ASK DOC: Why do I make my partners unwell?

Dr Flo, I have suffered excruciating lower back pain that has lasted for nearly 20 years. I once had syphilis which was treated until I tested negative. After that I started having lower back pain accompanied by redness on some parts of my body on and off; doctors said it was herpes simplex. I have tried to cure it several times including using herbs, but the pain is getting worse and my libido is so low, it is almost non-existent. Every time I have unprotected sex, I infect my partners with syphilis, yet when I go for tests, I test negative. Doctor, why is this happening?

Alfred

Dear Alfred,

You have raised several issues which might be independent medical problems. Firstly, syphilis is a sexually-transmitted bacterial infection that happens in stages, with different symptoms at each stage. In primary syphilis, there is a firm, round, painless sore or swelling at the original site of infection. This sore usually disappears after three to six weeks, and may even go unnoticed. In secondary syphilis, which develops a few weeks later, there is a skin rash, sores in the mouth, anus or vagina, fever, sore throat, patches of hair loss, and swollen lymph nodes. You may also develop red or brown spots on the palms or soles of the feet. These symptoms disappear after some time, and may also pass unnoticed. After this there is the latent stage during which there are no symptoms. If untreated, some people go on to develop tertiary syphilis, which causes very severe disease that may affect the brain, nervous system, eyes, heart and other organs. It is easy to diagnose, treat and cure syphilis using the right antibiotics at any stage.

However, any complications already developed in tertiary syphilis cannot be reversed, even though the syphilis itself can be treated. You can also get a new syphilis infection if you are exposed to the infection again.

Next, herpes simplex. This is a viral infection caused by the herpes simplex virus (HSV) and there are two types: HSV-1, which usually causes cold sores and blisters around the mouth, nose and elsewhere on the face, and HSV-2, which usually causes lesions or blisters in the genitals. The infection can cause lesions in other parts of the body as well. The virus is easily transmitted from person to person through sharing of utensils, sharing lip balm or lipstick, kissing and sexual contact. Most of us contract HSV, especially type 1, in childhood, though some people never develop symptoms. Pregnant women can also transmit the infection to their babies if they have sores at the time of childbirth. The infection is recurrent; it keeps coming back, triggered either by having a cold, being stressed, hormonal changes or changes in immunity. The lesions are usually painless, and may be accompanied by itching, pain when passing urine (for genital herpes), fever, tiredness, swollen lymph modes and headache. You can have a test done to confirm the HSV infection. However, because it is a viral infection, it has no cure. There are some anti-viral tablets and/or creams that can be used to deal with a flare-up, but there is no medication to completely eradicate the virus.

You may also be suffering from another herpes infection, called herpes zoster, which is caused by Herpes Virus 3 or varicella zoster virus. This is the virus that also causes chicken pox, and the virus can continue to live in the body even after the chicken pox has healed. The virus is spread through contact with someone who has the rash. The virus can cause an outbreak when someone’s immune system goes down e.g. due to HIV infection, diabetes, cancer, use of medicines that affect the immune system, having chemotherapy or radiotherapy, and being over 60 years old (due to poor immune system). Herpes zoster appears as a painful or burning rash on one side of the body. The pain usually comes first, before developing a red rash or blisters on one side of the body at a particular area. You may also get a fever, headache, itching, and muscle pain. There is no permanent cure for herpes zoster because it is a viral infection. There are anti-viral medications that can be used and medication to help with the itching and the pain.

The low back pain could be due to herpes zoster infection, which unfortunately may continue to cause pain even after the flare up has passed. The back pain can also be due to bone, muscle, nerve or disc problems, and severe low back pain can cause low libido due to the discomfort or due to nerve problems.

I would advise you to visit a doctor and get checked for herpes simplex, herpes zoster, syphilis and other sexually transmitted infections. You also need to be evaluated for the back pain, so that the specific cause can be identified and managed. In the meantime, please practise safe sex by keeping one faithful partner and by using a condom correctly every time, so as to stop the spread of the herpes virus, and syphilis, since it seems you may have gotten re-infected. You may also benefit from visiting a urologist or a sex therapist once these issues have been resolved, so as to address the low libido.

Dr Flo, I appreciate your good work. I am 22 years old and I have a feeling that my stepfather messed with my fertility when I was a child. He used to step on my back and hit me hard. I started doing exercises to relieve the pain and to strengthen my back, and from this habit, I ended up becoming a gym instructor. The problem is that I have tried to conceive with my wife-to-be for almost a year, but we have been unsuccessful. I advised my girlfriend to go for a fertility check-up and she was told she has no problem. Even if it is her hormones with a problem, I don’t think they would interfere with our trying to conceive for this long. Could it be that I am the one with a fertility problem due to what my stepfather did to me?

Worried Reader

Dear Worried Reader,

I applaud you for turning your pain into something of benefit to you. Medically speaking, concern about sub-fertility or infertility arises after at least one year of trying to get pregnant. The problem may be from you, your partner or both of you. Sometimes, no problem is found to explain the inability to conceive.

It is good that your partner has already been checked. You also need to be checked, by having semen analysis to check the number and quality of your sperms. Whatever the outcome, remember that out of between five and 20 million sperms produced every day, you need only one healthy one to conceive.

You still have time to continue trying, since a year is not over yet. In case any issues are picked up from the tests, then they can be addressed. If any of you has any problems with hormones, then this can be corrected with medication. There are also several methods of assisted reproduction like intra-uterine insemination and in-vitro fertilisation, which can be used if necessary.