home" territory. Outside their site of preference, both type 1 and 2 lose most of their punch."

I also found this very interesting: "Only about one quarter of people with genital HSV- 1 shed virus at all in the absence of symptoms, while 55% of people with HSV-2 do (Wald, New England Journal of Medicine, 1995). "Shedding data appear to parallel recurrence data, meaning that people who have a lot of recurrences also have a lot of shedding," says Wald."
archangelbeth 17th-Jun-2012 09:55 pm (UTC)
Statistically, HSV-1 has fewer outbreaks on the genitals, and/or milder ones, yeah! (Though it's not 100%; there are some people who've posted about some pretty extreme genital HSV-1 outbreaks, too. There's a bell-curve.)

If you get a "negative" on the blood tests, I'd suggest testing in another few months, in case it's a situation where this is actually a first outbreak (first outbreaks are usually extreme -- but not always), and your immune system hasn't built up detectable numbers of antibodies yet.

Crossing fingers that, whichever it is (if it is at all, of course), your immune system will beat it down quickly!
corinthia_moon 12th-Jun-2012 02:58 pm (UTC)
It really is just a minor health issue, that affects a large fraction of sexually active adults. It's not a big deal at all. I was once misdiagnosed with HPV and that was when I learned how prevalent both HPV and herpes are. Getting diagnosed with one is certainly not the end of the world or a cause to use heroin.
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