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Is it herpes?

Herpes Simplex (HSV) detection often can be a diagnosis just through visualization from your gyno, or your PCP primary care physciaan, and your gyno would likely be able to examine your partner as well.

  1. You will get to know the symptoms and you will know if you have recurrent infections without repeat testing. If you have what you think is a painful pimple or gentile area sore you may in fact have a herpes out break. Classic cases of HSV cause blisters or ulcers are fairly clear cut and your gyno would likely be able to diagnose the cause by visualization.

  2. Confirmation of active herpes simplex infection (HSV) is best, particularly for first outbreaks, done with medical testing.

  3. If there is a lesion then a culture test should be done, if not, then blood testing is indicated.

  4. Some people either never get the obvious blister cluster or just get such mild symptoms that they don't come to the gyno with an active infection to culture. But even with a cluster of herpes blisters it may not be an easy condition to confirm by culture tests as the virus is difficult to grow. Since the herpes virus is difficult to culture and in fact false negative culture results are common you may need a blood test anyway to see if you have herpes.

  5. Your gyno will determine which of all the tests available to you you should get. Understanding the science and interpretation can be complex, and we recommend consultaiton. The blood test for genital herpes is usually a test for HSV-2 IgG, but you should also get tested for HSV-1 IgG if you still suspect you have herpes but the HSV-2 test was negative. New or reactivated infections may also have IgM for HSV-1 or HSV-2 positive.

  6. Most gynos will do the tests for both virus strains, and for IgG and IgM together. IgM is less accurate, but does detect acute infections. And since 40% of new infections go undetected, be prepared for a positive test even if you don't have symptoms.

  7. Herpes infections can be somewhat devastating to contemplate, so speaking with your gyno about your case and the longer term management is important. Repeat testing is not really necessary for you, but for each partner, you may want to consider if you have them tested.

  8. If you do have a new case of herpes, don't feel alone, there are over 1 million new cases of herpes each year in the US alone. And blood tests will show that about 25% of all US women are positive for herpes. So blood testing is important, and some gynos want to test all their pregnant patients as we miss so many. When to re-test is as important as getting that first test, and again, it's a topic to gab with your gyno about, especially if you have a new partner or new symptoms.

  9. When you have a new partner, each of you should think about what STD tests to have, and again, a good time to discuss with your gyno:


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