Suppressive Therapy With Valtrex
Suppressive therapy is the use of prescription Valtrex on a daily basis whether an outbreak is present or not. Whereas Valtrex is commonly used to stop an outbreak, it can also be used daily to prevent outbreaks from occurring to begin with. This daily use of Valtrex also reduces the proclivity of the virus to shed, i.e. be contagious as often. Its use appears in studies to reduce the viral shedding periods by 50%.
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Men vs. Womens Transmission Rates and Contagiousness
Because of the nature of male and female genitalia, it is easier for herpes to be transmitted to a woman by a man than vice-versa. This is because female genitals have more exposed soft tissue. This also accounts for why approximately 1 out of 4 American women have herpes, whereas 1 out of 5 American men does.
Make A Disclosure Decision
If youre thinking about having sex with someone, its a good idea to share your STI status in advance. Dont wait until things are hot and heavy in the bedroom to disclose, though. Have the conversation fully clothed and in a place where you feel safe and comfortable. If you come to the conversation calm and prepared maybe with stats about how common herpes is, and how treatable your partner is likely to respond in a similar way.
Come prepared with answers to questions your partner may ask, like What does that mean for us having sex? Know that you dont have to answer all questions, though. Prying questions like How did you get it? only feed stigma and curiosity they dont actually give any useful information. .
You also dont have to disclose to every single person in your life. STI stigma is real, and if youre worried that disclosing to a particular person could put you in harms way, then you dont have to disclose . But, if youre planning on having sex with that person, you should disclose. Not just because some states have laws around STI disclosure, but also because everyone deserves to enter into sexual experiences fully informed.
How Did I Catch Genital Herpes
Genital herpes can be transmitted through direct contact with an infected blister or sore, usually through sexual contact. It can also be transmitted when there are no symptoms present.
If you have only just been diagnosed as having genital herpes and are in a monogamous relationship, this does not necessarily mean that your partner has been unfaithful to you, or sexually promiscuous in the past.
It is possible for a person to carry the virus without knowing that they have it, since up to 80% of people who are infected with HSV-2 show no signs of the infection. So it is very easy for a person to unwittingly transmit the infection to their partner.
The symptoms of the infection vary greatly between individuals. It might be totally unnoticeable in one person, but cause severe blistering in their partner.
Since the genital herpes virus can be transmitted through oral sex as well as vaginal sex, it is also possible to have caught the virus from a cold sore on your partners mouth or face. It is possible to pass the virus on even if they did not have a cold sore present at the time of contact.
Alternatively, you may have contracted the virus from a previous sexual partner, perhaps even several years ago. The virus can remain inactive in the body for long periods, so this may be the first time it has caused symptoms. Or, previous symptoms may have been so slight that the herpes condition went unnoticed or was dismissed .
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Can I Treat Herpes Simplex At Home
Avoiding known triggers, such as illness or stress, can help reduce how often you have herpes outbreaks.
How can I ease my symptoms during an outbreak of HSV-1 ?
- Over-the-counter creams such as L-lysine, benzocaine or docosanol .
- Applying ice to blisters or sores.
How can I ease my symptoms during an outbreak of HSV-2 ?
- Apply an ice pack to your genitals. Wrap the ice pack in a washcloth or apply it over your underwear.
- Keep your genitals dry. Wear cotton or other nonsynthetic underpants and avoid tight-fitting clothes. Moist sores take longer to heal.
- Soak in a warm bath.
- Take nonsteroidal anti-inflammatory drugs to relieve pain.
- Topical 1% or 2% lidocaine may be used as a topical analgesic.
Facts About Cold Sores
Cold sores usually appear as a single watery blister on the lip or mouth, or several blisters that consolidate into one.
However, HSV-1 can also lead to genital herpes during oral sex and HSV-2 can sometimes lead to cold sores.
HSV-1 is very common. About 67% of the worlds population under age 50 has HSV-1.
Cold sores affect roughly 3 of every 1,000 people each year, according to the Centers for Disease Control and Prevention . Of these, 33% will experience subsequent attacks triggered by stress, fever, and other causes.
Once you have HSV-1 it doesnt go away. If you develop a cold sore, the virus can spread more easily.
Cold sores are typically spread through saliva and direct contact. You can get them through kissing or sharing lip balm with someone who has a cold sore.
Cold sores can be painful and may take up to 14 days before active healing begins.
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What Is The Best Treatment For Genital Herpes
This is a personal choice. Some people prefer not to take prescription drugs due to the potential for side-effects and the expense, especially if they are not necessary. More and more people are focusing on correcting the problems which can trigger an outbreak, such as a vulnerable immune system or an inappropriate diet. There are also particular herbs, nutrients and ointments which can be helpful.
