Sexually Transmitted Diseases/Is this just friction and irritation?

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Angry Vag 1
Angry Vag 1  

Angry Vag two
Angry Vag two  
Hello!

I have an itchy rash and a bit of tearing on my vulva,  above my clitoris. It isn't overtly painful, unless I spread my Labia majora for a closer look. I have been scratching it though. I had sex with my (monogamous) boyfriend two days ago, but it didn't hurt -though he did have a harder time finding my clitoris, and due to the placement of the rash makes me think that is what caused this. We've both been tested for all STDs; and specifically asked for a herpes blood test asl well- both came back negative. I don't have any type of abnormal vaginal discharge, so it's not a yeast infection either.

I don't know if this will be helpful, but I'm not on any hormonal birth control, but have an IUD. I'm 24 and am generally a healthy person.

Any insight to what this could be and how to treat it would be very helpful!

Answer
Hello Justine,
Itchy vulvar rashes such as what you have look like yeast or herpes; it is possible that rarer infections from fungi, viruses or bacteria may cause this.  Herpes is not likely, as it is usually very painful, and I don't see any blisters.  

Even if preliminary tests were negative for yeast, it is considered an opportunistic infection and may develop following the scratches on the skin. I would try a topical vaginal cream such as miconazole, terconazole or something similar.  Clotrimazole is readily available but is the least effective of antifungal medications, even though it is commonly available as an over-the-counter preparation.  

It does NOT look like a classic STD though!

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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