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Sexually Transmitted Diseases/Is this a external yeast infection or herpes?

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The red areas is where he scratched me
The red areas is where  
Swollen red labia majora
Swollen red labia majo  
QUESTION: The last time i had sex was feb 23-26 i think my ex boyfriend was cheating on me. I went and got tested for gonnerhea, chlymedia,trich and hiv all negative however i had a internal yeast infection and a bacterial infection also i think he may have scratched me on the two sides of my clitoris the last time we were active together
Even after taking treatment *4 diflucan and a weeks worth of Doxycycline * the swelling/discoloration and white dots have never gone away
Is this a external yeast infection or jock itch? One of my friends mentioned it could be herpes :( is this herpes? He was my only sexual partner all sexual contact was protected with condoms
It swelled up even worse to how it is in the pictures after i did a external yogurt treatment overnight

ANSWER: Hello Samantha,
I do not recommend your returning to whomever prescribed you 4 diflucan and a week's worth of doxycyline, as they obviously did not confirm a diagnosis. Doctors are supposed to treat specific infections, not treat something hoping it will treat what they haven't diagnosed.

It does not look like herpes, yet herpes sometimes can cause unusual signs and symptoms. Yeast infections are not technically sexually transmitted. Jock itch is also caused by a fungus, but it's different from yeast (also a fungus). A microscopic evaluation of the vaginal discharge should cinch a diagnosis, but the provider must know how to do such a test.  You really need to be properly diagnosed from a gynecologist.  

Good luck!
--mark


---------- FOLLOW-UP ----------

QUESTION: Thank you Mark
I have been 5 times too my local planed parenthood each time I had a wet mount and each time i was told I had a internal & external yeast and my ph was off she said the diflucan would take care of the external yeast as well so not to worry

However the 5th time i was told I didn't have any current infections no yeast or anything. I'm at my wits end here and I would hate to go back to planned parenthood just to tell me they don't know whats wrong :(
I'm going again next week should i get them to swab the outside for yeast this time instead of the inside?

Answer
Hi Again, Samantha,
You may have a condition that is NOT necessarily sexually transmitted, but something that is due to hormonal changes or repeated disruption of your vaginal flora (normal germs present on the inside of the vagina).  Diabetes and repeated use of topical creams, douches, and medications can also cause persistent "vaginosis" (condition of vagina that causes irritation, but without an actual cause by infection with a germ or fungus).  

Your health care providers need to "escalate" their consideration for management of your complaints to something other than the most obvious yeast, trichomonas, or bacterial vaginosis.

Good luck!
--mark  

Sexually Transmitted Diseases

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Mark P. Behar

Expertise

Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!

Experience

Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Organizations
Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Publications
Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Education/Credentials
Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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