Dr Gian,

I am a married 51 year old woman who has been married for 10 years. He is the only man I have been with for 12 years. My husband told me he has genital herpes after we fell in love and had been to together for about 6 months. He explained everything, that the doctor had told him, to me about the disease. Very seldom did we have sex during a breakout, but we always used protection. For about a year now I have had several episodes of a small blister like spot come up either on the side of my vagina or between the opening and my rectum. At first I thought it may be an ingrown hair but this last time it spread to both sides. I discussed this with my husband and he was confident I did not have Herpes. He said that I didn't have classic signs. Pain, headache...etc. He has not been to the doctor for this since we have been together. I researched this online and read that Herpes can be spread even when there is not a breakout at the time of sex. I also read that lower back pain is a sign, which I have had for about a week now. What do you think I should do?

Hi,
I have not had sex for about a year with a partner but now recently I have been noticing that I have small white or flesh colored bumps around my penis and on my balls and I have also noticed I got a red rash around my neck and chest after I masturbated and I am really worried about it now because I have also been noticing bumps on my back and shoulders that itch and when broken form a scab. I thought it was some form of body acne but now I know its not and I am scared because I think it could be syphilis or Hiv/Aids what do you think?

Had swelling in one fold of labia minora ( a pimple like bump that burst out eventually) As per doctors it is folluculitis and I was advised to use great hygine care. Now I find this fold is increased in size compared to the other side fold as has been so since last 6 months. It is especially uncomfortable and slightly painful when wearing fitted clothes.

Please advise is this temporary or will this go. Is there any medication to cure this?

Appreciate your time and help!! Thank you

regards

Hello,

I would report this to your Doctor. It looks like the infection has persisted in the layers below the skin and mucosa. Medications definitely help and sometime a lancet to help the drainage. Keep an eye open to other possibile diagnosis if you have recurrences.

Be well.

Dr. Gian

Dear Doctor

I must say that you are doing a wonderful service to humanity providing answers to embarrassing questions and a willing shoulder to cry on. Maybe you could help me as well.

I am an Indian Accountant (age 49yrs ) based in New Delhi. I did an overseas contract in the middle East between 2003 and 2004. During that time I happened to have sex(unprotected) with my housemaid (who was looking quite healthy and clean ) couple of times . A nightmarish experience followed within the next 2 weeks . symptoms were like , severe itching of genitals , with an occasional droplets of watery discharge, swollen glands in armpits,neck arms and calf muscles, severe painful cracks at the corners of the mouth , tightness in the facial muscles neck and armpits, severe inflammation of the lower gums, severe pain in all the joints and muscles .Every single joint of the body was affected resulting in severe depletion .

Also every bone of the body became shortened to a certain extent ,including the knuckles and toes resulting in kinking up at the joints. I also developed a backward stoop at the midriff. Even the muscular structure got transformed to soft flesh. After nearly one year when it was time to go home, I went through several tests . like HIV Elisa , HIV (PCR) ,VDRL,TPHA ,Chlamydia (enzyme Immunoassay :Elisa for IgG and IgA ) and Chlamydia (by indirect immunoflouerenscence : IF for IgM ) all of which were negative.

As soon as I returned home , I had sex with my wife (age 45 yrs) and very

soon she developed practically all the symptoms which I had experienced. When we both consulted a specialist, we were put on Tetracycline for 15 days ( 3x100mg per day) We felt slightly better. We consulted another doctor after 4 months .He put us on Azithromycin for 1 week ( 2x250mg per day ) we felt really better. When I went for another consultation because of penis irritation and occasional watery discharge continuing intermittently) I was told that , if it was a sort of bacterial infection , then the 2 courses of antibiotics would have definitely taken care of the problem. What remains is a fungal infection which would need to be treated from time to time by Fluconazole alongwith a cream to be applied to the penis on the inside.

My question to you is :

1. How would you diagnose the condition given the above symptoms

2. Could it be a herpes infection? Although we never had any blisters on

the genitals, we used to have an occasional pimple on the cheek a couple of times.

3. Is it possible that the above damage could have been caused solely by a

fungal infection ,say, candida albicans and made worse by a course of metronidazole (30days @ 2x100gper day ) taken as advised by my GP 6 monhs after the incident while I was overseas.

4. By way of damage control, now that we are feeling quite normal other

from my occasional watery discharge , is there a way of regaining the mascular structure and the healthy joints as before ?

Your advice would be greatly appreciated.

Regards

Hi,

Thanks for your kind words and I am going to be straight with you. You are searching for an answer in the domain of biology and medicine. You think that a good medical explanation and related drugs may pacify you and solve the problem. You disregard the power of guilt and anxiety. You belittle the transformational effect on you body structure induced by emotional and social conflicts. You have taken all the medication and tests on the book and...yet you are still searching for an answer. I invite you to reflect for a moment on what is happening and why it is happening to you without rushing for an answer. May be what it being revealed in this email is an unconscious desire to finally take responsibility for one's own actions.

