How should I treat thrush (candida), when I have genital herpes?
Thrush is also known as candidiasis or a yeast infection.
It is widely thought that that using a thrush cream to treat a yeast infection can make a genital herpes outbreak worse. So if you have both at once, it is best to use a pill (oral medication) to get rid of thrush: you can buy fluconazole pills (brand name Difflucan or Canesten) at the chemist or it can be prescribed by your doctor. One dose should be enough.
First of all, it may be an idea to make sure that thrush is actually what you have. American studies show that two-thirds of women who buy over-the-counter thrush treatments don’t have a yeast infection at all.
It is surprising that people rarely catch it on the face as well as on the genitals! When you consider how often we do oral sex and ‘normal sex’ on the same night.
This is a common story/question that we get on the helpline/by email: “I was diagnosed two months ago with genital herpes. I got it off my partner’s cold sore – yes, it is type 1 – and now I have something on my lip/in my mouth. [Described as a cut on lip, a lump in mouth, or an ulcer on tongue/gum]. Could this be facial herpes too – have I got a cold sore as well?”
The answer is “No, that is not going to be a cold sore.“
Each year, Public Health England publishes the number of new cases of genital herpes – and all STIs – diagnosed in clinics. (More will be diagnosed by GPs but these are not counted.)
This year, for the fifth year in a row, the total number of new cases of genital herpes has gone down: 32,737. And by the way, the total number of people accessing this STI clinics’ service continues to rise year on year.
In two groups, only, has the rate gone up a tiny bit: females in the 25-34 year age group, it is up slightly at 6,781 and for men and women over 66, a few more have been diagnosed each year – but only 200 men and 159 women!
For other conditions, the situation is more troubling: both syphilis and gonorrhoea are up. Both can be very serious if untreated, and gonorrhoea is getting almost impossible to treat as it becomes resistant to all antibiotics. (And there are no new antibiotics ‘in the pipeline’.) So use a condom with all new sexual partners until you have both been given the all-clear at a sexual health screening.
Remember that to get a diagnosis of herpes, you have to been seen immediately, while the spot is there.
The government has passed responsibility for sexual health services over to local government to commission (for the cheapest possible price). It has been noticed that almost everywhere services are getting less accessible. Services have moved out of hospitals into the community. But sometimes this means that people don’t know where to go. We hear people on the helpline telling us how hard it is to be seen, no appointment system, you have to wait ages. At least in some places (e.g. Burrell Street, London) they give you numbered tickets and tell yo to come back in an hour or so.
If you are not satisfied – be heard!
If you want to comment, there is a template letter on this page. (Takes you to a different website) Or, more easily, you can sign the petition to maintain the sexual health services.
Did you get into the sexual health clinic easily? Did they make you wait days? The new commissioning system for sexual health services (GUM clinics) is via local authorities – it comes out of their public health budget. Sexual health is not paid for by the NHS any more. Continue reading Sexual health services – did you get good service?
The helpline gets a lot of calls every (week) day and here are some of the most common questions:
“Will I transmit my genital herpes to my child?”
The answer to that is of course, “no you cannot – it is transmitted directly skin-to-skin with the affected area so clearly a mum with a cold sore does need to take care, but a mum with a genital sore is not going to infect her child with her genital herpes.
“I had sex last night and now I have an outbreak, will I have infected my partner with genital herpes?”
The answer is there are two possibilities. One: if your body was planning on having an outbreak today, then possibly you were infectious last night and the partner might have caught it. Two: (and this is much more likely) the late night or the friction has triggered the outbreak, and you would not have had it if you had not had sex. So you were not infectious last night. By the way, if sex triggers outbreaks, use a sexual lubricant with silicone.
“Who did I get herpes from?”
It is important to remember that a person can have their first outbreak of genital herpes many years after catching it. So, often you cannot know for sure where it came from.
“Is this (…long description…) herpes?”
We cannot diagnose on the phone. Each of the symptoms of a primary outbreak of herpes can be linked to many other illnesses. So, the ‘flu-like symptoms’ might actually be flu. The ‘itchiness that comes before the blisters appear’ might be caused by anything from allergy to washing powder, to eczema. The ache in the leg might be a strained muscle… Get diagnosed at a clinic.
A member asked us about putting a Dates and Mates advert into the magazine: “I would like to meet some new friends male or female who I can trust and talk to… shall I put an ad in?” She added: “I had an invitation to a gathering but felt it was too big a step to take, I wish I had the confidence to do it …” Continue reading Meeting people with herpes
It amazes our new helpline volunteers how often a caller phones to describe their symptoms and get the helpliner to say what they have. We cannot do that. There are 24 ‘differential diagnoses’ that a sexual health doctor will be considering when s/he is shown what might be genital herpes.
We don’t list these on our website as we don’t want to encourage self-diagnosis. After all, they don’t give a medical student a link to a website and say ‘Now you can diagnose sexually shared conditions”! Continue reading Helpline – what they ask
Another Useful Product
Lidocaine 5% is handed out in some Sexual Health Clinics. It is a topical anaesthetic – it numbs the pain or itch.