My Partner Just Told Me They Have Herpes. I Don’t. Now What?

handsHas your new partner just informed you that he or she has herpes? People have many reactions when hearing this kind of news — and, depending on how informed you are about herpes, your reaction might be tinged with panic or fear. If that’s your instinct, try to keep those feelings in check: Your partner might be feeling very vulnerable, so it’s best not to react with shunning or shaming.


More than 80 percent of people with genital herpes are unaware of their infections.


By being open about his or her STD status, your partner has demonstrated a sense of responsibility toward your sexual health and a respect for your ability to make informed decisions. It’s possible that your partner was not given this same consideration by the person from whom he or she contracted herpes — some people with genital herpes choose not to disclose their status, while most don’t even know they carry the virus in the first place.

Herpes is more widespread than most of us realize. It can be caused by one of two strains of the herpes simplex virus: HSV-1 or HSV-2. While HSV-1 is more commonly associated with cold sores and HSV-2 is more commonly associated with genital herpes, either virus can infect the genital area. One estimate states that 1 out of 5 American females and 1 out of 9 American males between 14 to 49 years of age have a genital HSV-2 infection.

Now that you know your partner has herpes, you might have some questions. How easy is it to transmit genital herpes from one partner to another? What can you do to minimize your chances of catching the virus? And, while it is certainly stigmatized in our culture, is herpes something to fear? Continue reading

STD Awareness: Genital Herpes

Herpes viruses inside a cell. Image: CDC

In the most recent Planned Parenthood annual report, a Tucson mother describes her daughter’s mysterious ailment, which stumped doctors at the hospital. Her symptoms included an itchy, tender genital area with painful lesions — but the physicians who “pored over her poor vulva” decided it was nothing to worry about and sent her home. A few days later, though, she called her mother in the middle of the night, sobbing, her condition now worse. “There were lesions, pustules, and the area was deep red,” her mother wrote. So this time, she called the experts: Planned Parenthood.


If you have symptoms, get checked out! An accurate diagnosis is more likely when symptoms are present.


The condition wasn’t nothing — it was genital herpes, and the mother praised Planned Parenthood for “spot[ting] something other pros missed.” Indeed, sexual and reproductive health is what we do — day in and day out! Whether you’re young or old, sexually active or celibate, insured or paying out of pocket or eligible for sliding-scale fees, we’re here to share our expertise with you.

The word “herpes” comes from an ancient Greek word that means “to creep,” after the “creeping” nature of skin lesions that might spread across areas of one’s body. We now know that the herpes simplex virus can “creep” up and down nerves, retreating to nerve cells to go dormant and returning back to the surface of the skin to cause symptoms or “shed” new virus particles. (Like a cat sheds fur, so too can people shed viruses.) Continue reading

STD Awareness: How Can I Protect Myself if My Partner Has Herpes?

herpes protectionHas your partner, or potential partner, recently informed you that he or she has been diagnosed with genital herpes? After thinking about it, did you decide to continue with the relationship, despite not being infected with the virus that causes genital herpes yourself? Congratulations — the two of you are now a “discordant couple,” which means that one of you has genital herpes and the other doesn’t. While you might have come to the conclusion that acquiring a herpes simplex virus (HSV) infection below the belt won’t be the end of the world, you still might want to stay discordant — and do everything you can to minimize chances of virus transmission.


Condoms, medication, and abstinence during outbreaks can reduce risk for herpes transmission.


You can read all about herpes elsewhere on this blog, but here’s a quick rundown: Genital herpes can be caused by one of two strains of the herpes simplex virus: HSV-1 or HSV-2. While HSV-1 is more commonly associated with cold sores and HSV-2 is more commonly associated with genital herpes, either virus can infect the genital area. One estimate states that 1 out of 6 Americans between 14 to 49 years of age has a genital HSV-2 infection. Since genital herpes infections can also be caused by HSV-1, the number of people with genital herpes is actually higher.

Barring total abstinence from all sexual activity, you won’t be able to protect yourself completely from acquiring HSV — but there are many steps that you and your partner can take to decrease risk. Studies on discordant couples show that viral transmission can be reduced with condoms, antiviral herpes medications, practicing abstinence when symptoms are present, and patient education.

