Are condoms necessary?

[sierratyrasyd]

Just two days ago I was informed by my doctor that I have contracted genital herpes. I'm not positive but I think this is my first outbreak.  I have on occasion (possibly 3 or 4 times over a five year period) have had just one sore come and go in the same exact spot without any noticeable vaginal discharge.  This time I had 7 sores and definitely had discharge over a couple of days.  I'm 52 years old, married for 30 years and had been faithful to my husband until one year ago when I had a one nightstand with someone from my past whom I absolutely trusted.  This man is married, made no mention about having herpes, was not concerned about wearing a condom and he performed oral sex on me as well as intercourse.  My husband and I don't have a lot of sex in fact the last time was approximately two months ago and the sores appeared approximately 5 weeks later.  I don't recall my husband ever complaining about sores or otherwise. So I really don't know who's infected me.  My doctor prescribed Acyclovir tablets and ointment. I asked the doctor about having to use condoms after the sores were gone and he said there was no need to as I have had a hysterectomy (10 years ago).  Could this be true?  And what are the chances of oral sex when there are no sores on me?

[Alan Rockoff, MD]

I cannot say for sure whether you contracted herpes from your encounter last year, but that is a possibility.  Herpes can be latent (not out in the open) for a long time, and virus can be shed when there's nothing visible.  So it's conceivable that you had it all these years, or that your extramarital contact shed virus with no sore.

Either way, you have herpes now.  Your risk of transmitting herpes to your husband even when there's no sore is small but not zero.  Condoms do help prevent spread, but I think that insisting on regular condom use in the context of a 30-year marriage would be, among other things, hard to explain to your husband.

It seems to me that the best approach is to bring the matter out in the open.  (Your husband is bound to at least wonder what may have gone on just from hearing that you have herpes.)  Then you could avoid intercourse (or oral sex) just when you havfe a visible outbreak, even if that left a small risk of transmission when there's no sore.

I understand full well that it will not be easy to talk about this, but the consequences of leaving the matter undiscussed are potentially explosive, bot medically and psychologically.  I therefore suggest that you wiegh your options carefully before proceeding.

Best.

Dr. Rockoff

[sierratyrasyd]

Just for the record, my husband was not always faithful to me, especially during the first half of the marriage.  I really don't know if that's still the case as I have not suspected anything - certainly not in the last ten years.  In the early part of the marriage (about five years into it) during a pregency, he informed me that he had caught crabs.  Because it was late into my pregency at the time we were not really having sex and so therefore were not transmitted to me.  My point here is that if he told me that, would he not tell me if he has herpes?  Unless he has not had any outbreaks and just doesn't know.  I usually go with him to his doctor visits (into the examination room) and unless he saw the doctor without me, there's been no mention of the virus. The other strange thing is that he has not approached me for sex in over two months.  With my job I travel an average of six times a year for two to five day spans - so you know anything could happen.

The other man was someone I had been with for three years before meeing my husband and we were planning to marry.  I walked out of the relationship, met the man who is now my husband and we married less then a year later.  The other man was very hurt but went on with his life and married a very nice girl whom he loves very much but still has feelings for me.  This was our only encounter since leaving him over thirty years ago.  Unfortunately I can't get a hold of him to ask him if in fact it was him who transmitted the virus to me.

But my main concern was about using condoms.  Is there anyone out there who does have the virus and does not use condoms  with their regular partner between outbreaks? Where there any problems?

[Alan Rockoff, MD]

If you don't use condoms, the risk of transmitting herpes is higher.  Your best chance of not spreading it is to use them.

Dr. Rockoff