How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Owen Your Own Question

Dr. Owen
Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience:  Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
18703594
Type Your OB GYN Question Here...
Dr. Owen is online now
A new question is answered every 9 seconds

I began having unprotected sex approx 3 months ago

Customer Question

I began having unprotected sex approx 3 months ago with a new boyfriend. I have been to my gyn 3 times and have tested negative for everything, including a herpes swab. However, my symptoms have persisted for nearly 7 weeks. Itching and burning on vulva and constant itching of face and nose, esp. Three days ago I found a single puss-filled bump under the labia minor...very hard to see, but it has since popped and ironically does not hurt. Doc did diagnose me with BV ten days ago and gave me flagyl and clobetasol. Said it looked like lichen planus and I had the white lines on interior cheeks to match. All along I have suspected HSV and have nearly driven myself mad from anxiety. The appearance three days ago of the "blister" of sorts does have me overly concerned, as I can find no other explanation other than HSV. BF was tested two weeks ago and "claims" to have gotten all negative results, but it was just a phone call from Dr., no paperwork given. I find it to be just too ironic that I have NEVER had an issue, was married for many years, and that the first unprotected sex I have had in over fifteen years would just happen to coincide with lichen planus. Of interestMay be that Around this time I began to workout daily and have been on a fairly unhealthy diet, resulting in a drastic 30 lb+ weight loss.
Submitted: 1 year ago.
Category: OB GYN
Expert:  Dr. Owen replied 1 year ago.
Hello, I am Dr Owen, I am a Board Certified Ob/Gyn Medical Doctor and I want to help you.

Hello - well as for the HSV and a single blister that did NOT hurt - I do Not think this is HSV because usually HSV would be multiple very SMALL clear fluid filled lesions that burn and sting - and a single blister like you have described can be easily attributed to irritation from rubbing of the skin of the vulva/labia - and hence such as a sebaceous cyst or inclusion cyst - so more than likely this was not HSV.

As for Lichen Planus - interesting - rare to diagnose in a 38 year old women - and I would actually confirm this diagnosis if you can with an ob/gyn who can do a very small biopsy so that a pathologist can confirm this because to treat the lichen planus treatment with the clobesterol is for 6 months and that is a long time to be using a high potency steroid.

As for BV - and your vagina - I would suggest using a daily Probiotic - this will help your vagina keep a normal pH (acid - base balance) - and a good probiotic to use would be using RepHresh vaginal gel.

And, since you are having all that itching / burning - get the biopsy - this is called a 'Punch biopsy' and also get a culture for a yeast infection (this is a swab that gets sent to check for a yeast infection such as Candida glabrata - and other yeasts that are resistant and that do not necessarily show on a simple swab on the doctor's microscope).

I hope this helps
Please if you have more questions, please do ask
Please click on EXCELLENT (please do not click on poor or bad, instead please ask more questions)
Thank you
Dr Owen
Customer: replied 1 year ago.
Dr. Owen:

Have you ever seen HSV that presents as just a single blister? Is this possible? And an initial outbreak that lasts 7-8 weeks?
Expert:  Dr. Owen replied 1 year ago.
Actually it is quite rare - and really does not happen as hsv lesions are very small lesions - look very small about 1 to 2 mm in size and hurt/ burn/ sting real bad - and if this did have pain then this was not herpes.

Also an initial outbreak - usually lasts at most about 1 to 3, but Never 7 to 8 weeks.

I hope this helps
Please if you have more questions, please do ask
Please click on EXCELLENT (please do not click on poor or bad, instead please ask more questions)
Thank you
Dr Owen
Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.
The area where the single blister had been now has begun to sting just slightly. The blister was not a watery blister, bit more like a pimple or smal cyst. It is not visible today, even with the application of hydrogen peroxide in an effort to locate what I thought would have been ulcerated by now. It has just frankly disappeared. However, I am now fairly certain that a yeast infection of sorts has been presented as a result of the Flagyl antibiotic taken for a full week. The upper vulva burning persists, to the point that Ambien has become my friend providing me an escape from googling all night. The Dr has recommended Provella and Rephresh to try to get the "balance" of things back on track. She has also given me the option of an anti anxiety drug, should I need that. My question still persists as to the length of the problem...nearing 8 straight weeks will zero relief and am beginning to feel really down. I had a friend who told me I was crazy prescribe Valtrex for ten days so I started that today hoping for some relief. Anything else I should consider?
Expert:  Dr. Owen replied 1 year ago.
I'm glad you are starting the valtrex....