Condoms

Latex condoms protect against most STDs, especially fluid-borne infections like HIV and gonorrhea. But condoms also provide some protection against STDs that are transmitted by skin-to-skin contact, including genital herpes. One large study found that condom usage was associated with lower rates of HSV-2 acquisition — the more frequently someone used condoms, the lower the risk. Unsurprisingly, risk was also associated with frequency of sex acts: People having vaginal or anal intercourse more than twice weekly were 77 percent more likely to acquire HSV-2 than people having less sex. Continue reading

Can Oral Herpes Be Spread to Genitals?

A cold sore on the lower lip on the second day after onset. Image: CDC

Herpes simplex virus is mystifying, fascinating, and sneaky. Mystifying because we have yet to unravel all of its secrets; fascinating because when we do uncover one of its mysteries, we are amazed by the capabilities of such a tiny, microscopic object; and sneaky because it enters our bodies by stealth and conceals itself in our cells, taking us by surprise when it comes out of hiding and causes outbreaks of blisters and other lesions.

It can also be confusing. Herpes simplex virus actually comes in two flavors: HSV-1 and HSV-2. HSV-1 is associated more with oral herpes, which can cause “cold sores,” a type of blister that appears on the lips or face. HSV-2 is associated more with genital herpes, which can cause blisters and other lesions in the genital area. It used to be standard to describe HSV-1 as an “above-the-waist” infection and HSV-2 as a “below-the-belt” infection — but now many researchers are pointing out that it’s more appropriate to say that HSV-1 is both an orally and genitally transmitted infection while HSV-2 is a predominantly genitally transmitted infection. If HSV-1 enters the body in the genital area, it can cause a genital herpes infection — and likewise, if HSV-2 enters the body in the facial area, it can cause an oral herpes infection.


Using condoms and dental dams during oral sex reduces risk of herpes transmission.


What exactly is a cold sore, anyway? A cold sore, also known as a fever blister, is a cluster of blisters that can pop up around the lips or even in the mouth. Sometimes, cold sores are so painful that eating or drinking is difficult, and in extreme cases sufferers must be treated for dehydration. An especially severe infection could also cause high fever or swollen lymph nodes, and in young adults a first oral HSV-1 infection might be misdiagnosed as tonsillitis, possibly leading to unnecessary tonsillectomies. Most symptomatic first-time cold-sore outbreaks occur during childhood, and take about two or three weeks to clear up. Luckily, the first infection is almost always the most severe, and when the infection is reactivated it usually happens without symptoms.

Because both cold sores and genital herpes are caused by herpes simplex viruses, and because oral herpes is so common, many people are concerned that they might be more vulnerable to acquiring a genital herpes infection than they previously thought. They might have a lot of questions, and if they’ve sought answers to those questions, they might have heard a lot of conflicting answers. Let’s see what the scientific literature has to say.

  • Can I get genital herpes if someone with cold sores performs oral sex on me?

Because HSV-1, the virus responsible for most oral herpes infections, can also cause genital herpes, many people wonder if someone with cold sores can transmit the virus to someone else by performing oral sex, resulting in a genital herpes infection. Other people wonder if HSV-1 can be transmitted via oral contact with the anus, resulting in a herpes infection in the rectal area. The answer to these questions is: Yes! Continue reading

STD Awareness: Oral Herpes

A transmission electron micrograph reveals HSV particles. Image: Fred Murphy, CDC

One of the most common sexually transmitted diseases is herpes, which most people associate with “outbreaks” in the genitals. In actuality, most cases have no symptoms, and the majority of people with genital herpes don’t know they have it. Herpes simplex virus, which causes genital herpes, can also infect facial nerves around the mouth, and its “outbreaks” include blisters called cold sores.

A cold sore outbreak involves an “eruption” of blisters around the mouth, which slowly heal as the virus returns to dormancy. Most cold sores are caused by herpes simplex virus type 1, or HSV-1. Around 60 percent of Americans are infected with HSV-1, and most of these infections are oral, asymptomatic, and acquired in childhood through nonsexual contact. Despite how common this infection is, only 20 to 40 percent of us actually get cold sores — and an even smaller percentage experience cold sores more than once a year. The rest of us don’t get cold sores at all, even if we are infected with HSV-1. That’s one quirk about HSV — an infection is permanent and incurable, but most people never have symptoms!


