Physical Exam - Seeing Your Health Care Provider

Consultation with a physician or other health care provider is an important step in getting an accurate diagnosis for herpes. There are laboratories that provide some HSV serology tests on site. However, only a clinician can prescribe effective antiviral medication for herpes. A clinician also knows other parts of your medical situation that might be important. Your visit should include a careful history as well as an examination.

Taking a History: Your health care provider will probably start by asking you for details regarding what brought you into the office. A major part of this, naturally, is to review what symptoms you are having right now but he or she will also want to know if you have experienced these or similar symptoms before. He or she will also ask questions about your sex life, such as how many partners you have had, if you have changed partners recently and whether you use condoms. Some of this may strike you as quite personal, but it's important in determining what further tests to do and, ultimately, in making a correct diagnosis.

The Visual Exam: In addition to taking a sexual history, your doctor will need to perform a thorough examination, including visual examination of the genital area.

For men, the exam usually includes a close look at penis, scrotum, and rectum, looking for blisters or skin lesions characteristic of herpes. Discharge from the urethra is another possible sign of herpes. The clinician might also swab the urethra and anus for a laboratory test.

For women, the current standard of care is to perform a pelvic exam using a speculum to gently hold the vagina open so that the cervix and vagina can be inspected. The clinician should also carefully inspect the labia and the area between the vulva and anus for signs of infection. Swabs of the cervix and anus might be taken for a laboratory test.

For both men and women, the health care provider also should check the lymph nodes, especially those in the inguinal or pelvic region because swollen lymph glands often accompany herpes blisters or skin irregularities.

A visual examination is only one part of a complete diagnostic work-up. Making a diagnosis of genital herpes by visual inspection and by asking you questions is not easy and even experts can be wrong. For one thing, genital herpes doesn't look the same in every patient; it can "mimic" the appearance of other sexually transmitted diseases (STDs) and other STD's can look like herpes.

A mild case of herpes can easily be mistaken for something that has nothing to do with STDs such as a pimple, an ingrown hair, or a simple rash. Thus confirming a diagnosis with a laboratory test is critical.

If your health care provider sees any genital lesions, you should ask if this could be herpes and ask if he or she has ordered a laboratory test for herpes. Most authorities and the Centers for Disease Control feel that laboratory tests are important to be sure that what looks like herpes really is herpes. On the other hand, we do not recommend a swab test (for virus detection) if lesions are not seen. In this situation, we recommend asking for a herpes antibody test.

Consultation with a physician or other health care provider is an important step in getting an accurate diagnosis for herpes. There are laboratories that provide some HSV serology tests on site. However, only a clinician can prescribe effective antiviral medication for herpes. A clinician also knows other parts of your medical situation that might be important. Your visit should include a careful history as well as an examination.

Taking a History: Your health care provider will probably start by asking you for details regarding what brought you into the office. A major part of this, naturally, is to review what symptoms you are having right now but he or she will also want to know if you have experienced these or similar symptoms before. He or she will also ask questions about your sex life, such as how many partners you have had, if you have changed partners recently and whether you use condoms. Some of this may strike you as quite personal, but it's important in determining what further tests to do and, ultimately, in making a correct diagnosis.

The Visual Exam: In addition to taking a sexual history, your doctor will need to perform a thorough examination, including visual examination of the genital area.

For men, the exam usually includes a close look at penis, scrotum, and rectum, looking for blisters or skin lesions characteristic of herpes. Discharge from the urethra is another possible sign of herpes. The clinician might also swab the urethra and anus for a laboratory test.

For women, the current standard of care is to perform a pelvic exam using a speculum to gently hold the vagina open so that the cervix and vagina can be inspected. The clinician should also carefully inspect the labia and the area between the vulva and anus for signs of infection. Swabs of the cervix and anus might be taken for a laboratory test.

For both men and women, the health care provider also should check the lymph nodes, especially those in the inguinal or pelvic region because swollen lymph glands often accompany herpes blisters or skin irregularities.

A visual examination is only one part of a complete diagnostic work-up. Making a diagnosis of genital herpes by visual inspection and by asking you questions is not easy and even experts can be wrong. For one thing, genital herpes doesn't look the same in every patient; it can "mimic" the appearance of other sexually transmitted diseases (STDs) and other STD's can look like herpes.

A mild case of herpes can easily be mistaken for something that has nothing to do with STDs such as a pimple, an ingrown hair, or a simple rash. Thus confirming a diagnosis with a laboratory test is critical.

If your health care provider sees any genital lesions, you should ask if this could be herpes and ask if he or she has ordered a laboratory test for herpes. Most authorities and the Centers for Disease Control feel that laboratory tests are important to be sure that what looks like herpes really is herpes. On the other hand, we do not recommend a swab test (for virus detection) if lesions are not seen. In this situation, we recommend asking for a herpes antibody test.