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Ask Dr. Norm S. Your Own Question
Dr. Norm S.
Dr. Norm S., Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 11244
Experience:  Over 30 years of experience in OB/GYN practice, including teaching students. Fellow of American Board of Obstetrics and Gynecology.
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How would you treat a vaginal ulcer? I have SLE also.

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how would you treat a vaginal ulcer? I have SLE also.
How long have you had the vaginal ulcer? Is it painful? Thank you.
Customer: replied 6 years ago.

It is not painful. I've have it about a week. I'm currently taking antibiotics for Bacterial Vaginitis. The practitioner I went to said to wait and let it heal on its own. She and the lab lady at the clinic did not think it was Herpes because it looks like an ulcer. But, I went on an let them do the blood test to be on the safe side. I am still awaiting the results. I have been with the same partner for 6 months. I read on webmd that SLE patients could get nose, mouth and vaginal ulcers from time to time. this is my first time experiencing this. I had my year pap in Dec 2010 and everything was fine. Please help.

Although mouth ulcers occur with SLE, I believe vaginal ulcers are rare. It's unfortunate that a herpes culture wasn't taken, since most vaginal ulcers are from herpes. Blood tests usually are not helpful in diagnosing vaginal ulcers, since many people have positive antibodies to the herpes virus who don't have genital herpes, and a recent genital herpes ulcer usually won't show positive antibodies, since they may take weeks or more to develop. Genital herpes ulcers are usually painful, but not always. Painless vaginal ulcers suggest syphilis, but that's far more unusual. I would recommend that you get a herpes culture done from the ulcer, if at all possible. If the ulcer goes away (which herpes always does), you won't know until it comes back, if it does. There's no way to know how to treat it until you know what is causing it, other than keeping it as clean and dry as possible. Best wishes.
Customer: replied 6 years ago.

They had drawn some blood from me on Wed for a Herpes Simplex. I haven't gotten the results back yet. She said something about doing a culture but it wasnt a blister or a head on it. It looks like a small ulcer about the size of a pea or a little smaller. Syphilis...OMG!!! Couldn't my OBGYN detected this from my PAP in Dec if I had any of these diseases? He said my results were fine. I had to go back to him like a month later because he wanted to make sure my pills were working okay for me. Don't the Pap check for these diseases too? Is Syphilis treatable? What do I need to do? Just wait for the Herpes Simplex lab results first...then what?

As I said, blood tests won't help. Genital herpes is usually an ulcer with no blister or head. The only way to diagnose genital herpes is by a culture from the ulcer. It won't show up on your Pap smear, nor will syphilis. Syphilis is treatable, but you most likely don't have it. If the ulcer doesn't go away within a week, then you should be checked for it. I would not wait, but find a doctor to do a herpes culture.
Customer: replied 6 years ago.
Is herpes treatable? will I have to live with this for the rest of my life? What will the treatment me to get rid of this little ulcer? Is herpes contagious? I really don't know if it is an ulcer or cut. Me and my boyfriend had sex on sunday a week ago and he's rather large and we tried a new position and it was uncomfortable. So we stopped. Within the same week was when i noticed the "uninvited guest". Could herpes show up so soon? I don't have any open sores or anything...and I didn't see any on him or his mouth area.
Herpes is treatable but not curable. Some women get one outbreak and it never occurs again. If it does keep coming back, we have pills that keep recurrences to a minimum. It the ulcer is herpes, it will go away on its own. Herpes is contagious. I doubt that your ulcer is because your boyfriend is large. Herpes can show up in 1 week.
The only way to know is from a herpes culture. If you don't get that, you won't get any answers.
There is more information on herpes here
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