Controlling Recurrent Genital Herpes: The Use Of Oral Antivirals In Herpes Management
The following section gives you in-depth information about the use of oral antivirals to treat herpes. Aciclovir has been used for this indication for a number of years now and found to be highly effective in controlling herpes recurrences.
Some people with genital herpes have identified factors which may influence the frequency or severity of recurrences. Factors such as stress, diet and lifestyle may be worth considering when looking at ways of managing herpes in your life. Each case is individual and what works for one may not work for another.
Frequent or severe recurrences of genital herpes infection may interfere with normal work and social activities, and cause disruption to your sex life. However, there are steps which you can take to reduce outbreaks and help bring the herpes virus under control. This section explains what you can do and answers some other questions which you may have about living with genital herpes.
How Is Herpes Simplex Treated
Some people have few to no herpes outbreaks and choose not to have treatment. But many people prefer to use medications that shorten outbreaks and reduce symptoms.
During an outbreak, you may use an antiviral ointment or cream to help lessen your symptoms and help them go away faster, but it only works if you start it soon after you start an outbreak. Many people with HSV-2 take daily oral medications to keep outbreaks at bay.
Your provider may prescribe a topical medication or oral medication such as:
Everything You Need To Know About Herpes And Sex
Herpes infects more people worldwide than any other sexually transmitted infectionand it spreads through a simple equation: One partner has the virus. Another partner doesn’t. Any sexual contact between the two can infect the uninfected.
The virus most easily enters the body through a break in the skin, Glatt sayssay, an abrasion from rough sex, a cut in your mouth, or a sore from another condition. However, herpes can also slip through the body’s normal defenses, especially through mucus membranes in the mouth, eyes, genitals, or rectum.
There’s no cure for herpesand though your risk of spreading it tends to decrease over the years, it’s still possible for you to infect a partner. Here’s what you need to know to avoid sharing more than you bargained for.
Sex Isn’t The Only Way to Test PositiveIf your doc gives you a herpes diagnosis, make sure you’re clear on exactly what you have, Glatt says. There are eight types of herpes simplex virus. One type, HSV-2, causes most cases of genital herpes. Another, HSV-1, most often causes cold soresbut perhaps due to all the great oral we’re giving and receiving, type 1 is increasingly causing genital infections too.
If you gave every American a blood test, nine out of ten would have some evidence of infection with one of the eight types, Glatt says. But only about one in six has genital herpes.
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Percentage Of Hsv Risk: Hsv 2 Transmission Probability
People often want to know what the chances are of spreading herpes to another person. Overall, the risk is about 10% per year that an infected male would transmit HSV 2 to an uninfected female. That is, if 100 infected men were having one-onone sex with 100 uninfected women, about 10 women would get infected per year. If the situation were reversed, about 4 uninfected men would get herpes in a year from infected women.
The studies that gave us those numbers were based on the following criteria:
- 1) No sex during outbreaks,
- 2) No daily antiviral medication and
- 3) No regular use of condoms.
- 4) The people involved know that one of the people has genital herpes.
An infected male and an uninfected female:
If they avoid sex during outbreaks, dont use condoms regularly, and he doesnt take an antiviral therapy every day, the risk of transmission is about 10% per year, though there is a large range from 7 percent to 31 percent in different studies.
HSV 2 transmission female to male
HSV-12 is most contagious during an outbreak. If they avoid sex during outbreaks, dont use condoms regularly, and she doesnt take an antiviral therapy every day, the risk of transmission is about 4% per year.
Those percentages represent what studies consider an average sex life incorporating vaginal penetration over the course of one years duration, which, of course, is highly subjective.
Is It Possible To Get Herpes During Protected Sex
Yes! According to a 2010 study conducted by Emily T. Martin and others, there is a high risk of herpes transmission during protected sex when one of the partners is herpes-positive.1 The probability reaches 50% to 70%.1, 2 This is explained by the fact that Herpes is transmitted skin-to-skin or skin-to-mucosa.1 Therefore, the parts of the genitals that are not covered by the condom are open to herpes infection.1
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How Long Do Sores From Herpes Simplex Last
If youre infected with HSV-1, commonly known as oral herpes, you may notice tingling or burning around your mouth in the days before a cold sore appears. These blisters break open and ooze fluid before forming a crust. Usually, sores last for seven to 10 days.
If youre infected with HSV-2, commonly known as genital herpes, your first outbreak may last between two to four weeks. Recurrent outbreaks usually last between three to seven days.
How To Check If You Have Asymptomatic Herpes
If you have no herpes symptoms but believe you might have been exposed to the virus, you can take a herpes test to verify whether or not youre infected.