The virus that causes oral herpes can also cause genital herpes.


Making matters more confusing, there’s a related virus called HSV-2, which most people associate with genital herpes. However, HSV-1 can also cause genital herpes, and anyone with an HSV-1 infection in the facial area has the potential to transmit the virus to a partner’s genitals while performing oral sex — whether or not cold sores are present. However, when HSV-1 strikes the genitals, the infection is usually milder, with fewer (if any) recurring outbreaks. Additionally, a previous HSV-1 infection in the facial area might make you more resistant to acquiring an HSV-1 infection in the genital area — but it doesn’t confer total immunity. Continue reading

STD Awareness: “What Are the Symptoms of an STD?”

“I was treated for chlamydia, but my girlfriend feels fine, so she doesn’t need to get tested.”

“The only time I don’t use condoms is for oral sex, and everything’s been OK ‘down there,’ so getting tested for sexually transmitted diseases would be pointless.”

It’s important to be able to recognize the symptoms of a sexually transmitted disease (STD). Being savvy about symptoms can push you to get tested right away if you notice that something is amiss. However, being symptom-free can lull you into a false sense of security, especially if you’ve engaged in sexual activities that could have exposed you to an infectious agent. The fact of the matter is that many people with STDs have no symptoms at all. As they say, “The most common symptom of an STD is … no symptom.” Let’s take a look at some common STDs.


The most common symptom of an STD is no symptom.


Bacterial Infections

Bacterial STDs are curable with antibiotics. They include chlamydia, gonorrhea, and syphilis — all of which can be asymptomatic, and all of which can have severe complications when they are not treated in time.

Chlamydia: Around 3 million Americans are infected with chlamydia annually, and the infection is especially common among young people (less than 25 years of age). Chlamydia can infect the penis, vagina, cervix, anus, urethra, eye, or throat. You can be afflicted with a range of symptoms: pain or a burning feeling while urinating; vaginal, cervical, or penile discharge; swelling around the anus, testicles, or vagina; and more.

However, you’re much more likely not to experience any symptoms at all — most people with chlamydia are unaware they have it. Three out of four women with chlamydia have no symptoms, and half of men with chlamydia have no symptoms. Left untreated, chlamydia can become a serious health threat. Long-term complications might lead to fertility problems and arthritis. Continue reading

STD Awareness: Herpes

Here, individual herpes simplex virions can be seen infecting a host cell. Image obtained from the CDC’s Public Health Image Library.

Here, individual herpes simplex virions can be seen infecting a host cell. Image obtained from the CDC’s Public Health Image Library.

Last year, in my Anatomy & Physiology class, the subject of herpes came up, which launched a few people into mini-tirades laced with judgmental language, describing it as “disgusting” and “gross.” My classmates might have been more sensitive, as statistically speaking, there were probably several people in that very room who were living with herpes. Given that most of my fellow students were pursuing careers in the health-care field, it was especially disheartening. Yet despite being relatively widespread, herpes is often stigmatized and misunderstood.

Herpes is caused by herpes simplex virus (HSV), which comes in two strains: HSV-1 and HSV-2. HSV-1 is most often associated with oral herpes, while HSV-2 is most often associated with genital herpes, though by no means is this association exclusive. For example, HSV-1 can cause genital herpes when the site of infection is the genitals. It is estimated that only 10 to 15 percent of those with herpes exhibit symptoms, and that millions of people unknowingly carry the virus. After infection, the virus enters a latent state in nerve cells, where it will remain for the rest of the host’s life — the same is true for other viruses in the Herpesviridae family, such as the virus that causes chickenpox.

Oral herpes is incredibly common — about 60 to 90 percent of U.S. adults have been infected with HSV-1, and most of them caught it as infants or children through nonsexual transmission. HSV causing oral herpes remains latent in the trigeminal nerve ganglia in the face. Cold sores, which appear on the outer margin of the lips, appear when the virus has been activated and it moves along the pathway of nerves from the ganglia to the surface of the skin. They can be triggered by sunburn, stress, or even menstruation.

Continue reading