In good health,

Dr.Gian

Hello Dr. Gian, I am hoping you can point me in the right direction. About 3 weeks ago, I noticed a small red bump on the shaft of my penis, about .20 inch in diameter, with small white head. I thought it might me an infected hair folicle, and tried to squeeze it, which was painful. Very, very small amount of white fluid came out. This happened numerous times. It has morphed into what can best be described as a firm oval shaped red bump...looks sort of like an insect bite. It is not sore, but hurts & swells when squeezed hard. I have no obvious symptoms of any STD near as I can tell (no sores, discharge, or any other symptom near as I can tell from reding up on it on the i-net), and have been in a monogamous relationship for past 1 year, albeit we have unprotected sex. My girlfriend has been to her obgyn in this time, and been tested for STDs, with negative results. After doing some research, the only thing I could see that it might be is a wart derived from HPV. My question is this:

How do I go about getting this diagnosed, and could it be something other than what I think?. I have a PCP on my HMO plan, but am mortified to go to her with this. I am in Houston, TX.

Secondly, if it is a wart:

how do I get it removed?

will it return?

will it go away on its own or are there meds to take orally?

Please help!!

Hi,

First off I would not continue to do any more squeezing of this or other bumps and I would not be "mortified" to have my Doctor {don't worry - she is though skinned) take a culture of the bump. I would also ask to be tested for type 1&2 Herpes virus. In both cases, Herpes and HPV, there are effective treatments available orally and locally and in both cases skin manifestation can return. Don't forget...you are in charge!
Be well
Dr. Gian
 

Ok well about 4 months ago i had sex with a girl i didnt really know unprotected and two days later my penis area and balls hurt really bad for the next week, but there were no rash or discharge or sign it just hurt from like the inside of me and now its has come back i havnt had sex since then but now my penis and balls started to hurt from the inside again and i dont have any discharge, rash or signs ....what should i do doc do you know what this is i really would like to know if you have any advice i would really appreciate it.

Hi,
I doubt this is related to an STD. Have a talk and an exam with your physician.

In good health,

Dr. Gian

Dr. Gian,

This is the scenerio:

61 year old female(almost 62), between the ages of 25 and 27 had a sore on the inside of her thigh which was about the size of a dime with a pus center, taken for an ingrown hair. Sometime in that time period had a rash on both palms, taken for an allergic reaction to a floor cleaner.

Married in 1980 at the age of 36. Thinks she had a premarital blood test in Illinois for a marriage certificate which was negative (but not sure). Husband had a premarital blood test (RPR) in another state in which he lived which was NR for the result. He has a card to show this.

At about age 50 had a two year period of hives which the doctor treated the symptoms but did not search for the cause. About 2 or 3 years ago, developed a bumpy itchy rash on the right torso which comes and goes.

It lasts about 6 weeks or more. The doctor thought it was shingles by sight only. About 2 months ago, developed a minor case of tinitus (ringing in the ears which is only heard in the quiet) which could be result of minor high pitch hearing loss or TMJ caused by clenching of the jaw. Dentist suggested a night guard. Questions: 1. Are any of the latter symptoms related to the sore and rash found in the mid-twenties?

2. Would an RPR be the test to do at this point or would another test be appropriate.

Thanks for your response.

Hi,

It looks like you have been carrying this with you a long time. I do not think it has anything to do with syphilis but for peace of your mind I would get tested just to close the case. I think your Doc was right in diagnosing " shingles" which is a reactivation of a Herpes Varicella infection especially when immune system modulation is not the greatest. In this sense I wonder if the tinnitus could also be due to a mild trigeminal neuralgia secondary to a herpes type 1 virus infection. Check it out with your Doctor.
Be well.
Dr. Gian
 

Dr. Gian,

Please help me out! I'm seventeen years old and have had absolutely zero sexual experiences. On a couple of occasions, I have noticed some puss-filled sores on my vagina. I'm absolutely mortified and have told no one. Im not a disgusting or unclean person and I haven't had sex or anything like that, so how could I possibly have puss-filled warts on my private areas? What is it? What causes it? What can I do to fix the problem in the most discrete way possible? Please, oh, Please help me find a solution to my problem. Please write back.

Thanks for Listening

Hi,

What you describe could simply be small abscesses due to garden variety bacteria present in your vagina and which are very responsive to antibiotics. So do not be afraid to see a physician if this occurs again.

In good health,

Dr. Gian

Dear doctor:

I need your advice as to what to get tested for. This is my case:

45 year old male. Went to Bangkok. Had heterosexual sex with condoms with 3 girls, they were all between 18-22. French kissed and oral sex [they looked healthy] - all sexual intercourse was protected.

10 days after the first contact or 7 days after the last contact I developed:

· Mild sore throat. More like the tonsils were bulky then actual pain, disppeared at two days.

· Severe malice ( a strange head pressure),

· Cold sweats during the day and night sweats.

