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Hi there Aunt Vadge,
Last week my boyfriend and I had sex for five hours. My labia was bleeding, sore and stinging afterwards, unexpectedly. I didn’t think much of it, but it didn’t stop bleeding, so I went to the ER, and they said I had tears/sores in my vagina and on my labia.
I had a swab for herpes that came back negative – but I do have lichen planus, and I went through menopause at about 30. The other day we had sex for five hours again and the same thing happened. I’m still scared it’s herpes, even with the blood test too.
Can it be herpes?
Thanks,
Stinging
Age 48, USA
Dear Stinging,
Let’s settle the herpes fear firmly first: you almost certainly do not have herpes. You’ve had a negative swab and a negative blood test, and herpes antibody blood tests are reliable (false negatives are uncommon), so between the two you’re well covered – and just as importantly, the picture you describe doesn’t fit herpes anyway.
Herpes is painful clustered blisters and ulcers, not friction tears and bleeding brought on specifically by very long sex. So please put that worry down.
What’s actually happening is mechanical, and it makes complete sense given two things you mention: you have lichen planus, and you went through menopause at around 30.
Both leave the vulval and vaginal tissue thinner, more fragile and slower to heal than average – and five hours of intercourse is a marathon of friction that would challenge even robust tissue, let alone fragile, low-oestrogen, lichen-planus skin. So it tears, stings and bleeds, twice now, for exactly that reason.
The fixes follow from that: keep your lichen planus well managed with your dermatologist or vulval specialist, since the right prescribed treatment keeps the skin as resilient as possible; talk to your doctor about local (vaginal) oestrogen given your very early menopause, because rebuilding that tissue makes an enormous difference to fragility and comfort; and use plenty of good lubricant.
And gently – five-hour sessions are simply too much for your tissue right now; shorter, well-lubricated, with breaks, will let you enjoy it without the aftermath. If the tearing keeps happening despite all that, a vulval clinic can check whether the lichen planus needs a treatment tweak.
You’re not dealing with anything sinister – just fragile tissue that needs a bit more care than it’s been getting.
Warmest regards,
Aunt Vadge
This is general information based on current research and our clinical experience, not a substitute for personalised medical advice.