Sometimes I prescribe LIdocaine jelly to numb he area - it might help

But, I would check to see if this is a resistant yeast infection - and you might need diflucan, and then you might get that biopsy I suggested for diagnosing Lichen and if you have lichen then a high potency steroid such as clobesterol might be need.

I wish you well
Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55752
Experience: Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
Dr. Owen and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.
My Dr thought I was nuts when I ordered the IGG and IgM bloodwork yesterday, but I still have buttock pain, lower back pain, and even what feels like uterine pain. The vilva is red and calloused, but not blistering and there is discomfort around the anus that can only be described as itchy. I am in tight spandex pants most days for a few hours and my diet has been too unhealthy as well. I wonder if I have stripped my auto immune system down and should be taking something to boost that. The blood test was also drawn at approximately seven weeks post-exposer, so will that be a long enough time to detect the antibodies!
Customer: replied 1 year ago.
I have the lidocaine gel as well as the clobetasol ointment and am using them both intermittently with only minimal relief, combine with ice packs directly applied several times per day.
Expert:  Dr. Owen replied 1 year ago.
Let me ask you this - have you been tested for 'shingles'?
This can be checked with a Varicella titer?
Customer: replied 1 year ago.
No, but once I receive the bloodwork results, if they are negative, would you recommend this? My gyn said she would then refer me to a specialist at that point.
Expert:  Dr. Owen replied 1 year ago.
Hello - yes I would definitely get checked for shingles - but also I would get a biopsy in one or two areas that are the worst areas and the size of the biopsy is ONLY about 3mm (so very small).
I really wish you the best and Please keep me informed ( am very curious about this.
Thank you
Dr Owen
Customer: replied 1 year ago.

Last night I began having bad pain again, like in the beginning. Checked, and definitely a horrible yeast infection exists. Likely from the Flagyl, I presume. Called Dr., and got Diflucan for the third time in 8 weeks. Also, got the HSV results in. I am not sure if this is correct, but she said that both hsv 1 and 2 were negative as far as being in the active state. She did say that I have hsv-1 (value was 5+??? what does that mean) but that is was very dormant, "oral" hsv-1, and had likely had it since childhood. I do get ulcers on the inside of my mouth in times of severe stress and have for years and years, but never a fever blister. Wouldn't I have been tested for this and someone alerted me during my previous pregnancies? She said it was completely unrelated and that I should not worry b/c if it were genital hsv-1 then it would have shown up in the "active" blood test. Does any of this make sense. I asked if I should take Valtrex and she said, "Heavens No, you don't need that!" One test was igG and one IgM I think, but not sure which was which. The hsv-2 value was <.9.....still unsure as to what that all means. Once the current yeast clears she intends to refer me to a more specialized gyn for further testing.

Expert:  Dr. Owen replied 1 year ago.
As for herpes - the only TRUE test is a culture of the Lesion or sore itself - a BLOOD test does NOT tell you anything if you have active herpes or not - all a blood test tells you is that you have been exposed to herpes at some point in your life - it really does nothing else - so ONLY a culture from the skin itself will tell you if this is herpes or not.

And, as for pregnancy - we do NOT do blood tests for herpes in pregnancy - ONLY a culture if you have a lesion that is suspicious for herpes...

But I still think you need a Culture of the skin Plus a Biopsy of the skin - because more than likely ONE or Both of these tests on your vaginal / vulva skin will give you the EXACT answer that you need and not just a guess which it sounds like is happening....

Blood tests are fine - but that is not what you need.
I would Push to get the cultures and biopsy done.

I hope this helps
and if you have more questions, pleaase ask
Thank you
Dr Owen
Customer: replied 1 year ago.

Interesting. Surprising (and frustrating) that my Dr. doesn't tell me this, although there is no longer a lesion to culture. She did say that 8-9 weeks with yeast and BV could happen, but is def. not a herpes incident. I will let you know, since we are both curious, what the outcome with the specialist indicates and many thanks for your prompt and thorough responses.

