Oral Herpes and Testicular Pain: What You Need to Know

Oral herpes and testicular pain?

I would like to ask about a situation involving my girlfriend.
At the end of February, she performed oral sex on me, and later I found out that she might have had a herpes sore on her lips (though I'm not certain).
This week, I started experiencing a mild itch and pain inside my penis, which eventually subsided.
However, I began to feel pain in one of my testicles and in the perineum area.
I have already visited a urology clinic where they examined me with a magnifying glass and light, and they said it is not herpes.
They prescribed hyoscine butylbromide for the testicular pain, but I still feel discomfort.
Could this be a testicular condition? Additionally, when I asked to have a herpes virus serology test, the doctor said that if it has not been two months since exposure, the test would not be reliable.
Is this true? Are there other testing methods available? I apologize for asking for guidance from the doctors.

hen jin zhang, 20~29 year old female. Ask Date: 2013/03/28

Dr. Xu Weikai reply Urology

Hello, regarding herpes, it generally does not require special treatment.
Unless the immune system is significantly weakened, antiviral medications are typically not prescribed.
In Taiwan, the carrier rate exceeds 80%, meaning most people have been infected but do not show symptoms.
Herpes rarely accompanies testicular pain, which may indicate other infections or conditions.
It is advisable to seek medical evaluation, including urine tests, bacterial cultures, and testicular ultrasounds, for an accurate diagnosis.
As for testing, it does not directly measure the virus; instead, it detects the immune system's response after infection, which usually takes about 6-8 weeks or more.
Testing now is also possible; if an infection is detected, it indicates that you have been infected for some time.
Note: to test for the virus, viral DNA needs to be measured.
If there are any unclear points, feel free to ask again for further discussion and research.
Online responses should only serve as a reference; it is essential to visit a healthcare facility for proper medical care.
This response is provided by Dr.
Hsu Wei-kai, Chief of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2013/03/28

More Info

Understanding oral herpes and its potential implications for sexual health is crucial, especially when symptoms arise following intimate contact. Oral herpes, primarily caused by the herpes simplex virus type 1 (HSV-1), can manifest as cold sores or fever blisters around the mouth. If your girlfriend had an active outbreak at the time of oral sex, there is a possibility of transmission to the genital area, leading to genital herpes, which is typically caused by herpes simplex virus type 2 (HSV-2) but can also be caused by HSV-1.

The symptoms you described, including a mild itch and pain in the penis followed by unilateral testicular pain, warrant careful consideration. While the initial symptoms may have subsided, the persistence of testicular pain raises concerns. Testicular pain can arise from various conditions, including epididymitis (inflammation of the epididymis), orchitis (inflammation of the testicle), or even referred pain from other areas such as the prostate or lower back. Since you have already consulted a urologist who ruled out herpes, it is essential to explore other potential causes of your symptoms.

Hyoscine butylbromide, the medication prescribed, is an antispasmodic that can help relieve abdominal and pelvic pain by relaxing the muscles in the gut. However, if the pain persists despite treatment, further investigation is warranted. It may be beneficial to consider additional diagnostic tests, such as a scrotal ultrasound, to assess for any structural abnormalities or infections that may not be apparent through a physical examination alone.

Regarding the herpes virus blood test, it is true that testing for antibodies typically requires a window period of at least 2 to 12 weeks after potential exposure for accurate results. This is because it takes time for the body to produce detectable levels of antibodies following infection. However, if you are experiencing symptoms suggestive of herpes, a swab test from any active lesions (if present) can provide more immediate results. If no lesions are visible, and you are still concerned about herpes, you may want to discuss with your healthcare provider the possibility of a type-specific herpes serology test once the appropriate window period has passed.

In summary, while your symptoms may not be directly indicative of herpes, it is essential to continue monitoring your condition and maintain open communication with your healthcare providers. If the testicular pain persists or worsens, further evaluation by a urologist or a specialist in infectious diseases may be necessary to rule out other potential causes and ensure appropriate management. Additionally, practicing safe sex and discussing any concerns about sexually transmitted infections with your partner is crucial for both your health and that of your partner.

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