· A strange urgency of the stomach, but no diarrhea.

· No matter how hard I tried I could not detect a fever.

· I never saw a rash (manically checked often).

· Severe anorexia, for 1 week, eased the next week, lost 10 lbs.

· Two days into this I felt a swelling of my hard pallet [near the front were its all wrinkled]. Then I reached in and pulled off a hard crusty thing. Looked in with great difficulty using a mirror and saw a large lesion with clearly defined red borders and a gray/beige interior. It was painless and lasted 1 week or so as it slowly shrunk. I had inflamed gums and one small ulcer on the gum next to a molar that hurt and bled some.

· A gland swelled on my neck when that happened and it disappeared after it started to heal. I felt one inguinal gland that lasted for at least 2 months, pea size - very hard.

· I had a bizarre tingling of my cheeks and eye lids.

· At least 3 episodes of hard leg jerks - a partner noticed one as we were watching TV.

· All symptoms cleared at 10 days, specially the malaise and gained my weight back by 3 weeks.

· No genital symptoms.

· No other symptoms since then, its now 6 months.

Clearly primary HIV come to mind but after much fear and anguish, I tested negative {Home Access - sorry) at 3 and 5 months.

But what was it? Syphilis, primary herpes, mono, toxoplasmosis?

I need to rule out anything contagious. What STD [other] panel do you recommend?

Thanks,

Worried

Hi,

I am intrigued by the distinction you make between "oral sex'' and ”sexual intercourse" in the
context of STD. May be you are referring to oral versus vaginal intercourse. I also have to assume that your three partners were commercial sex workers and that the " oral sex" on your side was both of the insertive (you performed) and of the receptive (you received) type.
It all sounds like you had some sort of bacterial or viral infection of the mouth and pharynx with destruction and reconstruction of mucosal cells of the soft palate. This goes along with your swollen cervical gland and general malaise. Most of the other symptoms you describe could be attributed to anxiety or guilt which magnifies the normal body perceptual signals. These kind of emotions are common reactions when one engages in paid sex which, more than sex, is aggression since it is typically deprived of intimacy which instead gives sex its glory.
It is very likely you were affected by a garden variety virus or bacterium but, for peace of mind, you may want to get tested with a comprehensive panel for STD and also use the time for some self reflection.
In good health,
Dr. Gian.
 

I have a question in which i am very nervous about.
This week (Wed evening) I noticed a perfectly round looking bump on hte top of my penis' shaft just below the head in the area where the fore skin would normally be if not circumcised. I had no redness swelling, flu like symptoms, nothing but htis bump. It almost looked like a white head. i got nervous so i put antibiotic cream on it.
Thursday am when i woke up the bump had gotten lower in size so i pushed on it and a little discharge came out. So i put more cream on it as i have been doing since.
I havent noticed anymore of these near it, and still havent noticed any redness burning tingling etc.
I am scared because i don't know what it could be. I have looked at many many pics of herpes on line and nothing looks like tthis did. it didnt really resemble a blister.
what do you think it oculd be and what should I do?
by putting the cream on it it seems to be almost healed
thank you for your time

Hi

Probably a Staph skin infection caused by the bacteria Staphylococcus aureus. Many healthy people carry staph bacteria on their skin without getting sick. But when the skin is punctured or broken, staph bacteria can enter the wound and cause infections, which can lead to other health problems. One can carry staph bacteria from one area of his or her body to another on dirty hands and under dirty fingernails. Staph can pass from person to person the same way. So hand washing and a strong immune system are the most important ways to prevent staph infections from developing.

In good health

Dr. Gian

Hello Dr. Gian first off I would like to thank you for taking the time to read my email I really appreciate all the help you can give me. I have had a girlfriend for 8 months now we have had sex on a regular basis from 3-4 times a week, lately I have been noticing that I have been developing some type of sore a pimple like thing. I have some sort of redish sores in my Pubic area but only above my testacles and penis. They do not itch nor hurt infact I dont feel them at all, they arent connected to each other like a sort of herpes they are kind of separated. Could this be an allergic reaction it looks like an irritation and I tried using Cortizone10 Plus but it didnt work to make them go away. The only thing I can think of is it might be because I sweat and the rubbing during sex somehow creates them.

They could be ingrown hairs but dont ingrown hairs usually go away after a certain amount of time. I have had these for around a month or 2, Im so confused about it I was thinking it might have been when I trimmed my pubic hairs with the electric trimmer, although i didnt completely cut all the hairs. Could I have had some sort of allergic reaction when I had sex with my girlfriend? I have one of these sores on my buttock aswell. Can you please help me Dr. Gian, thank you for your time.

Hi,

Probably what you think is right but i would show the situation to a dermatologist and hear his/her opinion.

Be well.

Dr. Gian

Hi Hubert,

I would show the " pimple like " to a Physician. It might be a small wart that can be easily treated.

Be well.

Dr. Gian