Genital Symptoms: Herpes or Fungal Infections? - Urology

Reproductive organs

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Hello, Doctor! I would like to ask whether my symptoms are indicative of genital herpes or candidal balanitis.
I have been symptom-free for six months, but recently I have been feeling more stressed, depressed, and anxious.
Occasionally, I experience a cramping sensation in the glans, particularly in the area where I previously had ulcers.
Therefore, I would like to clarify my situation.
I am someone who is hesitant to identify as someone who likes men, but I have had three encounters, all of which involved condom use.
The only other sexual activity I engaged in was mutual masturbation on May 21, 2017, with no genital contact.
Shortly after, I noticed some inflammation on my glans, which eventually led to localized ulceration at the coronal ridge.
I visited Dr.
A on June 13, 2017, and he diagnosed it as a fungal infection, prescribing Fungus Cream, which resolved the issue after two weeks.
(I previously did not have a habit of cleaning under the foreskin.) He advised me to retract the foreskin for cleaning, as this was my first experience with inflammation leading to ulceration.
Around September 30, 2017, I had another encounter involving mutual masturbation, during which there was brief genital contact for about 10 seconds.
This time, I did not experience any symptoms, and the ulcers mentioned earlier were not located in the area of contact.
(During this period, I did not engage in any further mutual masturbation.)
On March 10, 2018, I had a symptom-free encounter, but several months later, I began to masturbate frequently.
Initially, when I touched the coronal ridge, it was very sensitive, and even water from showering would cause a stinging sensation when it came into contact with the retracted glans.
The glans appeared red, had a slight odor, and there were many white flakes.
When I retracted the foreskin, I noticed small blisters inside, which were not located at the ulcer site.
I visited Dr.
B in early March 2018, and he diagnosed me with balanitis (at this point, there were no obvious red patches).
He prescribed Meikang Cream, which showed improvement in the first week, but I continued to masturbate frequently.
During weight training, I accidentally pressed against the glans while stretching, which caused a nerve-like pain.
After resting, I noticed some localized red patches that were not raised.
I continued applying Dr.
B's Meikang Cream for the second week, but I observed scattered small blisters under the retracted foreskin, which I could not determine if they were rashes or blisters (all were under 0.1 cm in size).
I did not notice any blisters of varying sizes.
At that time, the coronal ridge and glans had ulcerations, and there was a point of slight bleeding, which left a bit of blood on tissue when pressed against it, indicating some injury.
As the ulceration worsened, I quickly sought another clinic for a consultation.
The doctor did not perform any tests or explain my symptoms, but prescribed medication for balanitis, which did not improve my condition.
During my follow-up, he suggested an antiviral injection, and I inquired about the reason, to which he mentioned a "cold" in the genital area (at that time, I was unaware of herpes).
I opted for the injection and antiviral medication, and he advised that if my condition did not improve, I should visit a larger hospital.
During that follow-up, I received a prescription for a herpes cream (5% Acyclovir) from Dr.
C.
After researching, I was shocked to realize that I had not engaged in any sexual encounters since September of the previous year, so I was confused about why symptoms would appear in March of this year.
However, after applying that medication, the ulceration worsened, and I noticed more bleeding points.
After a month of this situation, I returned to Dr.
A, feeling that my condition was serious.
He stated that I had a fungal infection and skin allergy, possibly due to incomplete treatment previously.
He advised me to use a specific wash and prescribed the same Fungus Cream.
After a week of application, I noticed some improvement, but I was still concerned about potential herpes symptoms.
I felt a general warmth in my body, and even while sitting, I felt a warm sensation in my left testicle, along with some overall allergic reactions, including conjunctivitis (which I consulted an ophthalmologist about).
By the second week, I noticed significant improvement, so I continued using Dr.
A's medication for a total of three weeks, which gradually resolved my symptoms.
He mentioned that the initial fungal infection had not been completely eradicated, so I continued using the cream for over a month.
As of now, I have been under Dr.
A's care for about seven weeks in total, with two weeks from Dr.
B and two weeks from Dr.
C.
However, throughout this process, I have felt very low, especially when the ulcers began.
I have been worried about sexually transmitted infections, which has caused me to wake up in the middle of the night in a cold sweat, and my appetite has diminished significantly for at least a month.
Since seeing Dr.
C, I have experienced a sensation of warmth, which I am unsure if it is psychological or due to not eating much, leading to significant weight loss.
After seeing Dr.
C, my condition did not improve and instead worsened, prompting me to return to Dr.
A, where I felt a bit feverish and weak.
I am uncertain if this is related to prolonged anxiety or the effects of the antiviral injection.
During my second follow-up with Dr.
A, I became very focused on my genital area.
I have noticed two small black spots on the foreskin from previous masturbation, which I believe have been there for a long time and are not related to this episode.
I went to a large hospital for a check-up about two weeks after my visit to Dr.
A, as I still had some ulceration and continued to apply his medication.
The hospital doctor was unsure about the black spots and planned to conduct blood tests for syphilis and herpes types 1 and 2.
A week later, after approximately three weeks of applying Dr.
A's medication, the test results came back negative.
However, I am concerned that the antiviral injection from the small clinic may have affected these results.
In my subsequent observations, I have not noticed any blisters of varying sizes, nor have I experienced any inexplicable stinging sensations.
There are no deeper ulcerations with scabs that appear to have pigmentation changes.
The color is gradually returning, but I still feel some warmth and cramping sensations, possibly due to recent stress, anxiety, or a decline in my immune system.
1.
Do I still need to check for the possibility of herpes?
2.
What is the likelihood of contracting herpes through mutual masturbation alone? (There was minimal genital contact; only the previously mentioned instance involved brief contact.)
3.
I am concerned that long-term use of the Fungus Cream prescribed by Dr.
A may lead to frequent urination.
(Since the fungal infection was not completely resolved, I have been using the cream for an extended period, and I feel an increased urge to urinate.)
Please help me assess my situation based on the timeline provided.
This has truly become a shadow over my life, and I am unsure if it is herpes.
I regret my initial attraction to men and feel conflicted about my experiences.
I am really troubled by this situation, and I appreciate your assistance in evaluating my concerns.
Thank you.

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Bai Bai, 20~29 year old female. Ask Date: 2018/10/16