You can read about different options available in the Herpes Treatment section.
For many people with genital herpes, the physical consequences of the infection are far outweighed by the emotional feelings it sometimes brings with it. There are many misconceptions about genital herpes, including the belief that it is associated with promiscuity, and these have given it a reputation which may cause you to feel angry and shocked by the diagnosis. You may feel betrayed by your partner, or by a previous partner who may have transmitted the infection.
Anxiety, guilt, loss of assertiveness and fear of rejection are also common emotions. The support of a partner, friend, or family member can be very important in helping you to deal with these feelings and to minimize the effect of genital herpes on your life.
If you are feeling lost or need a little bit of guidance and support please read our Positive Thinking section.
How Common Is Genital Herpes
Genital herpes infection is common in the United States. CDC estimated that there were 572,000 new genital herpes infections in the United States in a single year.1 Nationwide, 11.9 % of persons aged 14 to 49 years have HSV-2 infection .2 However, the prevalence of genital herpes infection is higher than that because an increasing number of genital herpes infections are caused by HSV-1. 3 Oral HSV-1 infection is typically acquired in childhood because the prevalence of oral HSV-1 infection has declined in recent decades, people may have become more susceptible to contracting a genital herpes infection from HSV-1. 4
HSV-2 infection is more common among women than among men the percentages of those infected during 2015-2016 were 15.9% versus 8.2% respectively, among 14 to 49 year olds. 2 This is possibly because genital infection is more easily transmitted from men to women than from women to men during penile-vaginal sex. 5 HSV-2 infection is more common among non-Hispanic blacks than among non-Hispanic whites . 2 A previous analysis found that these disparities, exist even among persons with similar numbers of lifetime sexual partners. Most infected persons may be unaware of their infection in the United States, an estimated 87.4% of 14 to 49 year olds infected with HSV-2 have never received a clinical diagnosis. 6
The age-adjusted percentage of persons in the United States infected with HSV-2 decreased from 18.0% in 19992000 to 12.1% in 2015-2016. 2
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What Can My Partner And I Do To Reduce The Risk Of Transmission
The risk of transmitting the virus can often be reduced by using condoms. The continued use of condoms in a long-term relationship is a personal decision that only you as a couple can make. Most people find that as the importance of the HSV infection in their relationship is seen in perspective, that condom use can become less relevant if this is the only reason condoms are being used.
However, at all costs couples should try to avoid sexual intercourse during an active episode of herpes, because this is when the virus is most likely to be transmitted. This period includes the time from when your partner first has warning signs of an outbreak, such as tingling or burning in the genitals, until the last of the sores has healed. Also, sexual activity prolongs the healing of the episode.
Transmission risk is increased if there are any breaks in the skin, for example, if you have thrush or small abrasions from sexual intercourse, often due to insufficient lubrication. It can be helpful to use a lubricant specifically for sexual intercourse and avoid sex if you have thrush. Sexual lubrication is helpful right at the start of sexual activity.
You will find more information about thrush and candida in the Female Herpes Issues section.
Testing For Genital Herpes
If you think you may have genital herpes you should make an appointment with your GP or local sexual health services.
If there are symptoms present such as blisters, sores and ulcers, your doctor or nurse may be able to make a diagnosis straight away.
If you have visible blisters, your doctor or nurse may take a swab for testing, to check if this is herpes and what type. This swab can also test for another STI which causes blisters called syphilis.
The genital herpes swab tests are very reliable, though if the ulcer is too dry then it may be less likely to find a positive result.
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How Does Genital Herpes Affect Pregnancy
Herpes simplex virus doesnt affect fertility or your ability to conceive. Pregnant women diagnosed with HSV-2 should start a daily antiviral at 36 weeks of pregnancy as prescribed, to prevent outbreaks during delivery. If you have an active infection at the time of childbirth, you can pass the herpes virus to your baby. Neonatal herpes puts a baby at risk for blindness, brain damage, skin infections and death. Your healthcare provider will perform a cesarean section to lower this risk.
How Should I Take Valacyclovir Tablets
- Take valacyclovir tablets exactly as prescribed by your healthcare provider. Your dose of valacyclovir tablets and length of treatment will depend on the type of herpes infection that you have and any other medical problems that you have.
- Do not stop valacyclovir tablets or change your treatment without talking to your healthcare provider.
- Valacyclovir tablets can be taken with or without food.If you are taking valacyclovir tablets to treat cold sores, chickenpox, shingles or genital herpes, you should start treatment as soon as possible after your symptoms start. Valacyclovir tablets may not help you if you start treatment too late.