The most accurate herpes testing method for asymptomatic people is an IgG test, which checks for the presence of IgG antibodies in your blood. These antibodies can signal a herpes infection using certain testing methods, they can also be used to differentiate between HSV-1 and HSV-2.
IgG antibodies can take several months to form after a herpes infection, meaning youll typically need to wait for 12 to 16 weeks before taking an IgG test to make sure you receive an accurate result.
If youre concerned that you might have asymptomatic herpes, the best approach is to speak to your doctor about testing options. Your doctor will be able to schedule a test based on the date of your potential exposure to the virus and provide you with an accurate diagnosis. If you discover you do have HSV-1 or HSV-2, the most important thing is to not panic. These viruses are extremely common, and there are a variety of anti-viral medications out there to help minimize the severity and requency of outbreaks. Most notably, vacyclovir.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.
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Who Response To Herpes
As well as increasing awareness about HSV infection and its symptoms, improved access to antiviral medications and heightened HIV prevention efforts for those with genital HSV symptoms are needed globally.
In addition, development of better treatment and prevention interventions is needed, particularly HSV vaccines. WHO and partners are working to accelerate research to develop new strategies for prevention and control of genital and neonatal HSV-1 and HSV-2 infections. Such research includes the development of HSV vaccines and topical microbicides. Several candidate vaccines and microbicides are currently being studied.
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How Is Genital Herpes Treated
Herpes has no cure. But antiviral medicines can prevent or shorten outbreaks during the time you take the medicine. Also, daily suppressive therapy for herpes can lower your chance of spreading the infection to your partner.
Your doctor will either give you antiviral medicine to take right after getting outbreak symptoms or to take regularly to try to stop outbreaks from happening. Talk to your doctor about treatment options.
During outbreaks, you can take the following steps to speed healing and prevent spreading herpes to other parts of your body or to other people:
- Keep sores clean and dry.
- Try not to touch the sores.
- Wash your hands after any contact with the sores.
- Avoid all sexual contact from the time you first notice symptoms until the sores have healed.
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How Big Is The Risk Of Infection
The likelihood of being infected with genital herpes during sex depends on many factors, including how often you have sex, whether and how frequently you use condoms, and how long your partner has already been infected. Someone who has had the virus for a long time is less contagious than someone who has just been infected. In general, women have a higher risk of becoming infected than men. Having other sexually transmitted diseases such as HIV also increases the risk of transmission.
In studies with couples where one partner had genital herpes, the other partner became infected within one year in 5 to 10% of the couples. The people in these studies only rarely used condoms, though and if they did, it was mostly during an outbreak. One of these studies showed that infection occurred in an estimated 1 out of 1,000 sexual acts.
Does A Cold Sore On My Mouth Mean I Have Genital Herpes
No, a cold sore on your mouth usually means you have herpes simplex virus type 1 . You can get HSV-1 by kissing someone or sharing utensils, towels, razors, or lipstick with someone who has HSV-1.
HSV-1 cannot turn into HSV-2 , but you can get a cold sore on your mouth from HSV-2 if you give oral sex to someone with HSV-2. Cold sores caused by HSV-1 or HSV-2 are contagious. You can spread it to other people or other parts of your body if you touch an open sore and then touch another part of your body. That means if you have a cold sore and give oral sex to someone, that person will get the herpes virus on his or her genitals.
Avoid touching your cold sore as much as possible. If you touch your cold sore, wash your hands right away to avoid spreading the infection to other parts of your body or other people.
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Recurrent Herpes Outbreaks And Their Effects On Sex
While some people with herpes never experience any symptoms, many people will experience occasional outbreaks of oral or genital herpes.
Because herpes is an incurable virus, these outbreaks can continue to occur for life, making it important that you have a treatment plan worked out with your healthcare provider.
The most common medication used to treat herpes is valacyclovir. Our guide to valacyclovir explains more about how this drug works to treat herpes outbreaks, with information on common dosage protocols for oral and genital herpes.
Your risk of infecting your sexual partner with herpes is as its highest during an outbreak, since the herpes sores that can develop during this period contain large amounts of highly infectious viral fluid. As such, its best to avoid all sexual activity during recurrent outbreaks.
This can sound frustrating, but the reality is that herpes outbreaks tend to become less frequent as your body develops its immune response. Most people with HSV-1 only ever experience one to two outbreaks per year, which typically take one to two weeks to heal.
People with HSV-2 usually experience outbreaks four to five times per year, with each outbreak lasting for one to two weeks.
Once you have a prescription for an antiviral drug like valacyclovir and understand how to use it to treat herpes symptoms, treating herpes outbreaks becomes fairly easy, making the impact on your ability to maintain a normal sex life much less serious than you might think.
