Wednesday, January 24, 2007

Herpes revisited - a followup Ask Dr Peg question

Dear Dr. Peg

Recently my girlfriend was diagnosed with vaginal Herpes Type 1 that I’ve given her orally. We are both pretty good kids and haven't kissed too many other people. But my question is, seeing as how it can pretty much be assumed that I’ve transmitted the disease to her, is there any danger in me continuing to perform oral sex on her? If I already have it and we know that between the two of us all we have is herpes Type 1, is there still a danger?

Dear Kisser,

This is a great question, because it brings up two issues: virus spread, and herpes in relationships. I’ll address them one at a time. In my column Curious About Cold Sores, I explained that there are two Types of Herpes Simplex viruses, Type 1(HSV1) and Type 2 (HSV2). Usually HSV1 lives on the face and HSV2 lives on the genitals. However, as you and your girlfriend so clearly illustrate, Herpes viruses are flexible, and can take up residence in either location.

I’m not sure exactly what you mean by danger, but I’m guessing you are referring to contagion. As it stands now, you have oral herpes and she has genital herpes, both HSV1. You have already passed the virus to her genitals, so continuing to perform oral sex on her won’t do anything, except make her happy. Go for it.

It is possible, but unlikely, that she could now develop oral lesions and/or that you could develop genital lesions. Once you have one established herpes site on your body, it’s rare to develop another, probably because your immune system makes antibodies to the virus. Also, now that you have HSV1, you are less likely to catch HSV2. There appears to be some cross-protection in the antibodies that are formed. Finally, people with HSV1 tend to have fewer recurrent outbreaks than those with HSV2. So you could even consider yourself lucky.

The second issue this brings up is how to handle herpes as a couple. What do you do if one of you has it and the other doesn’t? How do you talk about this with a prospective partner?

The couples I’ve known who deal with herpes in the healthiest way are those who tell me, “We have herpes.” In other words, they see it as a shared problem. They don’t expend a lot of energy trying to prevent passing it to each other, or let it put a crimp in their sex life. Their love for each other and their desire to express that love sexually overrides their worry about contagion.

I’m not suggesting you blithely rub your open sores all over each other. It still makes sense to avoid contact with open sores, for comfort’s sake if nothing else. I’m just pointing out that, for the sake of your relationship, it makes sense not to obsess about it. And medically speaking, herpes is very rarely a big deal.

If you have herpes and are in a new relationship, I think it’s only fair to inform your prospective partner before you have sex. Ideally, you’ll be close enough emotionally by that time that you can talk freely about such things, and figure out how you as a couple want to handle the situation. I realize this isn’t always easy, since our society still has lots of judgment and stigma around sex-related topics of any kind, and having a sexually transmitted infection can be emotionally upsetting. If you need help, the medical practitioners and/or the counselors at the Student Health Center would be happy to meet with you and your partner to answer questions and help you discuss it together.


The Marinator said...

This is the most fantastic sexual advice column I've ever seen. You've made the discussion of various types of herpes and relationships as clear as--well, as clear as a clear, fluid-filled vesicle.

Thanks for raising many important issues involved in this type of STD, and emphasizing prudent and healthy ways to handle it physically, medically, emotionally, etc.

This could be another "blog contest writing award winner," right up there with some of our previous favorites of yours.

Giovanni said...

Appreciate your advice to these people, Peg. Very well put.

Peg Spencer, MD said...

Wow, thanks, marinator and giovanni, for your kind words. Glad to hear my article was clear as a "fluid-filled vesicle!"

Anonymous said...

I would like to ask Dr. Peg a question, I hope this is the correct way by posting a comment.

I have herpes so my husband and I decided to deliver my baby via c section. She continually gets a couple of blister sores on her pubic bone area. She is almost a year and this has been happening since about 8 months. Is it possible that I transmitted it to her by touching something on myself and then touching her? I am careful to wash my hands because Im not sure if I can pass it to her this way. Or could it just be a recurring diaper rash? Is it possible that she contracted the virus through me even though I had a c section? Please help, I am very confused and worried.

Peg Spencer, MD said...

Dear anonymous - There's no way I can accurately answer your question without examining your daughter. It is possible that she caught herpes from you if you touched one of your open sores and then touched her. From what you're telling me about how careful you are, though, I'd guess this isn't very likely. Take her to her pediatrician when she has those blisters, and the doctor can take a culture to be sure. Good luck!

Harmony Online said...

I caught HSV type 1 in the same way, via a partner who had cold sores. We are no longer together but knowing how emotionally difficult it is having to tell prospective partners about my condition, I went about setting up a dating website specifically for people with herpes so I could meet others in the same boat.

Anonymous said...

You will find this article a storehouse of information on herpes articles.

Anonymous said...

dating a girl with herpes at STDromance

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Kristina said...

This is great advice Doctor Peg. This particular STD is very devastating for people to learn, especially when there is no cure for it. Thank you for helping.

- Kristina
Cure for HerpesCure for Herpes

Anonymous said...

For the past 18 months, I have been experiening a burning sensation in the body, tingling around the lips, feels like a circle like burning around the muschache area (severe), burning under the skin (arms, hands), burning mouth sensation, tooth sensation, ear problems (like a steam feeling, and funny feeling of the skin and scalp.

All my blood test came back negative, b12, MS, MRI, thyroid,etc. However, Herpes I came back 1st time equivalent, 2nd positive, and 3rd negative. I have been to several doctors and no one can pin point my problem. I have also had x-rays on the tooth it came by negative, the doctor replaced the tooth with a crown since it had a large filling. I am still having problems around that tooth.

I have these symptoms one of them each day. I started feeling these symptoms about 3 days after an oral experience with my husband. I think he had a core sore on his lip around that time or it just went away. The oral experience was only on his part. I had a rash, but know bumps shortly after. I am trying hard to find out what is going on with my body. Could you please direct me in which way to feel better and what to take? I have tired valtrex and gabapentin. No help. My doctors don't think I will have these symptoms from herpes, but I am not sure. Please help!

Peg Spencer said...

Dear anonymous,

I'm sorry you've had such a hard and frustrating time. It sounds medically confusing as well.

I can't legally or ethically advise you without seeing you, but I will ask: have you seen a neurologist and/or a dermatologist?

Hang in there!

Anonymous said...

Yes, I have seen 3 dermatologists and 2 neurologist and etc.
Thanks, I am praying, pushing, and hanging!

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Anonymous said...
This comment has been removed by a blog administrator.
fetty said...

The herpes family of viruses includes eight different viruses that affect human beings.

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