Outbreak pain consistent or not?

[Djwahe]

Hi everyone, 

I just experienced what I think was my first outbreak of herpes in my urethra.

My question is, when you have an outbreak is the pain consistently there until it all clears or does it go in and out through out the day/weeks?

I think I may have herpes sores in my urethra, but they are just small red spots with no blisters. I was in pain for about 6-7 weeks on and off. Urination was not painful. Now I have no more real pain (still in the background sometimes) but the red spot is still visible in my urethra although inflammation has gone down.

Would like to hear about your experience with consistency of pain during an outbreak. 

Thanks for listening.

[Djwahe]

Anyone?

[tiredandlonely]

This is not consistent with what I experienced during my primary outbreak. I had a "classic" primary outbreak and it was agonizing. Mostly because of the blisters, I believe. 

I don't think it is normal for herpes to cause pain for 6-7 weeks. The outbreak would clear up within a month even without antivirals.

You could potentially have a positive IgG test now if you haven't been on antivirals. I think it's worthwhile to try that. If it is positive, at least you will know and you can stop agonizing over it (if it's negative, it won't be definitive until 12-16 weeks).

I tested negative on IgG during my initial outbreak, and positive about a month later. I know this varies for everyone, though.

I saw in another post that you took acyclovir briefly so I assume you saw a doctor. Did the doctor diagnose you with herpes or give you any guidance on this?

FWIW, trying to diagnose yourself on the internet based on non-textbook symptoms is going to drive you crazy (it looks like it's already starting to). You might come across someone who says, "yes, I had these symptoms and they ended up being herpes" but that doesn't give you a diagnosis. Only a doctor and confirmatory testing can do that. 

[Djwahe]

7 hours ago, tiredandlonely said:

I saw in another post that you took acyclovir briefly so I assume you saw a doctor. Did the doctor diagnose you with herpes or give you any guidance on this?

FWIW, trying to diagnose yourself on the internet based on non-textbook symptoms is going to drive you crazy (it looks like it's already starting to). You might come across someone who says, "yes, I had these symptoms and they ended up being herpes" but that doesn't give you a diagnosis. Only a doctor and confirmatory testing can do that. 

I saw a primary care doctor that didn’t think it was anything just irritation and “in my head”...it was not just mental. Then I saw a urologist who took a look in my urethra after I told him about the constant tingling/pain and he literally said “try acyclovir and see what happens” took it for 7 days and felt some relief, but then it all came back on day 8 after I stopped meds? Nobody has diagnosed anything, but I don’t see what else could be the cause at this point. Doesn’t add up.

[tiredandlonely]

Why did you take acyclovir for 7 days? What dose did you take?

The dose/regimen for acyclovir for a primary herpes outbreak is usually 400 mg 3x/day for 10 days.

Since your symptoms have returned, have you gone back to the doctor?

Have you had any cultures done? And skin scrapings? Any other non-herpes related blood work? It could be irritation. It could be a bacterial or fungal infection. You say this does not "add up". Add up to what? What you are experiencing does not necessarily add up to herpes.

There are lots of things that can go wrong down there. After I was diagnosed with herpes I had pain, tingling, inflammation, burning, etc. for MONTHS with no blisters. I was swabbed and tested for yeast and bacteria and even had a biopsy and nothing came back positive. I finally saw a different doctor (she is still my doctor now) and she suggested a trial of metronidazole gel (antibacterial/anti-fungal) and I was fixed within a week. My new doctor said it was probably some strain of bacteria that didn't show up on a test. 

But I was convinced for months that it was herpes causing my symptoms because of things I read on the internet. 

The point is there are LOTS of things that can cause discomfort in that area. A good doctor will help you find a solution to your symptoms. It doesn't sound like you have been to a good doctor yet. I hope you find someone who can really help you. 

Also, go get an IgG test. 7 days of acyclovir shouldn't affect seroconversion. I said in an earlier post that if it is negative you will have to get tested again after 12-16 weeks, but if it's positive, you'll know and you can go back on antivirals and get your symptoms under control.

[Djwahe]

On 5/5/2019 at 5:05 PM, tiredandlonely said:

Why did you take acyclovir for 7 days? What dose did you take?

The dose/regimen for acyclovir for a primary herpes outbreak is usually 400 mg 3x/day for 10 days.

Since your symptoms have returned, have you gone back to the doctor?

Have you had any cultures done? And skin scrapings? Any other non-herpes related blood work? It could be irritation. It could be a bacterial or fungal infection. You say this does not "add up". Add up to what? What you are experiencing does not necessarily add up to herpes.

There are lots of things that can go wrong down there. After I was diagnosed with herpes I had pain, tingling, inflammation, burning, etc. for MONTHS with no blisters. I was swabbed and tested for yeast and bacteria and even had a biopsy and nothing came back positive. I finally saw a different doctor (she is still my doctor now) and she suggested a trial of metronidazole gel (antibacterial/anti-fungal) and I was fixed within a week. My new doctor said it was probably some strain of bacteria that didn't show up on a test. 

But I was convinced for months that it was herpes causing my symptoms because of things I read on the internet. 

The point is there are LOTS of things that can cause discomfort in that area. A good doctor will help you find a solution to your symptoms. It doesn't sound like you have been to a good doctor yet. I hope you find someone who can really help you. 

Also, go get an IgG test. 7 days of acyclovir shouldn't affect seroconversion. I said in an earlier post that if it is negative you will have to get tested again after 12-16 weeks, but if it's positive, you'll know and you can go back on antivirals and get your symptoms under control.

You’re right my doctors were not very helpful...and he just said try acyclovir for 7 days only. That was the urologist, who was not helpful other than giving me anti virals to try. My primary doctor is convinced I don’t have anything based off my negative igg after 5 weeks and says any relief I experienced was likely a placebo effect lol what. I will get retested in a couple months. My urethra is still inflamed, but doesn’t hurt/tingle any more (after 6-7 weeks of pain)...that’s the most concerning thing for me and all the urologist could tell me was try antivirals because I didn’t experience pain urinating. No blisters, glans has some grey spots now after previously being red. Not itchy though. I’m heavily confused on what’s happened to me. 

[tiredandlonely]

Maybe the antivirals helped you, maybe there was some placebo effect going on (the placebo effect is a real thing), or maybe you coincidentally had a reduction in symptoms during the time you were taking the antivirals.

As you already know, to get a diagnosis without blisters, you need to wait until enough time has passed for you to have built up antibodies and get another blood test. 

You say that you have been looking inside your urethra and seeing a lot of inflammation for 2 months, but you are not in pain. Did you ever look inside your urethra before this? How do you know it did not always look this way, or that it at least did not look inflamed  before your sexual encounter?

 

I still think this could be caused by a number of things that are not herpes (bacteria, fungus, etc) that have not been ruled out. I have had yeast infections that were not painful but caused visible inflammation.

 

If there is a lot of inflammation and no identifiable infection, it may be worth asking your doctor about trying a course of steroids. The downside of this is that if you do have herpes, steroids can cause a flare up (especially if you're not on antivirals). 

 

However this may not be all bad; if you have a flare up, you can get a swab and potentially get diagnosed. You an also get back on antivirals more quickly, which will hopefully lead to earlier long term comfort/easing of your symptoms if this is herpes.

 

If you don't have a flare up, steroids should help the inflammation to go down and you will at least be more comfortable while you wait to get the blood test.