Other STI questions

Concerned about friend with herpes

  Q . One of my friends is having some sex problem. He had this STD called herpes. He got the treatment for it and took Acyclovir 200mg 3 tablets for 6 months but not cured. Let me give the details of his problem from the start:My friend is 30. He had sex with a call girl about 10 years back and his problem started from that day. After 2-3 days of sex he started having red rashes and many small pea size infections in one place just below the head of the penis and under the foreskin on the right side and great itching and pain on those peas and got puss and found these have gone themselves after 4-5 days. After that whenever he had oral sex he got the same symptoms and themselves disappears. He got the same treatment for herpes and got the Igg and Igm tests which confirmed the infection. after 2-3 years he thought the problem gone but the situation was as it is. Even after 10 years the same problem is there. His doctors again suggested a 6 month course of Acyclovir as referred above. Even after completing this course he is still having pain and itching and red rashes after oral sex. He also has pain while passing urine. He is very disturbed and feeling ashamed of the situation. He is now married and using condoms while doing sex with his wife. Please suggest something to prevent him from committing suicide.

A. If he is considering self harm you must convince him to seek help for this let alone the herpes. IN truth we make a big fuss over herpes and it hit the headlines a couple of decades ago. This was all put into perspective when HIV came along. There is no cure for Herpes and he will have to come to terms with this. The medical treatments stop the flare up but the virus tends to lie dormant. It can pass to the mouth through oral sex so he should use a condom for both when he has the blisters present on his penis or around his mouth ('cold sores').

Some people say he should use a condom all the time while others say he should use one while the blisters are present. Others say you should avoid sex altogether while the blisters are present. Commonsense and the fact that he has a stable relationship make all the difference. Take his talk of suicide very seriously and get him to seek help via the Samaritans and his own doctor.

Should I still worry about genital herpes?

Q . Over 8 months ago I slept with someone who I later found out had genital herpes. I did use protected sex when I had penetrative intercourse but also I had oral sex (from her to me, not the other way around) where I didn't wear a condom. After the initial shock I went to a STD clinic and was checked out and everything seems to be OK even to this day. (I have shown no symptons of the signs of having genital herpes). However, 8 months on I'm still affected by the chance that I may have caught something and this in turn is affecting my mental state of mind especially when it comes to thinking about relationships.

Where do I stand? I mean I was told that after the initial incubation period if I didn't show signs that I could still have it lying dormant within me. And after 3 months if no signs had occurred then the probability of me having it was slim! What shall I do now? Is there anyway in which I can know for certain what my physical health state is so I can go forward either way and get on with my life? Or am I just worrying about nothing?

A. You are upsetting yourself far too much over this. For a start, Herpes is a million miles away from the likes of Hepatitis or HIV. It rarely ever causes any major problems, although the type II variety can cause an encephalitis, an inflammation of the covering of the brain. This is very rare and in most cases it shows itself as small blisters which ooze and can be very painful and itchy. While the blisters are present the person is at their most infectious and should wear a condom. It is possible to pick up genital herpes from oral sex but is less likely. 

The type I virus tends to cause 'cold sores' around the mouth although there is some overlap. It certainly has been a long time since you had contact and although it is theoretically possible for you to remain a carrier with no symptoms all your life, it would appear that you are probably not infected. It is possible to check your blood for the presence of antibodies to the virus but it is a poor indication of the likelihood of an outbreak.

You should enjoy sex as much as anyone else. If you do not have any blisters then the chances of infecting anyone, even if you are infected, are very low. Should they appear, and this doesn't seem likely, you should use a condom to protect your partner.

Thrush?

Q . I have red blotches on the head of my penis and is it very itchy, what is wrong and what can i use to get rid of it, i am really worried it could be serious, i have read that it could possibly be "Balanitis". Is this close to the correct answer.

A. It sounds as though you might have thrush. Candida, or thrush, is a yeast infection which causes problems for both men and women. Thrush shows itself as a red mottling on the helmet of the penis. There may be a build up of yellow pus under the foreskin unless you are circumcised. A burning sensation may be present when you pass water. There are some things which will increase your risk from thrush. Diabetes, prolonged courses of antibiotics and immune system problems. AIDS is a thankfully rare cause but you should be checked out for any risk factor.

There are other infections which can cause similar problems. If you have pain passing water, or there is a discharge from your penis you may have a sexually transmitted infection. Nip down to your local GUM clinic where you don't need to give your name and no-one, including your, GP will ever know.

Have I caught something?

Q . I met a woman at a party and had sex with her. I haven't seen her since the party. The next day I had really bad itching under my foreskin and there is patchy reddening of the glans. This problem has persisted for the past month although occasionally I have days when it is not present. Do you think I've caught an std? What should I do?

A. It sounds as if you have caught thrush (candida). Many women carry the fungus that causes thrush in their vaginas without actually knowing it because their body defence mechanisms keep it under control. However, the infection can get out of control and cause unpleasant, often intense, itching and a curd-like discharge in women, sometimes with soreness and redness of the vulva. Diabetic women are especially prone to thrush infection.

Thrush in men gives rise to the signs and symptoms you describe. Fortunately, treatment is generally simple and effective and involves applying an anti-fungal cream to the affected area. There are several proprietary anti-fungal creams available from pharmacists without prescription. The woman should also be treated, usually with anti-fungal pessaries. As the infection can pass back and forth between partners you should use condoms until the infection has been treated.

Although thrush is a common problem and is easily treated it would be wise to attend the genito-urinary clinic at your local hospital to be checked, just in case you picked up another infection from this one night stand.

Genital warts

Q . Approximatly eight months ago I was diagnosed with genital warts. I have sucessfully treated the warts several time yet the warts always reapear. I understand that the virus causing the warts will allways be with me. But I have heard that it possible given time to build up a resistance to the virus, reducing it to almost nonexistent levels. What percentage of people are eventually able to control the virus to this degree? is it unrealistic for me to think that I will be able to get to a point where the warts do not reappear on an almost monthly basis.

A. You are quite right to be concerned over genital warts and most men do not realise that they are on the increase. There is a link between genital warts and cervical cancer in women which kills around 2000 each year, often young women. It is also loosely linked to penile cancer, thankfully rare. The virus which causes it - the Papilloma virus - is very difficult to eradicate once infected. Even so, by removing warts as they appear it reduces the risk of infection. Using a condom brings that risk down to almost zero. It is impossible to know what percentage of people eventually bring the presence of the virus to near non existent levels, not least because of the poor attendance - particularly by men - at genito urinary clinics. Because of this we don't know how many men have genital warts, so we don't know how many finally lose them.

The good news is that like any other wart there does seem to be a cycle of activity and that this can lead to complete disappearance. You have actually been infected for a short space of time so there is every possibility that you will be free of them.