How Can I Reduce My Risk Of Herpes Simplex
Preventing HSV-1
You can reduce your risk of contracting HSV-1 by avoiding physical contact with someone who has a cold sore. People can still spread HSV-1 when cold sores arent present, but its less likely.
If someone has an active HSV-1 infection, avoid:
- Sharing utensils, cups, lip balms or other personal care products.
- Touching the skin near their mouth.
Preventing HSV-2
If youre sexually active, you can take these steps to protect yourself and others from the herpes virus and other STIs:
- Be monogamous with one sexual partner or limit your number of partners.
- Get tested for STIs and complete any prescribed treatment.
- Tell your sexual partners if you have genital herpes so they can get tested.
- Use condoms during intercourse and dental dams during oral sex.
Wash your hands often if you have an outbreak or are around someone with symptoms.
If your sexual partner has genital herpes, these actions can lower your risk of getting the virus:
- Dont have sex when your partner has active symptoms. Condoms may not cover all sores, so you may still get the virus.
- Make sure your partner takes antiviral medication as prescribed.
- Wait to have sex until scabs fall off active lesions.
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Myth #: People Cannot Spread Herpes To Others Unless They Have Sores Or Blisters
Fact: People can spread herpes to others at any time, including when they do not have any symptoms.
People with herpes may experience outbreaks and remissions. During an outbreak, a person has active sores or blisters, but in remission, they may have no symptoms at all.
The virus is usually more contagious when a person has an outbreak, but it can also spread when it is in remission.
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How To Tell Your Partner You Have Herpes
Before we get into the practical side of having sex with herpes, its important to cover another topic that many infected people worry about telling their sexual partner about their infection status.
If you are aware that you have herpes, you need to tell your sexual partner. Even when you avoid sex during outbreaks, use condoms and follow other safe sex practices, theres still a risk of transmitting the virus. This makes it essential that your sexual partners are informed.
Many people feel anxious about telling their romantic interest that they have herpes, for reasons that are very understandable. Nobody likes to disclose that they have an STD, especially to the person theyre sexually and romantically interested in.
However, done the right way, letting your partner know that you have herpes doesnt have to be a stressful or negative experience.
First, before you disclose to anyone that you have herpes, its important to check which type of the herpes virus youre infected with. Our guide to herpes tests covers the most common herpes testing methods and explains how you can get tested to see if you have HSV-1 or HSV-2.
If you have HSV-1 and only develop herpes sores on your lips, disclosing your status to your sexual partner is fairly straightforward. After all, an estimated 67 percent of the worlds population under the age of 50 have HSV-1, meaning theres a good chance that your partner has the virus.
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Know If You’re At Risk For Catching This Incurable Infection
Ask Mens Fitness: A woman I just started seeing told me she has herpes, but that shes on meds for it, so I cant get it. Is that true? If not, is it worth having sex with her if I might catch it? I know its not curable MARK P., EAU CLAIRE, WI
The Expert: Pyschotherapist/Sex Therapist Tammy Nelson, PH.D
The Answer:Today if you meet someone honest enough to admit they have herpes, theyre probably on Valtrex or acyclovir. Both suppress the infection, which reduces the risk to uninfected partners, including the risk from viral shedding, which occurs even with no open sores.
If you use condoms, the odds are lowabout 0.4%of being infected if shes on antiviral suppressive meds theres also little chance of an outbreak. If there is an outbreak , avoid sexual contact for at least seven days.
Its up to you to make the decision about being sexual with someone who has herpes and to know what medication shes on and symptoms shes experiencing. Open communication is critical if you want to be in a relationship going forward.
What Is The Risk Of Transmission Between Recurrences
Studies have shown that virus may sometimes be found on an infected area, even when there are no visible symptoms. This is called asymptomatic shedding. If enough virus is present when direct skin contact takes place, a partner may become infected.
The fewer recurrences a person has, the less chance there is of asymptomatic shedding.
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Where Does The Herpes Virus Live In The Body
The herpes simplex viruses are latent, meaning they can live in the body without causing symptoms. After the initial infection, the virus gets into the nerve roots and spreads to the sensory nerve ganglia, the junctions where nerves from different parts of the body come together. For the genital area, the ganglia are adjacent to the spinal cord in the lower back. For orofacial herpes , the ganglia are located behind the cheek bone.
Understanding Herpes With H Hunter Handsfield Md
Herpes expert H. Hunter Handsfield, MD, explains the basics about genital herpes, including the difference between genital HSV-1 and HSV-2 infection, testing options and the importance of knowing virus type, and the three-prong strategy for prevention. See more herpes videos at sexualhealthTV.com.
Have a question about herpes youd like Dr. Handsfield or our other experts to answer? Visit our Ask the Experts page to learn how.
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