Is It Herpes or Not? Aunt Vadge's Expert Advice

Hi Aunt Vadge,

I had condom-protected sex with a guy in the beginning of July 2015, and in late August noticed a large lump, a painful swelling, on my left labia majora that appeared extremely rapidly, contained fluid when squeezed, but that went completely away within a day or two.

I have had unprotected sex with a second guy since then, and since the beginning of September I have been having unprotected sex often with my new boyfriend (third guy, second since swollen lump) and none of us had any signs or symptoms of anything.

Also, I’ve been tested for STIs twice in the last month or so, and the first time I had blood work done which came back normal (although I’m not sure if they tested specifically for herpes or not) and just a few days ago had a swab test and was treated for a yeast infection. I’ve spoken with the guy from July and he said he had thorough blood work done before he could participate in sports as he is a student athlete and does not have herpes as far as he knows.

Again, I’ve shown no symptoms since July and neither of my 2 recent partners (one of which who is now my boyfriend who I have unprotected sex with regularly) have shown any symptoms either.

I am wondering that, if infected with HSV2 and having constant unprotected sex with a partner, what is the likelihood of them having symptoms? If none of us have any symptoms is it safe to assume it was not herpes?

Yours,
Concerned
_____

Dear Concerned, It seems so unlikely to be herpes it’s not funny. Here’s why.

The reasons it probably isn’t herpes:

You used a condom with Guy 1.
You have been tested not once, but twice, and so has Guy 1. They routinely test for HSV.
It was almost two months between your sexcapades with Guy 1. Herpes symptoms, while not always popping up ‘on schedule’, usually appear between one and three weeks after contact (oral, anal, vaginal). This takes your symptoms outside of this time span.
Guy 2 and 3 seem to have zero to do with this, and do not have any symptoms of any kind.
Herpes is usually passed on by open lesions on the genitals, but it can be passed by body fluids with no lesions present, because it lives in our cells, not on our skin. People tend to notice these sores and avoid sex while they freak out about them. This doesn’t explain why people still end up with herpes very frequently, however, so see below.
Herpes sores are typically very painful. Your little pimple thing does not fit the typical bill – herpes sores may last for weeks, but they are not something you would squeeze and that comes and goes within a day or two. Or even three. Herpes outbreaks on the genitals are usually pretty noticeable, however lesions can present as small pimples or ingrown hairs, but because of the nature of viruses, their active time before your immune system can override them is longer than you describe. Symptoms can be very mild or non-existent, though, so you may still have herpes.
So, while herpes can look like an ingrown hair or pimple, you may have actually had an ingrown hair or a pimple. Hair follicles are easily blocked by sebum and gunk, and if you shave the area, ingrown hairs are more common. I’m not suggesting that you don’t know what an ingrown hair looks like (I’m sure you are all too familiar), but it has to be mentioned. Those, however, would be red and a bit inflamed.
It could be what’s known as a sebaceous cyst. These are small lumps filled with fatty sebum, and you can squeeze stuff out of them, and they appear as a lump under the skin. Look up some images online (if you dare – some of them are pretty gross) and see if your lump matches. True sebaceous cysts are pretty innocuous and not dangerous. They have this little sac in them that, if they recur, usually needs to be removed via a very small procedure that your GP can do. No big deal at all.
It could also, depending on the position, be a Bartholin’s gland/duct cyst. Also very benign, no big deal, and shouldn’t come back.

What to do now

Get hold of your medical records – you should always have a copy after every visit with any practitioner – simply request a copy to be posted to you, emailed to you, or available for you to pick up from the office.

Write again anytime.

Warmest regards,
Aunt Vadge