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The Sudden Itching

Is it STD Herpes or Yeast Infection?
Consult Us Now!

Genital itch is one of the most common symptoms we are likely to encounter at some point in our lives. It can be debilitating and significantly limit a person’s quality of life. Despite the inconvenience, we often choose to monitor the itch and silently wish it would resolve spontaneously over time. What if the issue keeps recurring? What if the itch may hint at an underlying condition, such as an STD?

In this article, we strive to guide readers to understand genital itch and delineate the differences between a vaginal yeast infection and herpes simplex viral infection. 

genital itch singapore
Genital itch is a common symptom that can be debilitating.

What is a yeast infection?

Vaginal yeast infection (vulvovaginal candidiasis) is a common female-related vaginal infection due to an overgrowth of fungus (Candida spp) in the vaginal cavity. Candida is a common and healthy commensal microbe that can be found in the vagina. 

Nonetheless, when the amount of candida is excessive, it can invade the vagina mucosal layer, causing uncomfortable vaginal symptoms such as vaginal itch and an abnormal whitish-yellow curdly vaginal discharge.

What is herpes infection?

Herpes is a sexually transmitted disease caused by the herpes simplex virus (HSV). Symptoms usually include itchy and painful rashes or blisters on the affected skin.

There are two types of HSV virus – HSV-1 and HSV-2.  Conventionally, HSV-1 is associated with oral cold sores, while HSV-2 is associated with genital cold sores. With the evolution of the human race and changes in sexual orientation, the viral strain of HSV no longer determines the location of a cold sore, i.e. HSV-1 can cause genital cold sore, and it no longer strictly causes oral cold sore. This applies to HSV-2 as well; HSV-2 can cause both oral and genital cold sores- depending on the area of exposure during sexual intercourse.

herpes singapore
Herpes is a sexually transmitted disease caused by the herpes simplex virus.

How is yeast or herpes infection transmitted?

Herpes virus can be passed on through direct skin-to-skin contact or skin-to-secretion of an affected person. Due to the mode of transmission, sexual intercourse (including oral, vaginal, and anal intercourse) are possible ways of transmitting herpes virus infection. It is worth noting that many people can be asymptomatic of herpes (i.e. no rash or blisters). Yet, they are still shredding the virus unknowingly to their sexual partners, triggering a herpes viral infection on their partner. 

Vaginal yeast infection is not an STD. Interestingly, vaginal yeast infection can be triggered during sexual physical activities due to the disturbances of the vaginal floral pH and microbes. Hence, vaginal yeast infection symptoms can occur following a sexual encounter, confusing most people that it may be an STD.

Unfortunately, you cannot tell by seeing or looking at partners whether they have herpes or STDs. The only safe and reliable way is through appropriate STD testings.

What are the similarities and differences between yeast infection and herpes infection?

SymptomsVaginal Yeast InfectionHerpes Simplex Viral Infection
ItchingYesYes
Vulva/Genital swellingYesYes
Burning sensationYesYes
Pain and irritation SensationYesYes
Abnormal urinary symptomsSometimesSometimes
Recurring symptomsYesYes, when the immune system is weak
Surrounding Skin RashSometimesYes
Blisters and shallow ulcers over the genital skinUsually no, though in severe yeast infection, the skin integrity can be broken and raw secondary from scratching and rubbingYes
Vaginal dischargeYes, Curdly, Cottage-Cheese-like dischargeMay have watery discharge or normal discharge
Vaginal OdourCan smell of yeast/bread smellNone
Painful intercourseYesYes
FeverNoSometimes
Lymph nodes swellingNoSometimes

As both conditions may have overlapped symptoms, you are encouraged to see your healthcare providers for testing to differentiate the two conditions, as treatment options are completely different for both conditions. Furthermore, herpes infection is a type of STD that can be easily spread to your partner if it is not managed appropriately.

yeast infection singapore
Yeast infections can be triggered by sexual intercourse and hence often get mistaken for an STD.

Can I test for herpes infection and yeast infection?

Yes, you can test for both conditions.

If a herpes viral infection is suspected, your doctor may discuss with you the screening option of PCR swab tests of the rash/blisters or serum blood tests to screen for herpes antibodies. 

For vaginal yeast infection, one can consider a fungal vaginal swab test and culture, which can confirm the suspected diagnosis. 

Both screening tests for herpes and yeast infection are relatively noninvasive and can be done in an outpatient setting with your trusted health care providers. Testing will ensure the right diagnosis is clenched down and the right treatment delivered without delay. 

How is herpes infection treated?

Unfortunately, there is no ‘cure’ for herpes viral infection. Nonetheless, even though the disease is not curable, there are effective medications to manage and control the symptoms.

Antiviral medications such as acyclovir, valacyclovir, and famciclovir can lower the virus in the body, manage flare-ups, and reduce the risk of transmission to others.

You are advised to discuss your symptoms/ frequency with your doctor. Your doctor will then advise you accordingly on the dosage and duration of your antiviral medication.

How is yeast infection treated?

Yeast infection can be treated with antifungal medications. Anti-fungal treatment options can range from vaginal suppositories, oral tablets, topical cream or even anti-fungal wash. 

In those cases of recurring yeast infection, your doctor will discuss with you on possible lifestyle triggers to avoid triggers, if possible, in preventing further yeast infection. In more recalcitrant cases, your doctor may discuss antifungal suppressive therapy to minimise the frequency of yeast infection flare-ups.

Is it a good idea to continue to have sex when I am symptomatic with yeast or herpes infection?

No, it may not be a good idea to continue your bedroom activities when you are symptomatic. It can be uncomfortable, and you may experience pain during intercourse when your underlying infection has yet to recover.

In the case of yeast infection, although it is not an STD, occasionally, your partner may experience transient urinary abnormal symptoms such as itching or red rash over the genital region.

If you are actively having a herpes infection, this can be passed on to your partner through skin-to-skin transmission or body fluid transmission. You are advised to get checked. Once the diagnosis is confirmed, antiviral medication can be delivered without further delay to prevent the spreading of symptoms to your partner.

What have I learnt today?

  • It can be confusing to differentiate yeast infection and herpes infection as both have similar symptoms.
  • Both yeast and herpes viral infection can be transmissible through sexual intercourse.
  • Treatment for herpes and yeast infections is vastly different. The former is treated with antiviral medication, while the latter is treated with antifungal medicines.
  • There are reliable tests to screen and detect herpes and yeast infections.
  • Early identification of STDs such as herpes is important to ensure the right medication is offered without delay and prevent further transmission of the infection to others.

If you are concerned about your genital symptoms and have concerns of exposure to STDs, do reach out to your healthcare providers early for further health advice and testing.

References

  1. Nyirjesy P, Brookhart C, Lazenby G, Schwebke J, Sobel JD. Vulvovaginal Candidiasis: A Review of the Evidence for the 2021 Centers for Disease Control and Prevention of Sexually Transmitted Infections Treatment Guidelines. Clin Infect Dis 2022 April 13;74 (Suppl_2):S162-S168.
  2. F van den Brûle. Vaginal infections and sexually transmitted disease. Rev Med Liege. 1999 Apr;54(4):296-302.
  3. Sauerbrei A. Herpes Genitalis: Diagnosis, Treatment and Prevention. Geburtshilfe Frauenheilkd. 2016 Dec;76(12):1310-1317. 
  4. Mary Jo Groves. Genital Herpes: A Review. Am Fam Physician. 2016 Jun 1;93(11):928-34.

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