Dear Alice,

I have pus-filled sores near my vagina, what could this be? They usually come when I get my period. It gets very itchy. Could it be herpes?

— Worried

Dear Worried,

This is a perfect example of where your health care provider is your best resource. The provider can talk with you about your symptoms, how long they last, how long you have been having them, and whether they have changed over time. They can examine you and if needed, the provider can select the appropriate tests, and take, for example, swabs of cells to examine and grow in a lab for a diagnosis. Once the diagnosis is made, then the appropriate treatment can be selected.

If you are worried about herpes, appointments need to be scheduled no more than 48 hours after symptoms appear to ensure more accurate test results for a herpes virus culture. However, if you no longer have visible symptoms, the health care provider may do a blood test, which tests for the presence of herpes antibodies, to see if you were ever exposed to the herpes virus.

A herpes episode usually begins with a tingling or itching sensation of the skin in the genital area. Then sores appear, starting as one or more red bumps. These change to watery blisters within a day or two as the sores rupture, leaving shallow ulcers that may ooze, weep, or bleed. After three or four days, a scab forms and the sores heal themselves without treatment. Some women also find it painful to urinate, have a dull ache or a sharp pain in the genital area, have an urge to urinate frequently, dispel a vaginal discharge, or experience vulvitis (a painful inflammation of the vulva).

Many people with herpes simplex virus-2 (genital herpes) have recurrent herpes episodes. Aside from menstruation in women, many things can trigger a herpes episode in people, including stress and illness.

For more information on this condition, check out the Q&As in the Herpes category of the Go Ask Alice! Sexual and Reproductive Health archives. And, kudos to you for noticing a change in your body — continuing to be aware of similar issues that occur in the future will help you determine when it's best to investigate further and seek medical attention.

Alice!

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