- If you miss a dose of valacyclovir tablets, take it as soon as you remember and then take your next dose at its regular time. However, if it is almost time for your next dose, do not take the missed dose. Wait and take the next dose at the regular time.
- Do not take more than the prescribed number of valacyclovir tablets each day. Call your healthcare provider right away if you take too much valacyclovir tablets.
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Is Herpes Simplex Related To Herpes Zoster
Like HSV-1 and HSV-2, shingles can cause a painful, blistering rash. The shingles rash usually shows up on the back, side, abdomen , neck and face. It is often only on half of your body, following the pattern of your nerves. See your healthcare provider if you have a new rash and suspect you may have shingles.
A note from Cleveland Clinic
Herpes simplex is a virus. Once you have herpes, its a lifelong condition. A herpes infection can lead to outbreaks , but youll also have times when you have no symptoms. The main sign of herpes is sores that appear on the infected skin. Some people choose not to treat herpes, especially if symptoms are mild. Others take antiviral medications to reduce the severity and frequency of outbreaks.
Last reviewed by a Cleveland Clinic medical professional on 05/17/2022.
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What Does Genital Herpes Look Like
While some people with genital herpes will never have any symptoms, other people can develop symptoms within a few weeks of being infected.
Often, before the lesions appear, patients describe a prodrome, characterized by a tingling or burning sensation in the area where the lesions will develop that can be noticed during urination, along with itching or discomfort in the genital area.
You can also have the following symptoms:
- Blisters on the mouth or lips
- Fever, headache or pain in the joints
- Trouble urinating
The symptoms of genital herpes often go away and come back as recurring outbreaks. For most people, the first outbreak is the worst, and can last from two to three weeks. Future flare-ups are often less severe and do not last as long. Still, some people shed the virus regularly. The following triggers can make outbreaks more likely to occur:
- Viral or bacterial infections
- Menstrual periods
Recurrent genital herpes is most common in the first year after the initial infection and decreases as time goes on.
In many cases, anti-herpes medicine can help patients. When a person experiences a prodrome and suspects a recurrence is going to happen, they begin taking anti-herpes medications that lessen symptoms and shorten the time of the outbreak.
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How Can Herpes Be Prevented
Correct and consistent use of latex condoms can reduce, but not eliminate, the risk of transmitting or acquiring genital herpes because herpes virus shedding can occur in areas that are not covered by a condom.25,26
The surest way to avoid transmission of STDs, including genital herpes, is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested for STDs and is known to be uninfected.
Persons with herpes should abstain from sexual activity with partners when herpes lesions or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms, he or she can still infect sex partners. Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk. Sex partners can seek testing to determine if they are infected with HSV.
Daily treatment with valacyclovir decreases the rate of HSV-2 transmission in discordant, heterosexual couples in which the source partner has a history of genital HSV-2 infection. 27 Such couples should be encouraged to consider suppressive antiviral therapy as part of a strategy to prevent transmission, in addition to consistent condom use and avoidance of sexual activity during recurrences.
How Can I Prevent Genital Herpes
If you are sexually active, you can do the following things to lower your chances of getting genital herpes:
- Being in a long-term mutually monogamous relationship with a partner who does not have herpes.
- Using condoms the right way every time you have sex.
Be aware that not all herpes sores occur in areas that a condom can cover. Also, the skin can release the virus from areas that do not have a visible herpes sore. For these reasons, condoms may not fully protect you from getting herpes.
If your sex partner has/have genital herpes, you can lower your risk of getting it if:
- Your partner takes an anti-herpes medicine every day. This is something your partner should discuss with his or her healthcare provider.
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What Are The Possible Side Effects Of Valacyclovir Tablets
Kidney failure and nervous system problems are not common, but can be serious in some patients taking valacyclovir tablets. Nervous system problems include aggressive behavior, unsteady movement, shaky movements, confusion, speech problems, hallucinations , seizures and coma.
Kidney failure and nervous system problems have happened in patients who already have kidney disease and in elderly patients whose kidneys do not work well due to age. Always tell your healthcare provider if you have kidney problems before taking valacyclovir tablets.
Common side effects of valacyclovir tablets in adults include headache, nausea, stomach pain, vomiting and dizziness. Side effects in HIV-infected adults include headache, tiredness and rash. These side effects usually are mild and do not cause patients to stop taking valacyclovir tablets.
Other less common side effects in adults include painful periods in women, joint pain, depression, low blood cell counts and changes in tests that measure how well the liver and kidneys work. The most common side effect seen in children < 18 years of age was headache.
Talk to your healthcare provider if you develop any side effects that concern you. These are not all the side effects of valacyclovir tablets. For more information ask your healthcare provider or pharmacist.