Expert:  Dr. Owen replied 1 year ago.
I wish you well
Keep in contact...
Dr Owen
Customer: replied 1 year ago.
Have not seen specialist, but am certain now that it is GHSV-1. A small line of 7 or 8 water-filled blisters finally appeared on the labia major. So small that I actually had to take a picture and zoom in to tell for certain. Odd, b/c I felt this rough patch for the last 6-7 weeks, had my Dr. Look at it and that is when she said she thought it was lichen planus. Now, three days after discovering the blisters, they are still there, I am taking 2 1000mg valtrex daily, and symptoms seems to actually be progressing rather than subsiding. Lower back pain, random itching primarily in buttocks and face, and fairly intense pain, enough that I am breaking a Lortab into thirds and taking that to get the edge off. You seemed curious so I thought I would update you. I plan to get into Dr tomorrow or Tues to biopsy/swab the blisters just to confirm. Given the duration of this, I would suspect that I really didn't have prior exposure? Additionally, although I have had chronic ulcers in my mouth always during times of extreme stress, aren't I correct to assume that even if I have had hsv-1 for many years, that it would not manifest on it's own in the genital region? I realize that pointing fingers upon discovery is a common reaction, but my hope truly is that there is a slim possibility that this could be self-contained? Make sense?
Expert:  Dr. Owen replied 1 year ago.
Welcome back...
Do these blisters itch at all?

Do you have any allergies too?
Customer: replied 1 year ago.
No allergies and no itching. They are very small. 7 or 8 located in an area literally half the size of my fingernail. But they do hurt and the area just below my nose above my lip is very itchy....am assuming prodromal or a reaction to the valtrex? I have taken so many meds over the last eight weeks and applied so many creams that while I am sure that I have taken unnecessary meds that could have messed me up, the appearance of these tiny blisters serms to be very indicative of hsv. Is there a way for me to send a picture to you? I would be happy to if you would like to see it. Not expecting a photographic diagnosis, more to appease your curiosity than mine. My hsv-1 level was high enough to confirm at least that much for me. I just want to be responsible henceforth if I am fortunate enough to find someone that will consider a relationship with that kind of "baggage". Fortunately I am extremely well-educated and have an excellent career and children who keep my like fairly fulfilled!
Expert:  Dr. Owen replied 1 year ago.
Well these could be either herpes, but also I see these similar appearing lesions with a Bacteria Staph infection.
so if the Valtrex or similar medications are not working well - then usually a medication such as an Antibacterial medication cream such as Bactroban (a presscription) cream helps, or you might try an over the counter product such as Neosporin.

I hope this helps
If you have more questions, please ask
Thank you
Dr Owen
Customer: replied 1 year ago.
You have been most kind and helpful. I will let you know what the results of the swab are this week. Enjoy the rest of your weekend!
Expert:  Dr. Owen replied 1 year ago.
Great
have a great Sunday
I'll be online day!
Take care

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Last | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. C.

    Board Certified

    Satisfied Customers:

    1618
    28 years of experience and an award-winning educator.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/DrCollins/2013-11-3_1283_Cascade669.64x64.jpg Dr. C.'s Avatar

    Dr. C.

    Board Certified

    Satisfied Customers:

    1618
    28 years of experience and an award-winning educator.
  • http://ww2.justanswer.com/uploads/drhearne/2009-11-8_74742_monika_hearne2.jpg Monika Hearne, M.D.'s Avatar

    Monika Hearne, M.D.

    Board Certified OB/GYN

    Satisfied Customers:

    5745
    With experience and compassion, I treat my patients like family.
  • http://ww2.justanswer.com/uploads/jmcjrmd/2009-6-26_4212_Joepicture_Edited.jpg Dr. Charles's Avatar

    Dr. Charles

    OB/GYN (Doctor)

    Satisfied Customers:

    140
    Board Certified. Solo practice for 8 years; delivered more than 1300 infants and performed more than 800 surgeries.
  • http://ww2.justanswer.com/uploads/DR/DrK99/newpic2.64x64.jpg Dr. K.'s Avatar

    Dr. K.

    MD

    Satisfied Customers:

    1503
    Board certified OB/GYN with 20 years of experience.
  • http://ww2.justanswer.com/uploads/drprabirkumarda/2010-08-07_144928_Photo-0010_1.jpg DR PRABIR KUMAR DAS's Avatar

    DR PRABIR KUMAR DAS

    CONSULTANT GYNAECOLOGIST

    Satisfied Customers:

    1352
    MBBS(CAL)MD(G&O)
  • http://ww2.justanswer.com/uploads/jbbrowndoc/2009-09-29_180651_headshot.jpg Dr.JBB's Avatar

    Dr.JBB

    Board Certified OB/GYN

    Satisfied Customers:

    1293
    15 yrs experience in Women's Health, Pelvic reconstruction and Incontinence
  • http://ww2.justanswer.com/uploads/RP/Rpjtlawr/2012-9-5_16443_Robportraitadjusted.64x64.jpg Dr. Lawrence's Avatar

    Dr. Lawrence

    OB/GYN

    Satisfied Customers:

    442
    Board Certified OB/GYN and accomplished educator